A public health nurse and a public health team are assessing a community using the ecological model. Which of the following characteristics should the team consider first?

Choice A reason: There's no way to predict how a client will do on a medical regimen.
This statement is incorrect because the Theory of Reasoned Action/Planned Behavior (TRA/TPB) provides a framework for predicting and understanding behaviors, including adherence to medical regimens. According to this theory, behavioral intentions, influenced by attitudes, subjective norms, and perceived behavioral control, can predict actual behavior. Therefore, it is possible to predict how a client might adhere to a medical regimen based on these factors.

Choice B reason: There is a high chance of better outcomes with more education.
While education is important, it alone may not be sufficient to ensure better outcomes. The TRA/TPB suggests that intentions to perform a behavior are influenced by attitudes towards the behavior, subjective norms, and perceived behavioral control. Without addressing these factors, simply providing more education may not lead to improved adherence or outcomes.

Choice C reason: There is a higher chance of complications due to poor adherence to the plan.
This statement aligns with the TRA/TPB, which posits that poor adherence to a medical regimen can lead to negative health outcomes. In the context of diabetes management, poor adherence to dietary and exercise plans can result in uncontrolled blood glucose levels, leading to complications such as cardiovascular disease, neuropathy, and retinopathy. The client's reported lack of motivation and non-adherence to the meal plan and exercise regimen increases the risk of such complications.

Choice D reason: The outcomes will be about the same.
This statement is incorrect because it overlooks the impact of adherence on health outcomes. According to the TRA/TPB, adherence to recommended behaviors is crucial for achieving positive health outcomes. In diabetes management, adherence to dietary and exercise plans is essential for controlling blood glucose levels and preventing complications. Therefore, outcomes are unlikely to remain the same if the client does not adhere to the recommended regimen.

Choice A: Develop a Team Strategy
Developing a team strategy is an important step in the CHANGE model, but it is not the first step. Before a strategy can be developed, it is essential to have a team in place. The team will collaborate to create a strategy that aligns with the community's needs and goals.

Choice B: Gather Data
Gathering data is a crucial part of the community assessment process. However, it is not the initial step in the CHANGE model. Data collection comes after the team has been assembled and a strategy has been developed. The team needs to be in place to determine what data is needed and how it will be collected.

Choice C: Build the Community Action Plan
Building the community action plan is a later step in the CHANGE model. This step involves using the data collected to develop a plan that addresses the community's health needs. The action plan is created after the team has been assembled, a strategy has been developed, and data has been gathered.

Choice D: Assemble the Team
This is the correct first step in the CHANGE model. Assembling the team involves bringing together a diverse group of stakeholders who will work collaboratively to assess the community and develop an action plan. The team typically includes representatives from various sectors of the community, such as health care, education, business, and local government.