Social and environmental factors are significant contributors to heart disease and its associated risks. Underserved and underrepresented populations, especially African-Americans, are prone to heart disease and risk factors at a disproportion rate (Foraker, 2013). It is important to educate populations at risk regarding health-promoting behaviors. In addressing social determinants of health, it is critical that individuals have an early understanding of the connections between the social environment and heart health. The District of Columbia (DC) has one of the highest avoidable death rates from heart disease of all major US cities. The purpose of this School of Nursing study, using 11 pre-licensure accelerated bachelors of science in nursing students (ABSN) to), was to engage DC public school middle school adolescents in an interdisciplinary collaborative project to identify and address the facilitators and barriers to heart healthy communities in the DC area.
Methods:
Using a participatory action research approach consisting of three phases, pre-licensure ABSN and faculty mentors guided 19 African American middle school adolescents in performing a community assessment of heart health using photovoice technique. Data consists of photographs, critical group dialogue and collaborative analysis of their lived experiences and the facilitators and barriers to a heart healthy community. Using developed themes the ABSN students encouraged the middle school adolescents to explore connections between heart health and the environment. ABSNs comfort in teaching adolescents about social determinants of health and heart health were assessed with a pre/post survey surrounding their community clinical rotation.
Results:
The middle school students’ work culminated in two photography exhibits and the creation of letters that were sent to local stakeholders (health care providers and community leaders) to raise public awareness and stimulate community change. The first exhibit was displayed at a local DC school located in Ward 8, where heart disease reduces life expectancy by 15 years compared to other Wards in DC (DCDoH, 2013). The second exhibit was displayed at the Smithsonian’s National Museum of African American History and Culture for one month in 2019. In addition to the photovoice exhibits, the ABSN students developed a twitter account to share the pictures and stories through social media, which accelerated health information dissemination. The ABSN students’ knowledge and comfort in community nursing was significantly increased after this clinical rotation.
Conclusion:
Social determinants of health are important influences on heart disease and health outcomes. Empowering at-risk populations at earlier ages with the tools and resources for change is essential to addressing and promoting heart healthy outcomes in individuals, families, communities; and pre-licensure nursing students and faculty can lead this initiative. Pre-licensure community health nursing students teaching adolescents about heart health and social determinants of health through a participatory action research study seem to experience an increase in knowledge and comfort in community nursing.