Community health nursing covers a wide range of health care of populations and for individuals in community settings.  Students work with community health workers to carry out neighborhood assessments, home assessments, referrals to different levels of care, and immunization campaigns.  They achieve beginning competency in health promotion with individuals and families, working from a basis of cultural humility, assessment of health beliefs, and mutual respect. Students begin to recognize social determinants of health and their effect on health outcomes.  They learn about the effects of health systems on health care and work in a variety of health agencies.

NB:  the attached sample itinerary for 3 weeks at Puerto Peñasco allows for 96 clinical hours for a 3-semester credit, clinical community health nursing course.  It does not allow for 45 didactic hours for such a course.  These hours have to be carried outelsewhere.  That portion of the course must be offered online or in class before arrival.  Even if offered online, there is not sufficient time while in Puerto Peñasco for a student to complete didactic work concurrently during the clinical weeks at Puerto Peñasco.

1. Provide appropriate and evidence-based nursing care to individuals and families at primary, secondary and tertiary levels in a community setting.
2. Navigate health systems and services to link resources and clients.
3. Integrate cultural humility into the nursing care of individuals, families, and populations.
4. Apply principles of social justice and ethics into the nursing care of individuals and families, and populations.
5. Use evidence and theoretical models to apply environmental health approaches into the nursing care of individuals, families, and populations.
6. Apply epidemiological tools to assess health at the population level.
7. Use evidence and theoretical models to design, implement, and evaluate population-based health behavior interventions.
8. Analyze the effect of health policies at global, national, state, and local levels on health services and population health.

Students identify and compare national health issues and approaches to solve them in Mexico and the United States.  Analysis of leading health issues, health care systems, and health care financing will be informed by underlying history, politics, and social determinants of health, and ethics.  Explanatory theories and frameworks will guide discussions.  Examples of how the effects of global policy can be seen in local work will be drawn from work in Puerto Peñasco agencies.  Students will discuss evidence for solutions for identified problems.

1. Identify and compare political, historical, financial, social determinants of health, and ethical influences on the development of national health issues and systems in Mexico and the United States.
2. Use theories and frameworks to explain development of global health policy.
3. Analyze local health care in the context of global health policy.
4. Consider evidence for solutions to national health problems of Mexico and the United States.

Students address how cultural humility forms an important part of day-to-day clinical practice. Students will discuss the importance of the role of implicit bias and self-knowledge in clinical care.  Classroom discussion also addresses information about cultural beliefs and practices in health and illness as they affect care. Readings focus on ethnographic research, as well as health in childhood and adulthood, pregnancy and birth, illness states, and disability. Class discussion will include strategies for culturally assessment of individuals, policies, and organizations.

1. Evaluate oneself for cultural beliefs and implicit biases.
2. Critique selected definitions, standards, and approaches to cultural humility in clinical care.
3. Integrate culture specific responses to health and illness throughout the lifespan, pregnancy and birth, illness states, and disability into nursing care.
4. Select methods for cultural assessment of individuals, policies, and organizations.

Students use opportunities to serve to apply concepts of social justice, public health, cultural humility, and health promotion in community situations. Health professional students working with community health workers and health professionals in a Mexican health system will have opportunities to serve by carrying out home visits, participatingin neighborhood immunization campaigns, teaching clinical procedures, participating in community health surveys, and/or providing clinical care in community agencies (such as shelters and halfway houses).  These activities provide examples of applications of the concepts taught in the course, including social justice, public health, cultural humility, and health promotion.  Class discussion and assignments integrate theoretical content with service experiences.

1. Engage in a dialogue about health professions, service learning, and social justice issues.
2. Assess the social attitudes and structures (institutional, interpersonal, cultural, sociopolitical, and financial) that ameliorate or exaggerate health risks among the people served in your service-learning environment.
3. Write reflectively about your role as a health professional and citizen to promote social justice in a service-learning environment.  

Students will apply principles of health promotion in work with community health workers.  Cultural humility, motivational interviewing concepts, health behavior theories, evidence-based interventions to promote health, and social justice will inform discussion and application of health promotion to individual and population-based cases

1. Provide care that promotes the health of individuals and populations. 
2. Apply health behavior theory to promote the health of individuals and populations. 
3.  Use cultural humility in communication to promote the health of individuals and populations, with particular attention to cultural humility.
4.  Use evidence to identify, analyze, and implement interventions to promote the health of individuals and populations.
5. Apply ethical principles of ethics to promote the health of populations, with particular attention to issues of social justice, health equity and advocacy.