A public health nurse plans to assess a community using the CHANGE model. According to this model, which of the following steps should the nurse take first?

Choice A Reason:
My community is struggling with high morbidity due to heart health, so this initiative has merit. This statement indicates a clear understanding of the Million Hearts initiative, which aims to prevent heart attacks and strokes by improving cardiovascular health. Recognizing the high morbidity due to heart health issues in the community aligns with the initiative's goals, making it a suitable and beneficial program to implement.

Choice B Reason:
These initiative strategies are still in the experimental stage and have questionable merit in practice. This statement is incorrect because the Million Hearts initiative is a well-established program with proven strategies to reduce cardiovascular disease. It is not in the experimental stage and has demonstrated effectiveness in various communities.

Choice C Reason:
It is a local initiative and should not be used outside my state. This statement is incorrect as the Million Hearts initiative is a national program in the United States, designed to be implemented across different states and communities. It is not restricted to any specific locality and can be adapted to meet the needs of various populations.

Choice D Reason:
I will need to get a doctor's order or directive from the community health lead before considering outside initiatives. While collaboration with healthcare providers and community leaders is important, this statement does not reflect an understanding of the initiative itself. The Million Hearts initiative can be implemented by various stakeholders, including nurses, without requiring a specific directive from a doctor or community health lead.

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.