Guide Functional Health Pattern (FHP) Template Directions:
This FHP template is to be used for organizing community assessment data in preparation for completion of your collaborative learning community (CLC) assignment. Address every bulleted statement in each section with data or rationale for deferral. You may also add additional bullet points if applicable to your community.
- Predominant ethnic and cultural groups along with beliefs related to health.
- Predominant spiritual beliefs in the community that may influence health.
- Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.).
- Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)?
- What does the community value? How is this evident?
- On what do the community members spend their money? Are funds adequate?
- Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).
- Immunization rates (age appropriate).
- Appropriate death rates and causes, if applicable.
- Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient?
- Available health professionals, health resources within the community, and usage.
- Common referrals to outside agencies.
- Indicators of nutrient deficiencies.
- Obesity rates or percentages: Compare to CDC statistics.
- Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.).
- Availability of water (e.g., number and quality of drinking fountains).
- Fast food and junk food accessibility (vending machines).
- Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.).
- Provisions for special diets, if applicable.
- For schools (in addition to above):
o Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence)
o Amount of free or reduced lunch
Elimination (Environmental Health Concerns)
- Common air contaminants’ impact on the community.
- Waste disposal.
- Pest control: Is the community notified of pesticides usage?
- Hygiene practices (laundry services, hand washing, etc.).
- Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible.
- Universal precaution practices of health providers, teachers, members (if applicable).
- Temperature controls (e.g., within buildings, outside shade structures).
- Safety (committee, security guards, crossing guards, badges, locked campuses).
- Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.).
- Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.).
- Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.).
- Injury statistics or most common injuries.
- Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer).
- Means of transportation.
- Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]).
- Indicators of general “restedness” and energy levels.
- Factors affecting sleep:
o Shift work prevalence of community members
o Environment (noise, lights, crowding, etc.)
o Consumption of caffeine, nicotine, alcohol, and drugs
o Homework/Extracurricular activities