Taking Action: Community Advocacy in Pennsylvania: How I Worked to Make my Community Healthier




Taking Action


Community Advocacy in Pennsylvania: How I Worked to Make my Community Healthier



Patricia E. Tobal



“In every community, there is work to be done … In every heart, there is the power to do it.”


—Marianne Williamson


My Path to Becoming a Community Advocate


Nursing has been my vocation for over 40 years. My roles in nursing have changed over time, from beginning as a staff nurse caring for hospitalized individuals to concluding as a manager of a community-based, prevention-focused program for 125 first-time, low-income mothers. Along the way, I continued my education, obtaining bachelor’s and master’s degrees in nursing, which expanded my professional opportunities. It is these experiences that have led me to my avocation: community advocacy and volunteerism.


After receiving a diploma in 1967 from the Uniontown Hospital School of Nursing, I practiced in the community in Pennsylvania where I grew up, married, raised my family, and retired. Over the course of my career, I saw many changes in the health care system. Yet one thing remains the same. Chronic health problems such as diabetes, chronic obstructive pulmonary disease, and coronary artery disease continue to plague our population, and individuals with these conditions consume tremendous portions of our health care resources. Current data indicates that obesity, smoking, and other unhealthy lifestyle choices are at all-time highs and do not bode well for our population.


I began my nursing career in a hospital and transitioned into oncology nursing. It was my experience at an outpatient radiation oncology center that would raise my awareness of the research being done, not only to find a cure for cancer but also to identify factors that contribute to the development of the disease and efforts being made to educate the public about ways to reduce individual risk and ultimately prevent its occurrence. While at the center, I became co-facilitator of a support group for individuals and their families who were receiving treatment or who were cancer survivors. The stories they shared gave me a greater understanding of the challenges faced by individuals in the community who were dealing with a serious illness.


After leaving the cancer center and completing my master’s degree in 1998 at Duquesne University, I was approached to teach a community health nursing course for RN to BSN students at Penn State’s Fayette campus. This reaffirmed my commitment to prevention. It also led to a career transition with the Nurse-Family Partnership (NFP). The NFP is a prevention-focused, home visitation program for low-income, at-risk pregnant women expecting their first child. NFP home visitors are registered nurses who have received additional education preparing them to deliver the program with fidelity to the evidence-based model that evolved from findings gathered from three separate randomized, controlled trials. After beginning in 1996, the NFP has expanded through a national initiative to over 25 states. The Fayette County, Pennsylvania site was established in 2001 under the auspices of the Fayette County Community Action Agency (FCCAA). Fayette County is located in southwestern Pennsylvania (Figure 94-1). The coal mining industry was the most significant employer until that industry’s decline in the late twentieth century. This has resulted in a high rate of unemployment and dependence on government and social services. The FCCAA is an organization that assists individuals to work toward self-sufficiency through a myriad of services that include educational programming; a food bank; the Women, Infants and Children (WIC) program; nutrition education; senior centers; and medical and dental offices located at a central location to ease access. Thus began my “up close and personal” exposure to the unmet needs in my community.



The Hopwood Village Project—An Example of Community Collaboration


At the same time that I became involved with the NFP, my husband, Jim Tobal, and I joined the Hopwood Village Project, a group composed of people from the small community in which we live at the foot of the western slope of the Appalachian Mountains along the National Road (U.S. Route 40). The organization’s dream was to install sidewalks, erect period streetlights, and landscape the streetscape along the historic Road. We envisioned an environment in which people could safely walk and enjoy the natural beauty and history of our area. However, there were barriers to accomplishing this, and many thought it impossible. We knew that we had an achievable plan that could only be accomplished with the cooperation of our elected officials. Our village is unincorporated, and the National Road divides two neighboring municipalities: the North Union and South Union Townships. If we were to be successful, we would need to get the two groups of township supervisors to work together in collaboration with us. We began by sponsoring a community “Light-Up Night” event to bring residents together. The supervisors of each township were asked to support the event by providing traffic control. The event was a success, the supervisors were recognized for their help, and the Hopwood Village Project demonstrated credibility. As a result, each township’s board of supervisors began to send representatives to village project planning meetings.


We started work on a 7-year project that involved writing grant proposals that were completed with the assistance of the Fayette County Planning Office. We also reached out to local, state, and national elected officials. Township officials, county commissioners, state senators and representatives, and members of Congress representing our area received invitations to participate in each of our activities and often were in attendance. This provided an opportunity for them to see the progress that was being made in Hopwood as well as to interact with their constituents. They were included in our annual parade celebrating the National Road Festival, quoted in newspaper articles, and interviewed for television coverage. Hopwood was the site of community meetings with our U.S. representative, enabling us to keep him informed of our progress. These relationships proved invaluable as we continued to move forward. Communication with shopowners in the village was also critical. Information about every event was shared with them during the planning phase, and their input and involvement was sought.


The Hopwood Village Project was completed in stages and included the following:


Mar 18, 2017 | Posted by in NURSING | Comments Off on Taking Action: Community Advocacy in Pennsylvania: How I Worked to Make my Community Healthier
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