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:
Team member instinct should drive decisions made throughout the process. This statement is incorrect because the Strategic Prevention Framework (SPF) emphasizes data-driven decision-making rather than relying on instinct. The SPF process involves systematic assessment, planning, implementation, and evaluation based on evidence and community needs.

Choice B Reason:
Different steps of the framework should be assigned to specific subgroups. While it is beneficial to have subgroups focus on different aspects of the framework, the SPF encourages collaboration and integration across all steps. Assigning specific steps to subgroups can lead to a fragmented approach, which is not in line with the holistic and iterative nature of the SPF.

Choice C Reason:
During the assessment phase, the team should consider the available resources. This statement is true but not specific to the SPF. Considering available resources is a standard practice in many planning and implementation frameworks. The unique aspect of the SPF is its circular and iterative process, which allows for continuous improvement and adaptation.

Choice D Reason:
The process is circular, steps may be revisited, and more than one step may be happening at the same time. This is the correct answer because it accurately describes the nature of the Strategic Prevention Framework. The SPF is designed to be flexible and iterative, allowing for ongoing assessment, planning, implementation, and evaluation. This approach ensures that the prevention efforts can adapt to changing circumstances and new information, making it more effective in addressing community needs.

Choice A Reason:
The client reports there are bike paths or running trails in their community. This statement indicates a positive aspect of the built environment. The presence of bike paths and running trails promotes physical activity and overall well-being. It does not suggest any faults in the built environment.

Choice B Reason:
The client reports contaminants in their drinking water at home. This statement clearly indicates a faulty built environment. Contaminated drinking water poses significant health risks and reflects poor infrastructure or inadequate maintenance of water supply systems. Ensuring access to clean and safe drinking water is a fundamental aspect of a healthy built environment.

Choice C Reason:
The client reports that there is limited public parking on their street. While limited public parking can be an inconvenience, it does not directly indicate a faulty built environment. Parking availability is more related to urban planning and transportation policies rather than the overall quality of the built environment.

Choice D Reason:
The client reports a lack of community centers in their neighborhood. Although the absence of community centers can affect social interactions and community engagement, it does not necessarily indicate a faulty built environment. It highlights a gap in community resources but does not directly impact the safety or health of the environment.