Title : From classroom to community: Senior nursing students advancing rural health equity
Abstract:
Background: Existing literature demonstrates that multifactorial strategies that reduce barriers and address Social Determinants Of Health (SDOH) can improve population health outcomes (Butkus et al., 2020; Coombs et al., 2022; Guilamo-Ramos et al., 2023). Individualized community assessment tools are an important mechanism for identifying local needs, capturing community voice, and informing decisions aimed at improving community health (Huber et al., 2015; Kelley et al., 2019; Pazzaglia et al., 2023; Ravaghi et al., 2023). Rural populations experience persistent inequities, including decreased access to healthcare, lower health literacy, reduced financial support for care, poorer health education, less trust in medical intervention, and lower satisfaction with care (Chen et al., 2019; Coombs et al., 2022; DeBolt et al., 2023; Fraze et al., 2023; Henning-Smith et al., 2021). Although the United States outspends other developed countries on healthcare, these expenditures have not translated into equitable health outcomes, reinforcing the need for prevention-focused, community-based approaches (Hoyer et al., 2022; Kelley et al., 2019; Lewis et al., 2023; Liburd et al., 2020). In alignment with Healthy People 2030’s goal of eliminating health disparities, achieving health equity, and improving health literacy, addressing SDOH remains central to improving community well-being (Hoyer et al., 2022; Guilamo-Ramos et al., 2023; Peterson et al., 2021; Thornton et al., 2016; Valentine et al., 2022)
Purpose: This longitudinal study aimed to develop, implement, and evaluate a nursing-led community health needs assessment in Fremont, New Hampshire, to identify priority health concerns and inform interventions responsive to community-identified needs, while engaging senior nursing students in community-based population health practice.
Methods: From 2024 to the present, senior nursing students enrolled in a public health course collaborated with faculty on a community-engaged rural health initiative. Students reviewed literature, performed a windshield study, developed and administered a community needs assessment, and analyzed findings related to health concerns, barriers to care, and available supports. Based on these findings, students presented recommendations to the town selectmen and developed a community resource guide for digital and print distribution to increase resident access to local health and social resources.
Results: Preliminary findings support the value of a locally tailored assessment process in identifying community-specific barriers and informing feasible, community-responsive solutions. A key outcome of this phase was the development of a community resource guide designed to improve awareness of services and access to resources. The project also highlighted the role of senior nursing students as partners in community assessment, health promotion, and rural population health improvement.
Conclusions: Early phases of this longitudinal study suggest that a nursing-led, community-engaged model can identify rural health needs and generate actionable interventions while providing meaningful experiential learning for senior nursing students. Continued implementation and reassessment will evaluate intervention effectiveness and inform future replication in other rural communities.
