Science.gov

Sample records for area community health

  1. Role of community health nurse in earthquake affected areas.

    PubMed

    Gulzar, Saleema Aziz; Faheem, Zahid Ali; Somani, Rozina Karim

    2012-10-01

    The role of Community Health Nurses (CHNs) outside the traditional hospital setting is meant to provide and promote the health care needs of the community. Such nurses can play a substantial role in the community setting including emergencies like disasters. This became evident after the earthquake of October 8, 2005 in Pakistan. The objective was to address the issues, faced by primary healthcare providers working in earthquake-affected areas focusing on participatory approach. The experience of the interventions done by CHN by a guided frame work (assessment, planning, implementation and evaluation components) is described. Issues identified by CHN included: lack of training of health care providers, lack of collaboration, communication between the medical and management staff due to poor infrastructure of the healthcare facilities. The interventions were carried out, utilizing existing resources. Efforts were directed to build capacity of health care providers at grass root level to fill in gaps of health care delivery system for sustainable change. Overall, working in the earthquake affected areas is challenging. Health leadership should foresee role of CHN in emergencies where quality healthcare interventions are essential.

  2. Cohort profile: the Boston Area Community Health (BACH) survey.

    PubMed

    Piccolo, Rebecca S; Araujo, Andre B; Pearce, Neil; McKinlay, John B

    2014-02-01

    The Boston Area Community Health (BACH) Survey is a community-based, random sample, epidemiologic cohort of n = 5502 Boston (MA) residents. The baseline BACH Survey (2002-05) was designed to explore the mechanisms conferring increased health risks on minority populations with a particular focus on urologic signs/symptoms and type 2 diabetes. To this end, the cohort was designed to include adequate numbers of US racial/ethnic minorities (Black, Hispanic, White), both men and women, across a broad age of distribution. Follow-up surveys were conducted ∼5 (BACH II, 2008) and 7 (BACH III, 2010) years later, which allows for both within- and between-person comparisons over time. The BACH Survey's measures were designed to cover the following seven broad categories: socio-demographics, health care access/utilization, lifestyles, psychosocial factors, health status, physical measures and biochemical parameters. The breadth of measures has allowed BACH researchers to identify disparities and quantify contributions to social disparities in a number of health conditions including urologic conditions (e.g. nocturia, lower urinary tract symptoms, prostatitis), type 2 diabetes, obesity, bone mineral content and density, and physical function. BACH I data are available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories (www.niddkrepository.org). Further inquiries can be made through the New England Research Institutes Inc. website (www.neriscience.com/epidemiology).

  3. Community participation within an Irish Health Board area.

    PubMed

    McDonald, A; Chavasse, J

    This article gives a brief analysis of the concept of community participation followed by an account of a small study exploring the views and practices of two populations. Public health nurses have implemented their 'community as client' role and under favourable conditions would wish to develop further this aspect of their work. Women in the community are aware of the primary healthcare services available to them and as demonstrated by their comments have a holistic understanding of health. The study shows that both public health nurses and women in the community are interested and willing to take part in actions to improve health and welfare. Before genuine community partnership is developed a more defined leadership role which incorporates the skills of both community empowerment and community organization is needed.

  4. Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

    PubMed

    Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

    2014-01-01

    Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs. PMID:24280858

  5. Health trajectories in regeneration areas in England: the impact of the New Deal for Communities intervention

    PubMed Central

    Walthery, Pierre; Stafford, Mai; Nazroo, James; Whitehead, Margaret; Dibben, Christopher; Halliday, Emma; Povall, Sue; Popay, Jennie

    2015-01-01

    Background A large body of evidence documents the adverse relationship between concentrated deprivation and health. Among the evaluations of regeneration initiatives to tackle these spatial inequalities, few have traced the trajectories of individuals over time and fewer still have employed counterfactual comparison. We investigate the impact of one such initiative in England, the New Deal for Communities (NDC), which ran from 1999 to 2011, on socioeconomic inequalities in health trajectories. Methods Latent Growth Curve modelling of within-person changes in self-rated health, mental health and life satisfaction between 2002 and 2008 of an analytical cohort of residents of 39 disadvantaged areas of England in which the NDC was implemented, compared with residents of comparator, non-intervention areas, focusing on: (1) whether differences over time in outcomes can be detected between NDC and comparator areas and (2) whether interventions may have altered socioeconomic differences in outcomes. Results No evidence was found for an overall improvement in the three outcomes, or for significant differences in changes in health between respondents in NDC versus comparator areas. However, we found a weakly significant gap in life satisfaction and mental health between high and low socioeconomic status individuals in comparator areas which widened over time to a greater extent than in NDC areas. Change over time in the three outcomes was non-linear: individual improvements among NDC residents were largest before 2006. Conclusions There is limited evidence that the NDC moderated the impact of socioeconomic factors on mental health and life satisfaction trajectories. Furthermore, any NDC impact was strongest in the first 6 years of the programmes. PMID:26085649

  6. Enhancing the Care Continuum in Rural Areas: Survey of Community Health Center-Rural Hospital Collaborations

    ERIC Educational Resources Information Center

    Samuels, Michael E.; Xirasagar, Sudha; Elder, Keith T.; Probst, Janice C.

    2008-01-01

    Context: Community Health Centers (CHCs) and Critical Access Hospitals (CAHs) play a significant role in providing health services for rural residents across the United States. Purpose: The overall goal of this study was to identify the CAHs that have collaborations with CHCs, as well as to recognize the content of the collaborations and the…

  7. Traffic-related air pollution and sleep in the Boston Area Community Health Survey.

    PubMed

    Fang, Shona C; Schwartz, Joel; Yang, May; Yaggi, H Klar; Bliwise, Donald L; Araujo, Andre B

    2015-01-01

    Little is known about environmental determinants of sleep. We investigated the association between black carbon (BC), a marker of traffic-related air pollution, and sleep measures among participants of the Boston Area Community Health Survey. We also sought to assess the impact of sociodemographic factors, health conditions, and season on associations. Residential 24-h BC was estimated from a validated land-use regression model for 3821 participants and averaged over 1-6 months and 1 year. Sleep measures included questionnaire-assessed sleep duration, sleep latency, and sleep apnea. Linear and logistic regression models controlling for confounders estimated the association between sleep measures and BC. Effect modification was tested with interaction terms. Main effects were not observed between BC and sleep measures. However, in stratified models, males experienced 0.23 h less sleep (95% CI: -0.42, -0.03) and those with low SES 0.25 h less sleep (95% CI: -0.48, -0.01) per IQR increase in annual BC (0.21 μg/m(3)). In blacks, sleep duration increased with annual BC (β=0.34 per IQR; 95% CI: 0.12, 0.57). Similar findings were observed for short sleep (≤5 h). BC was not associated with sleep apnea or sleep latency, however, long-term exposure may be associated with shorter sleep duration, particularly in men and those with low SES, and longer sleep duration in blacks.

  8. The contribution of community health workers to the control of Buruli ulcer in the Ngoantet area, Cameroon

    PubMed Central

    Vouking, Marius Zambou; Takougang, Innocent; Mbam, Léonard Mbam; Mbuagbaw, Lawrence; Tadenfok, Carine Nouboudem; Tamo, Claire Violette

    2013-01-01

    Introduction Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. It is the third most common mycobacterial infection after tuberculosis and leprosy. Community Health Workers (CHWs) hold the potential to support patients and their families at the community level. Methods We conducted a cross-sectional descriptive study to assess the participation of CHWs in the early diagnosis and treatment of BU in Ngoantet, Cameroon. The CHWs performance was measured using: the number of cases referred to the Ngoantet Health Centre, the percentage of accomplished referrals, the percentage of cases referred by CHWs confirmed by the staff of Ngoantet Health Centre. Data was analyzed using Epi-info version 3.4.1. and Microsoft Office Excel 2003. The study focused on 51 CHWs in the Ngoantet health area. Results The referral rate was 95.0%. Most of the suspicious cases (91.5%) referred were confirmed by health workers. Most CHWs (78.4%) declared that they had identified at least one presumptive case of BU infection. Conclusion We conclude that the CHWs can play a key role in scaling up BU control activities using a referral system. This study confirms the role of home visits and inspections in the early detection and treatment of BU. PMID:24711863

  9. Community health profile of Windsor, Ontario, Canada: anatomy of a Great Lakes area of concern.

    PubMed Central

    Gilbertson, M; Brophy, J

    2001-01-01

    The rates of mortality, morbidity as hospitalizations, and congenital anomalies in the Windsor Area of Concern ranked among the highest of the 17 Areas of Concern on the Canadian side of the Great Lakes for selected end points that might be related to pollution in this relatively highly industrialized city. Mortality and morbidity rates from all causes were higher than in the rest of the province. Anomalously high rates of diseases included various cancers; endocrine, nutritional, metabolic, and immunity disorders; diseases of the blood and blood-forming organs, nervous system and sense organs, circulatory and respiratory systems, digestive system, genitourinary system, skin and subcutaneous tissue, musculoskeletal system and connective tissues; congenital anomalies, and infant mortality. Of particular concern was the early onset of the elevated rates of many of these diseases and conditions. Comparison of these incident rates with those in Hamilton, another industrial municipality in southern Ontario, suggested that in addition to a variety of local sources of industrial pollution from automobile manufacturing and use, transboundary air and water pollution from Detroit, Michigan, should be investigated as potentially important causes of these health outcomes in the Windsor Area of Concern. Some of the institutional and political trends of the past decade may need to be reversed before effective remedial programs are implemented for cleaning up contaminated sediments and for containment of leaking hazardous waste sites. This pilot project would seem to be a useful preliminary method of integrating human health concerns and of priority setting for the administration of the Great Lakes Water Quality Agreement and the Canada-United States Air Quality Agreement. PMID:11744501

  10. Reliability of community health worker collected data for planning and policy in a peri-urban area of Kisumu, Kenya.

    PubMed

    Otieno, C F; Kaseje, D; Ochieng', B M; Githae, M N

    2012-02-01

    A general introduction of this article is as follows: Reliable and timely health information is an essential foundation of public health action and health systems strengthening, both nationally and internationally (Aqil et al. in Health Policy Plan 24(3): 217-228, 2009; Bradshaw et al. in initial burden of disease estimates for South Africa, 2000. South African Medical Research Council, Cape Town, 2003). The need for sound information is especially urgent in the case of emergent diseases and other acute health threats, where rapid awareness, investigation and response can save lives and prevent broader national outbreaks and even global pandemics (Aqil et al. in Health Policy Plan 24(3): 217-228, 2009). The government of Kenya, through the ministry of public health and sanitation has rolled out the community health strategy as a way of improving health care at the household level. This involves community health workers collecting health status data at the household level, which is then used for dialogue at all the levels to inform decisions and actions towards improvement in health status. A lot of health interventions have involved the community health workers in reaching out to the community, hence successfully implementing these health interventions. Large scale involvement of community health workers in government initiatives and most especially to collect health data for use in the health systems has been minimal due to the assumption that the data may not be useful to the government, because its quality is uncertain. It was therefore necessary that the validity and reliability of the data collected by community health workers be determined, and whether this kind of data can be used for planning and policy formulation for the communities from which it is collected. This would go a long way to settle speculation on whether the data collected by these workers is valid and reliable for use in determining the health status, its causes and distribution, of a

  11. Community Health Clinics, Inc.

    ERIC Educational Resources Information Center

    Reese, David

    1986-01-01

    Describes successful Community Health Clinics, Inc., a private, non-profit health care corporation, founded in 1971, which provides health services for rural and low-income residents of southwestern Idaho. Focuses on administrative structure, staff, financial support, and services. (NEC)

  12. Community health advocacy

    PubMed Central

    Loue, Sana

    2006-01-01

    Competing health needs of diverse populations and ever shrinking resources available to support these needs often serve as the impetus for the initiation of advocacy efforts to improve community health. However, perceptions of what constitutes a community differ, as do approaches to advocacy itself. This glossary addresses five key questions: (1) What is advocacy?; (2) What is meant by community?; (3) What are the different approaches to community health advocacy?; (4) How are priorities established in the face of competing health advocacy goals?; (5) How can community health advocacy efforts be evaluated?; and (6) What challenges may be encountered in advocating for community health? Each of these issues could serve as the basis for a text on that subject alone. Accordingly, this article is not meant to be comprehensive text on these issues but is, instead, intended to highlight key foundational issues. And, although advocacy efforts can be conducted by individuals, this article focuses specifically on advocacy efforts of communities, however they may be defined and characterised. PMID:16698972

  13. Air Pollution Affects Community Health

    ERIC Educational Resources Information Center

    Shy, Carl M.; Finklea, John F.

    1973-01-01

    Community Health and Environmental Surveillance System (CHESS), a nationwide program relating community health to environmental quality, is designed to evaluate existing environmental standards, obtain health intelligence for new standards, and document health benefits of air pollution control. (BL)

  14. Biogeographic Ancestry Is Associated with Higher Total Body Adiposity among African-American Females: The Boston Area Community Health Survey

    PubMed Central

    Goonesekera, Sunali D.; Fang, Shona C.; Piccolo, Rebecca S.; Florez, Jose C.; McKinlay, John B.

    2015-01-01

    Objectives The prevalence of obesity is disproportionately higher among African-Americans and Hispanics as compared to whites. We investigated the role of biogeographic ancestry (BGA) on adiposity and changes in adiposity in the Boston Area Community Health Survey. Methods We evaluated associations between BGA, assessed via Ancestry Informative Markers, and adiposity (body mass index (BMI), percent body fat (PBF), and waist-to-hip ratio (WHR)) and changes in adiposity over 7 years for BMI and WHR and 2.5 years for PBF, per 10% greater proportion of BGA using multivariable linear regression. We also examined effect-modification by demographic and socio-behavioral variables. Results We observed positive associations between West-African ancestry and cross-sectional BMI (percent difference=0.62%; 95% CI: 0.04%, 1.20%), and PBF (β=0.35; 95% CI: 0.11, 0.58). We also observed significant effect-modification of the association between West-African ancestry and BMI by gender (p-interaction: <0.002) with a substantially greater association in women. We observed no main associations between Native-American ancestry and adiposity but observed significant effect-modification of the association with BMI by diet (p-interaction: <0.003) with inverse associations among participants with higher Healthy Eating Scores. No associations were observed between BGA and changes in adiposity over time. Conclusion Findings support that West-African ancestry may contribute to high prevalence of total body adiposity among African-Americans, particularly African-American women. PMID:25875902

  15. Community Bioethics: The Health Decisions Community Council.

    ERIC Educational Resources Information Center

    Gallegos, Tom; Mrgudic, Kate

    1993-01-01

    Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…

  16. Effect of health education on community participation in control of dengue hemorrhagic fever in an urban area of Thailand.

    PubMed

    Swaddiwudhipong, W; Chaovakiratipong, C; Nguntra, P; Koonchote, S; Khumklam, P; Lerdlukanavonge, P

    1992-06-01

    Dengue hemorrhagic fever (DHF), a disease transmitted by Aedes mosquitos, remains a serious public health problem in Thailand. This paper describes the effect of health education efforts on a community-based DHF vector control program in the municipality of Mae Sot District, Tak Province, northern Thailand, from 1988 through 1990. In 1988, public health education on DHF and larval control through mass media, lectures and discussions reduced the Aedes Breteau index from 241 in March to 126 in June 1988. In 1989 and 1990, twice a year house-to-house visits by trained health workers were added to the health education campaigns. Aedes larval indices were decreased far more in the epidemic year of 1990 than in 1989. During this 3-year period, water-storage containers for drinking, washing, bathing and ant-traps were the primary sources of larval habitats, accounting for about 90% of the total breeding places. Reduction of Aedes larvae in these sources was due to various larval control measures. By August 1990 water containers for non-drinking purposes were the remaining important breeding places. The introduction of larvivorous fish may be an effective method of larval control for these containers. Most houses were supplied by public piped water system; however, a shortage of piped water for a period of time resulted in a significant increase in the number of water containers. An adequate water supply to the community should be provided continuously to prevent creation of new breeding places. Modifying behavioral practices to reduce domestic man-made water containers should be encouraged.

  17. Ohio Valley Community Health Information Network.

    ERIC Educational Resources Information Center

    Guard, Roger; And Others

    The Ohio Valley Community Health Information Network (OVCHIN) works to determine the efficacy of delivering health information to residents of rural southern Ohio and the urban and suburban Cincinnati area. OVCHIN is a community-based, consumer-defined demonstration grant program funded by the National Telecommunications and Information…

  18. Diagnosis of malaria in a remote area of the Philippines: comparison of techniques and their acceptance by health workers and the community.

    PubMed Central

    Bell, D.; Go, R.; Miguel, C.; Walker, J.; Cacal, L.; Saul, A.

    2001-01-01

    OBJECTIVE: To compare the efficacies of remote symptom-based diagnosis of malaria, rapid diagnostic tests and microscopy in an area of low endemicity in the Philippines. METHODS: In Trial I, 350 symptomatic patients were tested within their villages using malaria Plasmodium falciparum (Pf)/Plasmodium vivax (Pv) immunochromatographic tests (ICT tests) and blood films stored and read under local conditions. The slides were later restained and read. In Trial II, unsupervised volunteer barangay health workers prepared ICT tests and slides after brief training. These slides were read at rural health units. Twenty-seven barangay health workers and 72 community members were later questioned about the three diagnostic strategies. FINDINGS: A history of fever alone was sensitive (95.4%) but poorly specific (16.5%) for predicting parasitaemia. The inclusion of other symptoms reduced the sensitivity to below 85%, while specificity remained low. The axillary temperature was poorly predictive. ICT tests achieved high sensitivity (97.9%) but many cases indicated as positive by ICT tests were negative by microscopy. Further analysis of these cases in Trial I indicated that ICT tests were detecting low-level parasitaemias missed by microscopy, and that local microscopy had poor accuracy. ICT tests were well accepted and accurately performed by barangay health workers. CONCLUSION: These tests meet a strong desire in the community for blood-based diagnosis and may increase the compliance and treatment-seeking behaviour of patients. PMID:11693975

  19. Traffic density in area of residence is associated with health-related quality of life in women, the community-based Hordaland Health Study.

    PubMed

    Gundersen, Hilde; Magerøy, Nils; Moen, Bente E; Bråtveit, Magne

    2013-01-01

    Vehicle traffic is increasing worldwide, and this is a major concern because traffic-related air pollution and noise may influence health. The aim of this study was to evaluate whether health-related quality of life (HRQoL) is associated with vehicle traffic density in area of residence. A total of 16,410 individuals, 40 to 45 years old, were asked to participate in this study (response rate: 55% for men, 66% for women). Using the 12-Item Short Form Health Survey (SF-12) questionnaire, both physical and mental HRQoL were investigated. Multiple linear regression analyses showed that women living in areas with high traffic density had significantly poorer physical HRQoL than women living in areas with moderate or low vehicle traffic density. There were no similar findings among men. Mental HRQoL was not associated with vehicle traffic density in the area of residence, neither for women nor for men. There is an association between high vehicle traffic density in residential area and reduced HRQoL in women.

  20. The Ramathibodi Community Health Program

    ERIC Educational Resources Information Center

    Buri, Prem; And Others

    1974-01-01

    The Ramathibodi Faculty of Medicine in Bangkok, Thailand, has developed a teaching and research program in community health aimed at brining the institution into close association with the health needs of the country. (Editor)

  1. [Childhood leukaemia in a residential area with a high-voltage power line: approach according to the Dutch Community Health Services' guideline 'Cancer Clusters'].

    PubMed

    Hegger, Carola; Reedijk, Ardine M J

    2013-01-01

    The new Dutch Community Health Services' (GGD) guideline titled 'Cancer Clusters' describes a phased plan for investigating reported cancer clusters. In each phase, attention is paid to both health and environmental issues and their possible links to one another. Throughout the entire cluster investigation, good risk communication is essential. In accordance with the new guideline, the Rotterdam-Rijnmond Public Health Services investigated the incidence of childhood leukaemia in a residential area as well as the data available on the high-voltage power line located there. More children in this residential area had been diagnosed with leukaemia than expected. However, the children had not been subjected to prolonged exposure to strong magnetic fields emitted from the high-voltage power line. With this type of cluster investigation, it is not possible to establish a causal relationship between childhood leukaemia and high-voltage power lines. However, the research did provide stakeholders insight into the health-and-environment situation and thereby, the opportunity to assess the situation appropriately and to act accordingly, if desired.

  2. Association between Smoking, Passive Smoking, and Erectile Dysfunction: Results from the Boston Area Community Health (BACH) Survey

    PubMed Central

    Kupelian, Varant; Link, Carol L.; McKinlay, John B.

    2007-01-01

    Introduction Although previous studies report an association between erectile dysfunction (ED) and smoking, few have examined the impact of passive smoke exposure on ED. This analysis examines the association of active and passive smoking and ED and investigates a dose-response effect of smoking. Methods The Boston Area Community Heath (BACH) survey is a study of urologic symptoms in a racially and ethnically diverse population. BACH used a multistage stratified random sample to recruit 2301 men, aged 30–79 yr, from the city of Boston. ED was assessed using the five-item International Index of Erectile Function. Smoking and passive smoking were assessed by self-report. Analyses adjusted for sociodemographic and lifestyle factors and important chronic illnesses. Results An association between smoking and ED was observed with a significant trend in increased risk of ED with cumulative pack-years of smoking (adjusted odds ratio [OR] = 1.68; 95% confidence interval [CI], 1.03, 2.30 for ≥ 20 pack-years). Compared to never smokers not exposed to passive smoking, men who never smoked but were exposed to passive smoking had a moderate, statistically nonsignificant, increase in risk of ED (adjusted OR = 1.33; 95%CI: 0.69, 2.55) comparable to the OR observed for a cumulative exposure of 10–19 pack-years of active smoking (adjusted OR = 1.25; 95%CI, 0.68, 2.30). Conclusions Results indicate a dose-response association between smoking and ED with a statistically significant effect observed with ≥ 20 pack-years of exposure. Passive smoking is associated with a small, statistically nonsignificant increase in risk of ED comparable to approximately 10–19 pack-years of active smoking. PMID:17383811

  3. Curriculum for Community Health Workers.

    ERIC Educational Resources Information Center

    Southwick, Paula S.

    The Community Outreach Curriculum described in this paper is designed to prepare community health aides employed through the Outreach Department of Pima County (Arizona) Indian Health Inc., (PCIHI), which consists of two medical clinics on two separate reservations. The first sections of the paper describe PCIHI, provide a rationale for the…

  4. Afghan Health Education Project: a community survey.

    PubMed

    Lipson, J G; Omidian, P A; Paul, S M

    1995-06-01

    This study assessed the health concerns and needs for health education in the Afghan refugee and immigrant community of the San Francisco Bay Area. The study used a telephone survey, seven community meetings and a survey administered to 196 Afghan families through face-to-face interviews. Data were analyzed qualitatively and statistically. Health problems of most concern are mental health problems and stress related to past refugee trauma and loss, current occupational and economic problems, and culture conflict. Physical health problems include heart disease, diabetes and dental problems. Needed health education topics include dealing with stress, heart health, nutrition, raising children in the United States (particularly adolescents), aging in the United States, and diabetes. Using coalition building and involving Afghans in their community assessment, we found that the Afghan community is eager for culture- and language-appropriate health education programs through videos, television, lectures, and written materials. Brief health education talks in community meetings and a health fair revealed enthusiasm and willingness to consider health promotion and disease-prevention practices. PMID:7596962

  5. Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area.

    PubMed

    Jung, Hee-Won; Jang, Il-Young; Lee, Young Soo; Lee, Chang Ki; Cho, Eun-Il; Kang, Woo Young; Chae, Jeoung Hee; Lee, Eun Ju; Kim, Dae Hyun

    2016-03-01

    Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population. PMID:26952571

  6. Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area

    PubMed Central

    2016-01-01

    Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population. PMID:26952571

  7. Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area.

    PubMed

    Jung, Hee-Won; Jang, Il-Young; Lee, Young Soo; Lee, Chang Ki; Cho, Eun-Il; Kang, Woo Young; Chae, Jeoung Hee; Lee, Eun Ju; Kim, Dae Hyun

    2016-03-01

    Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.

  8. Caring for older people. Community services: health.

    PubMed

    Pushpangadan, M; Burns, E

    1996-09-28

    Many frail or disabled elderly people are now being maintained in the community, partially at least as a consequence of the Community Care Act 1993. This paper details the work of the major health professionals who are involved in caring for older people in the community and describes how to access nursing, palliative care, continence, mental health, Hospital at Home, physiotherapy, occupational therapy, equipment, and optical, dental, and dietetic services. In many areas, services are evolving to meet needs and some examples of innovative practice are included.

  9. Community Health Workers as Support for Sickle Cell Care.

    PubMed

    Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

    2016-07-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care.

  10. Health Service Areas (HSAs) - Small Area Estimates

    Cancer.gov

    Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.

  11. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  12. Preserving community in health care.

    PubMed

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  13. Measuring Contextual Characteristics for Community Health

    PubMed Central

    Hillemeier, Marianne M; Lynch, John; Harper, Sam; Casper, Michele

    2003-01-01

    Objective To conceptualize and measure community contextual influences on population health and health disparities. Data Sources We use traditional and nontraditional secondary sources of data comprising a comprehensive array of community characteristics. Study Design Using a consultative process, we identify 12 overarching dimensions of contextual characteristics that may affect community health, as well as specific subcomponents relating to each dimension. Data Collection An extensive geocoded library of data indicators relating to each dimension and subcomponent for metropolitan areas in the United States is assembled. Principal Findings We describe the development of community contextual health profiles, present the rationale supporting each of the profile dimensions, and provide examples of relevant data sources. Conclusions Our conceptual framework for community contextual characteristics, including a specified set of dimensions and components, can provide practical ways to monitor health-related aspects of the economic, social, and physical environments in which people live. We suggest several guiding principles useful for understanding how aspects of contextual characteristics can affect health and health disparities. PMID:14727793

  14. Effective Collaboration Among Health Care and Education Professionals: A Necessary Condition for Successful Early Intervention in Rural Areas. Making It Work in Rural Communities. A Rural Network Monograph.

    ERIC Educational Resources Information Center

    Smith-Dickson, Bonnie, Ed.; Hutinger, Patricia, Ed.

    Addressing the lack of cooperation between early intervention programs and the rural health community, this monograph presents eight papers by educators and health professionals who identify specific problems and offer solutions in the form of effective collaboration techniques and model programs. Papers by Susan Hastings and Stewart Gabel…

  15. Building communities that create health.

    PubMed Central

    Wilcox, R; Knapp, A

    2000-01-01

    Typically, public health policy, program design, and resource allocation are based on issue-specific, targeted interventions directed at specific populations or sub-populations. The authors argue that this approach fails to meet the goal of public health-to improve health for all--and that the key to health improvement is to create a social context in which healthy choices are the norm. The authors present as case studies two Pennsylvania cities that used multisectoral approaches to achieve community health improvements. Images p141-a PMID:10968745

  16. Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.

    PubMed

    Teela, Katherine C; Mullany, Luke C; Lee, Catherine I; Poh, Eh; Paw, Palae; Masenior, Nicole; Maung, Cynthia; Beyrer, Chris; Lee, Thomas J

    2009-04-01

    In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. Their insights can facilitate program and policy efforts to overcome critical delays and insufficient management of maternal complications linked to maternal mortality. Focus group discussions (n=9), in-depth interviews (n=18), and detailed case studies (n=14) were collected from MHWs during centralized project management meetings in February and October of 2007. Five case studies are presented to characterize and interpret the realities of reproductive health work in a conflict-affected setting. Findings highlight the process of building supportive networks and staff ownership of the MOM project, accessing and gaining community trust and participation to achieve timely delivery of care, and overcoming challenges to manage and appropriately deliver essential health services. They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations

  17. Reading Area Community College Community Needs Assessment Telephone Survey.

    ERIC Educational Resources Information Center

    Reading Area Community Coll., PA.

    A telephone survey was conducted in 1981 at Reading Area Community College (RACC) to determine the educational needs of the community, particularly those of prospective students and employers. More specifically, the study sought to determine how the Berks County community perceived the quality of education provided at RACC and to ascertain the…

  18. Adult Learning, Community Education, and Public Health: Making the Connection through Community Health Advisors

    ERIC Educational Resources Information Center

    Mayfield-Johnson, Susan

    2011-01-01

    Community health education does more than educate communities about health. In the most basic form, community health education seeks to enable citizens to assume responsibility for their own and their community's health through an understanding of their community's health problems and the societal influences that act upon them. Many community…

  19. Does Level of Social Capital Predict Perceived Health in a Community?—A Study of Adult Residents of Low-income Areas of Francistown, Botswana

    PubMed Central

    2009-01-01

    This study explores and describes the relationships among neighbourhood characteristics, social capital, and health outcomes among low-income urban residents in Francistown, Botswana. Using an explanatory correlational research design to explore the relationships among the study variables, data were collected from 388 low-income urban residents in Francistown, Botswana. The study further examined the role of social capital on the environmental quality for the overall health and quality of life and the psychological, physical and level of independence domains of health. Several studies have explored these relationships but currently no study has explored this relationship in Africa and Botswana in particular. Selected concepts from social capital theory and stress theory were used as a conceptual framework. Using linear and multiple regression models, results of the study showed that social capital did not correlate with the overall health and quality of life and the level of independence domain of health but positively correlated with psychological well-being. Social capital negatively predicted physical health. Hierarchical moderated multiple-regression analyses were conducted to examine the moderating role of social capital. To the contrary, social capital did not moderate the effects of chronic community stressors on all health outcomes. Social capital, however, moderated the effects of the poor environmental quality on level of independence and physical health outcomes but not on the psychological and overall health and quality of life. These results underscore the importance of considering the role of social capital, especially in low-income communities. PMID:19761081

  20. Public health and health education in faith communities.

    PubMed

    Chatters, L M; Levin, J S; Ellison, C G

    1998-12-01

    This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

  1. Small area variations in health care delivery.

    PubMed

    Wennberg, J; Gittelsohn

    1973-12-14

    Health information about total populations is a prerequisite for sound decision-making and planning in the health care field. Experience with a population-based health data system in Vermont reveals that there are wide variations in resource input, utilization of services, and expenditures among neighboring communities. Results show prima facie inequalities in the input of resources that are associated with income transfer from areas of lower expenditure to areas of higher expenditure. Variations in utilization indicate that there is considerable uncertainty about the effectiveness of different levels of aggregate, as well as specific kinds of, health services. Informed choices in the public regulation of the health care sector require knowledge of the relation between medical care systems and the population groups being served, and they should take into account the effect of regulation on equality and effectiveness. When population-based data on small areas are available, decisions to expand hospitals, currently based on institutional pressures, can take into account a community's regional ranking in regard to bed input and utilization rates. Proposals by hospitals for unit price increases and the regulation of the actuarial rate of insurance programs can be evaluated in terms of per capita expenditures and income transfer between geographically defined populations. The PSRO's can evaluate the wide variations in level of services among residents of different communities. Coordinated exercise of the authority vested in these regulatory programs may lead to explicit strategies to deal directly with inequality and uncertainty concerning the effectiveness of health care delivery. Population-based health information systems, because they can provide information on the performance of health care systems and regulatory agencies, are an important step in the development of rational public policy for health.

  2. Area Community College and Area Vocational School Construction.

    ERIC Educational Resources Information Center

    Iowa State Dept. of Public Instruction, Des Moines.

    The purpose of this guideline is to assist in the planning process, to encourage good school plant design, and to serve as criteria in the evaluation of area community college and area vocational school plans. It is divided into the following five sections--(1) area plant planning, (2) area sites, (3) physical facilities, (4) service systems, and…

  3. Community Education and Health Services.

    ERIC Educational Resources Information Center

    Campbell, Elizabeth

    Because it is based on the premise that learning is a lifelong process and that citizen involvement is essential to neighborhood problem solving, community education is particularly attuned to the current needs of cities and can be a major vehicle for cities attempting to provide convenient, comprehensive health services in an efficient,…

  4. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: results from the Boston Area Community Health (BACH) Survey.

    PubMed

    Piccolo, Rebecca S; Duncan, Dustin T; Pearce, Neil; McKinlay, John B

    2015-04-01

    Racial/ethnic disparities in the prevalence of type 2 diabetes mellitus (T2DM) are well documented and until recently, research has focused almost exclusively on individual-based determinants as potential contributors to these disparities (health behaviors, biological/genetic factors, and individual-level socio-demographics). Research on the role of neighborhood characteristics in relation to racial/ethnic disparities in T2DM is very limited. Therefore, the aim of this research is to identify and estimate the contribution of specific aspects of neighborhoods that may be associated with racial/ethnic disparities in T2DM. Data from the Boston Area Community Health III Survey (N = 2764) was used in this study, which is a community-based random-sample survey of adults in Boston, Massachusetts from three racial/ethnic groups (Black, Hispanic, and White). We applied two-level random intercepts logistic regression to assess the associations between race/ethnicity, neighborhood characteristics (census tract socioeconomic status, racial composition, property and violent crime, open space, geographic proximity to grocery stores, convenience stores, and fast food, and neighborhood disorder) and prevalent T2DM (fasting glucose > 125 mg/dL, HbA1c ≥ 6.5%, or self-report of a T2DM diagnosis). Black and Hispanic participants had 2.89 times and 1.48 times the odds of T2DM as White participants, respectively. Multilevel models indicated a significant between-neighborhood variance estimate of 0.943, providing evidence of neighborhood variation. Individual demographics (race/ethnicity, age and gender) explained 22.3% of the neighborhood variability in T2DM. The addition of neighborhood-level variables to the model had very little effect on the magnitude of the racial/ethnic disparities and on the between-neighborhood variability. For example, census tract poverty explained less than 1% and 6% of the excess odds of T2DM among Blacks and Hispanics and only 1.8% of the neighborhood

  5. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: results from the Boston Area Community Health (BACH) Survey.

    PubMed

    Piccolo, Rebecca S; Duncan, Dustin T; Pearce, Neil; McKinlay, John B

    2015-04-01

    Racial/ethnic disparities in the prevalence of type 2 diabetes mellitus (T2DM) are well documented and until recently, research has focused almost exclusively on individual-based determinants as potential contributors to these disparities (health behaviors, biological/genetic factors, and individual-level socio-demographics). Research on the role of neighborhood characteristics in relation to racial/ethnic disparities in T2DM is very limited. Therefore, the aim of this research is to identify and estimate the contribution of specific aspects of neighborhoods that may be associated with racial/ethnic disparities in T2DM. Data from the Boston Area Community Health III Survey (N = 2764) was used in this study, which is a community-based random-sample survey of adults in Boston, Massachusetts from three racial/ethnic groups (Black, Hispanic, and White). We applied two-level random intercepts logistic regression to assess the associations between race/ethnicity, neighborhood characteristics (census tract socioeconomic status, racial composition, property and violent crime, open space, geographic proximity to grocery stores, convenience stores, and fast food, and neighborhood disorder) and prevalent T2DM (fasting glucose > 125 mg/dL, HbA1c ≥ 6.5%, or self-report of a T2DM diagnosis). Black and Hispanic participants had 2.89 times and 1.48 times the odds of T2DM as White participants, respectively. Multilevel models indicated a significant between-neighborhood variance estimate of 0.943, providing evidence of neighborhood variation. Individual demographics (race/ethnicity, age and gender) explained 22.3% of the neighborhood variability in T2DM. The addition of neighborhood-level variables to the model had very little effect on the magnitude of the racial/ethnic disparities and on the between-neighborhood variability. For example, census tract poverty explained less than 1% and 6% of the excess odds of T2DM among Blacks and Hispanics and only 1.8% of the neighborhood

  6. Community financing of health care.

    PubMed

    Carrin, G

    1988-01-01

    This article discusses ways to lesson the restrictions on health development in sub-Saharan Africa caused by limited public health budgets. Health improvements can be funded by the implementation of health insurance, the use of foreign aid, the raising of taxes, the reallocation of public money, and direct contributions by users or households either in the form of charges for services received or prepayments for future services. Community financing, i.e. the direct financing of health care by households in villages or distinct urban communities, is seen as preferable to a national or regional plan. When community financing is chosen, a choice must then be made between direct payment, fee-for-service, and prepayment (insurance) systems. The 3 systems, using the example of an essential drugs program, are described. Theoretically, with direct payment the government receives full cost recovery, and the patients receive the drugs they need, thereby improving their health. Of course the poor may not be able to purchase the drugs, therefore a subsidy system must be worked out at the community level. Fee-for-service means charging for a consultation or course of treatment, including drugs. A sliding scale of fees or discounts for certain types of consultations (e.g. pre-and post natal) can be used. In fee-for-service the risk is shared; because the cost of drugs is financed by the fees, those who receive costly treatments are subsidized by those whose treatments are relatively inexpensive. With prepayment or health insurance the risk of illness is shifted from the patient to the insurance firm or state. 2 issues make insurance plans hard to implement. When patients are covered by insurance, they may demand "too much" medical care (moral hazard) and thus premiums may be too small to cover treatment costs. On the other hand, people in low-risk groups may be unwilling to pay a higher premium, thus leading to adverse selection. Eventually, premiums may rise to the point where

  7. Community participation in rural primary health care: intervention or approach?

    PubMed

    Preston, Robyn; Waugh, Hilary; Larkins, Sarah; Taylor, Judy

    2010-01-01

    Community participation is considered important in primary health care development and there is some evidence to suggest it results in positive health outcomes. Through a process of synthesising existing evidence for the effectiveness of community participation in terms of health outcomes we identified several conceptual areas of confusion. This paper builds on earlier work to disentangle the conceptual gaps in this area, and clarify our common understanding of community participation. We conducted a research synthesis of 689 empirical studies in the literature linking rural community participation and health outcomes. The 37 final papers were grouped and analysed according to: contextual factors; the conceptual approach to community participation (using a modification of an existing typology); community participation process; level of evidence; and outcomes reported. Although there is some evidence of benefit of community participation in terms of health outcomes, we found only a few studies demonstrating higher levels of evidence. However, it is clear that absence of evidence of effect is not necessarily the same as absence of an effect. We focus on areas of debate and lack of clarity in the literature. Improving our understanding of community participation and its role in rural primary health care service design and delivery will increase the likelihood of genuine community-health sector partnerships and more responsive health services for rural communities.

  8. Patient moderator interaction in online health communities.

    PubMed

    Huh, Jina; McDonald, David W; Hartzler, Andrea; Pratt, Wanda

    2013-01-01

    An increasing number of people visit online health communities to share experiences and seek health information. Although studies have enumerated reasons for patients' visits to online communities for health information from peers, we know little about how patients gain health information from the moderators in these communities. We qualitatively analyze 480 patient and moderator posts from six communities to understand how moderators fulfill patients' information needs. Our findings show that patients use the community as an integral part of their health management practices. Based on our results, we suggest enhancements to moderated online health communities for their unique role to support patient care.

  9. Community Health Workers as Support for Sickle Cell Care.

    PubMed

    Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

    2016-07-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. PMID:27320471

  10. Empowered women from rural areas of Bolivia promote community development.

    PubMed

    Ríos, Roxana; Olmedo, Catón; Fernández, Luis

    2007-01-01

    Abstract: The United States Agency for Development in Bolivia (USAID/Bolivia) created in 2002 PROSALUD- Partners for Development Project (PfD) with the aim of improving the population's well-being. The project used three components: small grant scheme, technical assistance and database system management. Through the small grants scheme, the PfD supported a Community Participation Strategy (CPS) project over a three year period. The project involved the rural areas of six Bolivian departments and suburban areas of three Bolivian cities. The main objective was to increase health service utilization with a particular emphasis on empowerment of women, strengthening of local organizations and increasing the demand for health services. Women from both the urban and rural areas, and from different indigenous groups, were trained in project management, health promotion, reproductive health and family planning, advocacy and community participation. Participatory methodologies have allowed empowering women in decision making and capacity building throughout the entire project process. The experience shows that it is important to work with formally established grass-root community organizations and strengthen leadership within them. Additionally, the sub-projects demonstrated that interventions are more successful when promoters speak and write native languages, women are more motivated and empowered, projects are designed to be responsive to daily necessities identified by the communities and health services are culturally suitable. A preliminary evaluation, in both quantitative and qualitative terms, shows an overall improvement in health knowledge and practice, and utilization of health services.

  11. Collaborative Community: Health Education Web Site

    ERIC Educational Resources Information Center

    McCabe, Setta

    2004-01-01

    Four community colleges in Western Massachusetts--Berkshire Community College (BCC), Greenfield Community College (GCC), Holyoke Community College (HCC), and Springfield Technical Community College (STCC)--have created a collaborative Web site, at www.healthprograms.org, to present information on allied health associate degrees or certificate…

  12. Lessons in Community Health Activism

    PubMed Central

    Maldonado, Linda

    2016-01-01

    This study employed historical methodologies to explore the means through which the Maternity Care Coalition used grassroots activism to dismantle the power structures and other obstacles that contributed to high infant mortality rates in Philadelphia’s health districts 5 and 6 during the 1980s. Infant mortality within the black community has been a persistent phenomenon in the United States. Refusing to accept poverty as a major determinant of infant mortality within marginalized populations of women, activists during the 1980s harnessed momentum from a postcivil rights context and sought alternative methods toward change and improvement of infant mortality rates. PMID:24892861

  13. THE ROLE OF TEACHERS AND COMMUNITY WORKERS IN DEPRESSED AREAS.

    ERIC Educational Resources Information Center

    MARGURBER, CARL L.

    THE NEED FOR COMPENSATORY EDUCATION IN AND THE NECESSITY OF PROVIDING OUTSTANDING TEACHERS AND COMMUNITY WORKERS FOR DEPRESSED AREAS ARE DISCUSSED. DISADVANTAGED YOUTH ARE CHARACERIZED BY THEIR NONPURPOSEFUL ACTIVITY, INDIFFERENCE TO RESPONSIBLITY, POOR HEALTH HABITS, POOR COMMUNICATION SKILLS AND READING HABITS, LIMITED EXPERIENCES AND CONTACTS…

  14. Effects of Hurricane Hugo: Mental Health Workers and Community Members.

    ERIC Educational Resources Information Center

    Muzekari, Louis H.; And Others

    This paper reports the effects of Hurricane Hugo on mental health workers and indigenous community members. The response and perceptions of mental health staff from the South Carolina Department of Mental Health (Go Teams) from areas unaffected by the hurricane were compared and contrasted with those of a subsequent Hugo Outreach Support Team…

  15. Modeling duration of time lived in a residence, a community and mobility in rural areas of Merced and Ventura, California to assess potential health risks to airborne contaminants.

    PubMed

    Driver, Jeffrey; Price, Paul; vanWesenbeeck, Ian; Kaplan, William; Holden, Larry; Ross, John; Landenberger, Bryce

    2016-11-01

    A de novo population mobility survey of 800 households (random digit dialing-based phone interviews) was conducted in high demand areas of the agricultural fumigant, 1,3-dichloropropene (1,3-D) in Merced and Ventura counties of California. The survey included approximately 20 questions relating to the length of time individuals had lived in the high demand areas in each county, and also relating to weekly and annual mobility patterns. Lifetime inhalation exposures to 1,3-D are determined, in part, by the number of years individuals spend in an area where the fumigant is used. The purpose of the survey was to provide location-specific data for probabilistic modeling of long-term inhalation exposures to 1,3-D. The survey found that the majority of residents do not live in a high demand area or in the same house (99.99%) for 70years (a default assumption used by some regulatory agencies). It was also observed that residents move frequently and are mobile day-to-day and week-to-week, within the use area. Finally, estimates of total residency duration, derived from the survey results indicate that median times spent within a high demand area (which could include more than one residential location) were 18 and 26years for Ventura and Merced high demand areas, respectively. The average time spent in the high demand areas was 22 and 27years for the Ventura and Merced community, respectively. Less than 0.01% of the populations in either of the high demand areas spend 70years in the same house. PMID:27436777

  16. Modeling duration of time lived in a residence, a community and mobility in rural areas of Merced and Ventura, California to assess potential health risks to airborne contaminants.

    PubMed

    Driver, Jeffrey; Price, Paul; vanWesenbeeck, Ian; Kaplan, William; Holden, Larry; Ross, John; Landenberger, Bryce

    2016-11-01

    A de novo population mobility survey of 800 households (random digit dialing-based phone interviews) was conducted in high demand areas of the agricultural fumigant, 1,3-dichloropropene (1,3-D) in Merced and Ventura counties of California. The survey included approximately 20 questions relating to the length of time individuals had lived in the high demand areas in each county, and also relating to weekly and annual mobility patterns. Lifetime inhalation exposures to 1,3-D are determined, in part, by the number of years individuals spend in an area where the fumigant is used. The purpose of the survey was to provide location-specific data for probabilistic modeling of long-term inhalation exposures to 1,3-D. The survey found that the majority of residents do not live in a high demand area or in the same house (99.99%) for 70years (a default assumption used by some regulatory agencies). It was also observed that residents move frequently and are mobile day-to-day and week-to-week, within the use area. Finally, estimates of total residency duration, derived from the survey results indicate that median times spent within a high demand area (which could include more than one residential location) were 18 and 26years for Ventura and Merced high demand areas, respectively. The average time spent in the high demand areas was 22 and 27years for the Ventura and Merced community, respectively. Less than 0.01% of the populations in either of the high demand areas spend 70years in the same house.

  17. Securing health and human rights: Sandwell's community health network.

    PubMed

    Al-Osaimi, Ali

    2008-01-01

    Minority communities face discrimination and abuse. The main health problems they face are those of severe and early chronic disease and poor well-being due to inequality in jobs, education and access to health care. The Sandwell community health network provides support workers to six major minority groups in Sandwell, providing information and access to skilled health services. Without securing health as a basic right for our minorities we perpetuate divisions in our society which cause mistrust, conflict and violence. The health system has a vital role to play in securing people's rights and campaigning for equality and justice for all our communities, to enhance community cohesion.

  18. Bridging the Gap Between Community Health and School Health.

    ERIC Educational Resources Information Center

    Green, Lawrence W.

    1988-01-01

    The responsibility for community health should be shared and coordinated among schools, parents, and health agencies. Children's knowledge and skills should be developed so that they too can promote personal good health. Issues and strategies are discussed. (BJV)

  19. Procuring incentives for community health promotion programs.

    PubMed

    Engelberg, M; Elder, J P; Hammond, N; Boskin, W; Molgaard, C A

    1987-01-01

    Many community health promotion programs have used incentives to encourage participation and to reward health behavior change. To minimize expenses and to enhance a sense of shared responsibility, a number of projects have turned to community merchants as a source of incentives. This study investigated the relative effectiveness of solicitation methods used to procure incentives from local merchants for community health promotion programs. The effect of setting, i.e. level of urban development, and type of business were also analyzed in terms of procurement rates. Two hundred and eighteen merchants were solicited to gain incentives for two programs. Twenty-four incentives were procured at a total value of $480. Telemarketing and face-to-face contact had similar procurement rates, restaurants were by far the type of business most likely to donate, and rural merchants provided incentives significantly more often than urban merchants, while developing urban area merchants' donation rates were midway in between. Telemarketing was the solicitation method clearly most cost effective.

  20. Multiple intervention research programs in community health.

    PubMed

    Edwards, Nancy; Mill, Judy; Kothari, Anita R

    2004-03-01

    The authors describe an organizing framework for multiple interventions in community health. The framework provides a foundation for programmatic research on multiple interventions and poses critical questions that need to be addressed in the next generation of research in this field. Multiple intervention programs are characterized by the use of multiple strategies targeted at multiple levels of the socio-ecological system and delivered to multiple target audiences. Consequently, they complement the growing literature on the broad determinants of health and health promotion. The authors describe a 4-stage framework and identify gaps and challenges in this field of research. There are 5 key research areas requiring concerted action; researchers must: examine nested determinants, develop integrated conceptual frameworks, examine ways to optimize synergies among interventions, describe spin-offs from multiple intervention programs, and monitor the sustainability of their impact.

  1. The community leaders institute: an innovative program to train community leaders in health research.

    PubMed

    Crosby, Lori E; Parr, William; Smith, Teresa; Mitchell, Monica J

    2013-03-01

    An emerging best practice of addressing health and improving health disparities in communities is ensuring that academic health centers (AHCs) are engaged with area schools, primary care practices, and community advocates as equal partners in research, services, and programs. The literature documents the importance of ensuring that academic-community collaboration is based on equity, trust, and respect and that there is capacity (time and resources) and a shared culture (language, skills, and applied knowledge) for accomplishing mutual goals in academic-community research partnerships. It is also essential that an academic-community collaboration result in tangible and measurable goals and outcomes for both the target community and the AHC. Currently, the models for implementing best practices in community health partnerships, especially training programs, are limited.This article summarizes the goals and outcomes for the Community Leaders Institute (CLI), a six-week innovative leadership development training program designed to enhance academic-community research, integrate the interests of community leaders and AHC researchers, and build research capacity and competencies within the community. On the basis of two years of outcome data, the CLI is achieving its intended goals of engaging faculty as trainer-scholars while promoting academic-community partnerships that align with community and AHC priorities. The training and collaborative research paradigm used by the CLI has served to accelerate AHC-community engagement and integration efforts, as CLI graduates are now serving on AHC steering, bioethics, and other committees.

  2. Popular participation in community health programmes.

    PubMed

    Jones, A M

    1993-01-01

    Community health programmes can be one of the most important and most available forms of education for the total community. This article outlines health programmes and health education initiatives, as well as approaches to participatory training, in several South Pacific countries.

  3. Creating Meaningful Partnerships Between Communities and Environmental Health Researchers

    PubMed Central

    De Souza, Rachael; Aguilar, Genevieve C.; de Castro, A. B.

    2014-01-01

    Community engagement is a necessary, although challenging, element of environmental health research in communities. To facilitate the engagement process, direct action community organizing agencies can be useful in bringing together communities and researchers. This article describes the preliminary activities that one direct action community organizing agency used in partnership with researchers to improve community engagement in the first 6 months of an environmental health study conducted in a major U.S. city. Activities included developing communication strategies, creating opportunities for researcher–community interaction, and sustaining project momentum. To conduct environmental research that is both scientifically rigorous and relevant to communities, collaborating partners had to develop professional skills and strategies outside of their areas of expertise. PMID:23875568

  4. Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

    PubMed

    Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

    2012-04-01

    In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP

  5. Empowering community health: an educational approach.

    PubMed

    Lewis-Washington, Cynthia; Holcomb, Lygia

    2010-10-01

    Collaborative efforts among community members, health care professionals, and faith-based institutions can prove valuable in efforts to improve community health. This study used data obtained from before and after health risk assessment surveys to assess participant's knowledge of risk factors leading to chronic diseases among African Americans in an underserved community of Alabama. Data obtained from activity logs and health screening sessions was used to assess effect of knowledge gained on lifestyle practices. The study findings support the need for ongoing population-specific education program development in religious institutions located inside underserved communities.

  6. Aftercare and Rehabilitation in a Community Mental Health Center

    ERIC Educational Resources Information Center

    Scoles, Pascal; Fine, Eric W.

    1971-01-01

    The community, state mental hospitals, and a community mental health center work together to provide an environment conducive to the continued well being of chronic mental patients in an area of West Philadelphia, Pennsylvania. The authors describe a program that involves day care centers and the patients' everyday living. (Author)

  7. Community participation in primary health care.

    PubMed

    MacCormack, C P

    1983-04-01

    The advantages of a community participation approach in primary health care (PHC) are as follows: a community participation approach is a cost effective way to extend a health care system to the geographical and social periphery of a country; communities that begin to understand their health status objectively rather than fatalistically may be moved to take a series of preventive measures; communities that invest labor, time, money, and materials in health promoting activities are more committed to the use and maintenance of the things they produce, such as water supplies; health education is most effective in the context of village activities; and community health workers, if they are well chosen, have the confidence of the people. An error made in early efforts at community participation was to assume that villages were uniformly free from internal exploitation. Some are cohesive moral communities, but in other there is grievous exploitation of landless laborers by landowners and shopkeepers. Villages may be divided by caste or ethnic origin. Political organization of villages may be democratic or they may be governed in an authoritarian manner. In politically unstable countries where the central government has a rather tenuous control over the rural periphery, genuine community initiatives may be viewed as threatening and may not receive official encouragement. Social groups within communities may be tremendous assets. In planning the community participation aspects of primary health care, the collaboration of an anthropologist or rural sociologist with field experience is recommended. Promoting community participation is a skill which must be taught to community health workers, and backed up with support services. The genuine commitment of medical staff to community self help is crucial to the motivation process. Motivation within the community quickly breaks down if materials, expertise, and salaries fail to arrive when promised. Community activities are most

  8. Community health workers in global health: scale and scalability.

    PubMed

    Liu, Anne; Sullivan, Sarah; Khan, Mohammed; Sachs, Sonia; Singh, Prabhjot

    2011-01-01

    Community health worker programs have emerged as one of the most effective strategies to address human resources for health shortages while improving access to and quality of primary healthcare. Many developing countries have succeeded in deploying community health worker programs in recognition of the potential of community health workers to identify, refer, and in many cases treat illnesses at the household level. However, challenges in program design and sustainability are expanded when such programs are expanded at scale, particularly with regard to systems management and integration with primary health facilities. Several nongovernmental organizations provide cases of innovation on management of community health worker programs that could support a sustainable system that is capable of being expanded without being stressed in its functionality nor effectiveness--therefore, providing for stronger scalability. This paper explores community health worker programs that have been deployed at national scale, as well as scalable innovations found in successful nongovernmental organization-run community health worker programs. In exploration of strategies to ensure sustainable community health worker programs at scale, we reconcile scaling constraints and scalable innovations by mapping strengths of nongovernmental organizations' community health worker programs to the challenges faced by programs currently deployed at national scale. PMID:21598268

  9. Building Community for Effective Health Promotion.

    ERIC Educational Resources Information Center

    Keeling, Richard P.; Engstrom, Eric L.

    1996-01-01

    Health promotion on campuses has two audiences or targets: individuals and the community. Through strategies of leadership, consensus development, and community service, college and university communities cannot only change social norms, but more critically, found and nurture a flexible, gentle network of caring and connectedness that pulls people…

  10. Group Health Cooperative's community services initiative.

    PubMed

    Hildebrandt, K M; Beery, W L; Pearson, D C

    1993-12-01

    Service to the broader community is an important component of Group Health Cooperative's (GHC's) tradition, values, and mission. The role and potential of community services in a staff model HMO requires consensus, careful planning and communication, and attention to results. This paper describes GHC's efforts to define, implement, and sustain its community services initiative.

  11. Team management in community mental health.

    PubMed

    McGuinness, M

    2000-02-01

    The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager.

  12. Developing Community Health Worker Diabetes Training

    ERIC Educational Resources Information Center

    Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.

    2012-01-01

    We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

  13. Problems associated with community mental health programs.

    PubMed

    Bindman, A J

    1966-12-01

    Community mental health programs vary in relation to their types of administrative and fiscal policy and structure. Discontinuity of services may increase due to proliferation of community-based programs, and community mental health personnel must be trained to deal with many needs and new programs. There will also be conflicts over individual professional interests versus community needs. Problems of staff recruitment will increase and concerted efforts are necessary to increase inservice education in order to re-shape professional roles. Psychologists in particular are interested in new developments in "community psychology" as a means of contributing to these efforts. PMID:24190853

  14. The narrative psychology of community health workers.

    PubMed

    Murray, Michael; Ziegler, Friederike

    2015-03-01

    Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work.

  15. Health Knowledge Effects: An Integrated Community Health Promotion Platform.

    PubMed

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu

    2016-03-01

    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform. PMID:26657621

  16. Health literacy of an urban business community.

    PubMed

    Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M

    2012-02-01

    The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.

  17. Environmental metrics for community health improvement.

    PubMed

    Jakubowski, Benjamin; Frumkin, Howard

    2010-07-01

    Environmental factors greatly affect human health. Accordingly, environmental metrics are a key part of the community health information base. We review environmental metrics relevant to community health, including measurements of contaminants in environmental media, such as air, water, and food; measurements of contaminants in people (biomonitoring); measurements of features of the built environment that affect health; and measurements of "upstream" environmental conditions relevant to health. We offer a set of metrics (including unhealthy exposures, such as pollutants, and health-promoting assets, such as parks and green space) selected on the basis of relevance to health outcomes, magnitude of associated health outcomes, corroboration in the peer-reviewed literature, and data availability, especially at the community level, and we recommend ways to use these metrics most effectively.

  18. Health literacy of an urban business community.

    PubMed

    Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M

    2012-02-01

    The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses. PMID:22643474

  19. Building a community-academic partnership to improve health outcomes in an underserved community.

    PubMed

    McCann, Eileen

    2010-01-01

    East Garfield Park, IL, is an impoverished community with 59.7% of residents falling below twice the poverty level and 42.6% of its children in poverty. In 2001, the leading causes of hospitalizations were heart disease (10.3%), diabetes (2%), and asthma (3.9%), all of which occur at frequencies 33% greater than the Chicago average. Finally, a review of the health care facilities in the community suggests that there is a need for accessible primary health care services in the area. The purpose of this project was to improve health outcomes in an impoverished, underserved community with documented health care needs and lack of adequate health care services by creating a community-academic partnership to provide on-site, interdisciplinary, health care services within an established and trusted community-based social service agency, Marillac House. The short-term objectives for this project included creating a community-academic partnership between Marillac House and Colleges of Nursing, Medicine, and Health Sciences; providing comprehensive health care services; and developing an innovative clinical education model for interdisciplinary care across specialties. Long-term objectives included providing preventative services; evidenced-based management of acute and chronic illness; evaluating client's health outcomes; and creating a sustainability plan for the long-term success of the health center. PMID:20055966

  20. Weaving Clinical Expertise in Online Health Communities

    PubMed Central

    Huh, Jina; Pratt, Wanda

    2015-01-01

    Many patients visit online health communities to receive support. In face-to-face support groups, health professionals facilitate peer-patients exchanging experience while adding their clinical expertise when necessary. However, the large scale of online health communities makes it challenging for such health professional moderators’ involvement to happen. To address this challenge of delivering clinical expertise to where patients need them, we explore the idea of semi-automatically providing clinical expertise in online health communities. We interviewed 14 clinicians showing them example peer-patient conversation threads. From the interviews, we examined the ideal practice of clinicians providing expertise to patients. The clinicians continuously assessed when peer-patients were providing appropriate support, what kinds of clinical help they could give online, and when to defer to patients’ healthcare providers. The findings inform requirements for building a semi-automated system delivering clinical expertise in online health communities. PMID:26413582

  1. Community Response to a Public Health Threat-VEE

    ERIC Educational Resources Information Center

    McDonald, John L.; Vuturo, Anthony F.

    1975-01-01

    After identifying the mosquito as the Venezuelan equine encephalitis vector, health officials worked with the community to eliminate mosquito breeding sites. By educating the public first, cooperation was received in opening drainage areas and stocking water collection areas with mosquito eating fish to interrupt the host-vector-recipient cycle.…

  2. Linking personal and public health information: a vision for community-centered health information systems.

    PubMed

    Kwiatkowski, K; Brennan, P F

    2001-01-01

    As health care in the U.S. and worldwide has shifted from a centralized, institution-based model to a distributed process occurring largely in the communities, Integrated Advanced Information Management Systems (IAIMS) initiatives must also move toward addressing the challenges of integrating health information at the community level. The Wisconsin IAIMS initiative strives to create such a solution, anchoring its efforts in a regional health information technology architecture by partnering with Wisconsin-area communities as the foundation that will ensure the establishment of the appropriate collaborations to gain adequate investment and generate sustainable solutions for health information integration.

  3. Environmental and Community Health. Health Facts.

    ERIC Educational Resources Information Center

    Krantzler, Nora J.; Miner, Kathleen R.

    The 10-volume "Health Facts" series is intended to supplement health education curricula and provide a handy reference for individuals who would like additional background information on particular health topics. The emphasis is placed on topics and examples relevant to youth of middle and high school age. This book is divided into two parts: Part…

  4. The men's health forum: an initiative to address health disparities in the community.

    PubMed

    Grant, Cathy G; Davis, Jenna L; Rivers, Brian M; Rivera-Colón, Venessa; Ramos, Roberto; Antolino, Prado; Harris, Erika; Green, B Lee

    2012-08-01

    Racial/ethnic, socioeconomic, and gender disparities in health and access to and use of health care services currently exist. Health professionals are continually striving to reduce and eliminate health disparities within their own community. One such effort in the area of Tampa Bay, Florida was the creation of the African American Men's Health Forum, currently referred to as the Men's Health Forum. The African American Men's Health Forum was the result of the community's desire to reduce the gap in health outcomes for African American men. Later, it was recognized that the gap in health outcomes impacts other communities; therefore, it was broadened to include all men considered medically underserved (those who are uninsured, underinsured, or without a regular health care provider). The Men's Health Forum empowers men with the resources, knowledge, and information to effectively manage their health by providing health education and screenings to the community. This article provides an explanation of the key components that have contributed to the success of the Men's Health Forum, including challenges and lessons learned. It is intended that this information be replicated in other communities in an effort to eliminate health disparities. PMID:22105601

  5. Primary health care in an unsettled area of northern Thailand.

    PubMed

    Fox, P G; Komchum, S

    1992-01-01

    The implementation of primary health care by nurses in poor and geographically isolated areas of the world is a complex and difficult task. When the area is also unsettled and insecure the task becomes increasingly formidable. Under these conditions primary health care is bound by not only the allocation of resources and restricted mobility but also the instability of changing government policies that influence all parameters of life. Mounting evidence has demonstrated that self-determination--derived from community-based socio-economic development--is a prerequisite to the initiation of a successful health care system. In turn, socioeconomic development is possible only when people are secure from expulsion from their land and the country. In addition, they must also be protected against outside coercion and violence that undermines community stability. The following is a report on health care problems related to the socioeconomic instability of an unsettled area that has global implications for nurses in similar areas worldwide.

  6. [Health promotion in the Pankararu indigenous community].

    PubMed

    Oliveira, Jonas Welton Barros; Aquino, Jael Maria; Monteiro, Estela Maria Leite Meirelles

    2012-01-01

    The objective of the study was to know how the Pankararu indigenous perceive their health situation and identify actions they prioritize as necessary to promote health in their community. Qualitative research, in which the declarations collected were subjected to the technique of analyzing the Collective Subject Discourse. It was identified that in the indigenous perception, as the health status of their community, there is a lack of general assistance, and a lack of professionals to assist them meeting their needs. In relation to actions that the Indigenous prioritize as necessary to promote the health of their community, it was highlighted provision of health unit with trained professionals and access to health education actions. It was, thus, proposed an overhaul of the organizations and establishments of the subsystems in promoting indigenous health. PMID:23032334

  7. [Local health systems. Moral rationality of community decisions].

    PubMed

    Tealdi, J C

    1990-01-01

    The author examines the points of convergence between local health systems and bioethics in three basic areas: structural or institutional, methodological or justificatory, and regulatory or normative. Comparisons are drawn between the decentralization of the health system posed by local health systems and deconcentration of the power vested in multidisciplinary ethics committees; the strategy of social participation and the movement in the United States of community decision-making in the area of health; and the basic concepts of primary health care and the principle of justice. The theories of Pellegrino and Thomasma on the philosophic bases for medical practice provide the framework of this comparative analysis. The article concludes with a call for a local health systems-bioethical nexus in which this discipline can provide the basis for infusing an ethical component into participatory planning and community decision-making.

  8. Economic Shocks and Public Health Protections in US Metropolitan Areas

    PubMed Central

    Hogg, Rachel A.

    2015-01-01

    Objectives. We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods. The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results. Public health activities fell by nearly 5% in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25% of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions. Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns. PMID:25689201

  9. Developing Responsive Indicators of Indigenous Community Health.

    PubMed

    Donatuto, Jamie; Campbell, Larry; Gregory, Robin

    2016-01-01

    How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is "at risk" is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

  10. Developing Responsive Indicators of Indigenous Community Health

    PubMed Central

    Donatuto, Jamie; Campbell, Larry; Gregory, Robin

    2016-01-01

    How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

  11. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    PubMed

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell

    2008-03-01

    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served. PMID:18259870

  12. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    PubMed

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell

    2008-03-01

    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served.

  13. Improving population health: the business community imperative.

    PubMed

    Webber, Andrew; Mercure, Suzanne

    2010-11-01

    Information on the economic effect of poor population health is needed to engage the business community in population health improvement. In a competitive global market, the United States has high health care costs and poor outcomes (measured by such factors as healthy and productive lives) compared with other countries. US business needs to understand population health and not focus just on the health of employees at the worksite. We describe a long-term approach to population health, including incentives, and identify what is needed to engage business leadership in population health improvement.

  14. Listening to community health workers: how ethnographic research can inform positive relationships among community health workers, health institutions, and communities.

    PubMed

    Maes, Kenneth; Closser, Svea; Kalofonos, Ippolytos

    2014-05-01

    Many actors in global health are concerned with improving community health worker (CHW) policy and practice to achieve universal health care. Ethnographic research can play an important role in providing information critical to the formation of effective CHW programs, by elucidating the life histories that shape CHWs' desires for alleviation of their own and others' economic and health challenges, and by addressing the working relationships that exist among CHWs, intended beneficiaries, and health officials. We briefly discuss ethnographic research with 3 groups of CHWs: volunteers involved in HIV/AIDS care and treatment support in Ethiopia and Mozambique and Lady Health Workers in Pakistan. We call for a broader application of ethnographic research to inform working relationships among CHWs, communities, and health institutions.

  15. Health and Taxes: Hospitals, Community Health and the IRS.

    PubMed

    Crossley, Mary

    2016-01-01

    The Affordable Care Act created new conditions of federal tax exemption for nonprofit hospitals, including a requirement that hospitals conduct a community health needs assessment (CHNA) every three years to identify significant health needs in their communities and then develop and implement a strategy responding to those needs. As a result, hospitals must now do more than provide charity care to their patients in exchange for the benefits of tax exemption. The CHNA requirement has the potential both to prompt a radical change in hospitals' relationship to their communities and to enlist hospitals as meaningful contributors to community health improvement initiatives. Final regulations issued in December 2014 clarify hospitals' obligations under the CHNA requirement, but could do more to facilitate hospitals' engagement in collaborative community health projects. The Internal Revenue Service (IRS) has a rich opportunity, while hospitals are still learning to conduct CHNAs, to develop guidance establishing clear but flexible expectations for how providers should assess and address community needs. This Article urges the IRS to seize that opportunity by refining its regulatory framework for the CHNA requirement. Specifically, the IRS should more robustly promote transparency, accountability, community engagement, and collaboration while simultaneously leaving hospitals a good degree of flexibility. By promoting alignment between hospitals' regulatory compliance activities and broader community health improvement initiatives, the IRS could play a meaningful role in efforts to reorient our system towards promoting health and not simply treating illness. PMID:27363258

  16. Health and Taxes: Hospitals, Community Health and the IRS.

    PubMed

    Crossley, Mary

    2016-01-01

    The Affordable Care Act created new conditions of federal tax exemption for nonprofit hospitals, including a requirement that hospitals conduct a community health needs assessment (CHNA) every three years to identify significant health needs in their communities and then develop and implement a strategy responding to those needs. As a result, hospitals must now do more than provide charity care to their patients in exchange for the benefits of tax exemption. The CHNA requirement has the potential both to prompt a radical change in hospitals' relationship to their communities and to enlist hospitals as meaningful contributors to community health improvement initiatives. Final regulations issued in December 2014 clarify hospitals' obligations under the CHNA requirement, but could do more to facilitate hospitals' engagement in collaborative community health projects. The Internal Revenue Service (IRS) has a rich opportunity, while hospitals are still learning to conduct CHNAs, to develop guidance establishing clear but flexible expectations for how providers should assess and address community needs. This Article urges the IRS to seize that opportunity by refining its regulatory framework for the CHNA requirement. Specifically, the IRS should more robustly promote transparency, accountability, community engagement, and collaboration while simultaneously leaving hospitals a good degree of flexibility. By promoting alignment between hospitals' regulatory compliance activities and broader community health improvement initiatives, the IRS could play a meaningful role in efforts to reorient our system towards promoting health and not simply treating illness.

  17. Oral Health in Rural Communities

    MedlinePlus

    ... lack of dental care access? The Rural Health Information Hub provides two useful tools that may be useful when looking for additional strategies to address dental care access. RHIhub’s Rural Health ...

  18. Community organizing network for environmental health: using a community health development approach to increase community capacity around reduction of environmental triggers.

    PubMed

    Parker, Edith A; Chung, Lynna K; Israel, Barbara A; Reyes, Angela; Wilkins, Donele

    2010-04-01

    The Community Organizing Network for Environmental Health (CONEH), a project of Community Action Against Asthma, used a community health development approach to improve children's asthma-related health through increasing the community's capacity to reduce physical and social environmental triggers for asthma. Three community organizers were hired to work with community groups and residents in neighborhoods in Detroit on the priority areas of air quality, housing, and citizen involvement in the environmental project and policy decision-making. As part of the evaluation of the CONEH project, 20 one-on-one semi-structured, in-depth interviews were conducted between August and November 2005 involving steering committee members, staff members, and key community organization staff and/or community members. Using data from the evaluation of the CONEH project, this article identifies the dimensions of community capacity that were enhanced as part of a CBPR community health development approach to reducing physical and social environmental triggers associated with childhood asthma and the factors that facilitated or inhibited the enhancement of community capacity.

  19. Community Mental Health Centers and Insurance Reimbursements.

    ERIC Educational Resources Information Center

    Nissim-Sabat, Denis; And Others

    The economic solvency of Community Mental Health Centers (CMHCs) is a problem that needs immediate attention. In order to study the shift in funding sources for the 40 Community Services Boards (CSBs) which administer the 114 CMHCs in Virginia, the funding sources of CMHCs, and the fee collections of the CSBs, were examined. Data revealed that…

  20. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

    In this age of educational accountability, there is an increasing emphasis on assessment and institutional effectiveness, not only in the academic arena but also in other aspects of community college operation, such as fiscal health and stability, revenue generation, resource allocation, facilities, workforce development, and community enrichment…

  1. Mothers' Community Participation and Child Health

    ERIC Educational Resources Information Center

    Nobles, Jenna; Frankenberg, Elizabeth

    2009-01-01

    We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that…

  2. Strategies in Urban Community Mental Health.

    ERIC Educational Resources Information Center

    Kellman, Sheppard G.; And Others

    The paper presents an outline for the development of a community mental health program based on assessment of a first grade population in an urban Negro neighborhood and involving a strategy that places primary emphasis on establishing ongoing community sanction and participation in policy-making. The strategy included the development of a…

  3. Creating Health-Focused Academic Community Partnerships.

    ERIC Educational Resources Information Center

    Gaines, Sherry K.; Kelley, Susan J.; Spencer, Lorine

    1997-01-01

    Partnerships with communities help universities respond to contemporary societal issues, enrich educational experiences, and offer opportunities for research and faculty service. At Georgia State University, three health-related programs link campus and community in projects for grandparents raising grandchildren, migrant farm workers, and…

  4. Sexual health needs and the LGBT community.

    PubMed

    Campbell, Sue

    Lesbian, gay, bisexual and trans (LGBT) individuals have particular vulnerabilities to sexually transmitted infections and HIV infection. Globally, reasons for this include physiological factors, discrimination and poor understanding of their sexual health needs. In many countries LGBT individuals are not able to exercise fully their rights to health care. This raises public health concerns for the LGBT community and the wider population. This article explores these issues, and makes recommendations for the healthcare profession to address health inequalities and promote improved health outcomes for LGBT populations. This article aims to promote an evidence-based approach that focuses on rights and public health issues.

  5. Sexual health needs and the LGBT community.

    PubMed

    Campbell, Sue

    Lesbian, gay, bisexual and trans (LGBT) individuals have particular vulnerabilities to sexually transmitted infections and HIV infection. Globally, reasons for this include physiological factors, discrimination and poor understanding of their sexual health needs. In many countries LGBT individuals are not able to exercise fully their rights to health care. This raises public health concerns for the LGBT community and the wider population. This article explores these issues, and makes recommendations for the healthcare profession to address health inequalities and promote improved health outcomes for LGBT populations. This article aims to promote an evidence-based approach that focuses on rights and public health issues. PMID:23641652

  6. [The health community auxiliaries; their capital role in remote and scattered areas. The example of Tuamotu-Gambier Islands (author's transl)].

    PubMed

    Senellart, J M; Philippe, B

    1981-01-01

    To provide adequate health care in many islands or atolls scattered on a surface equal to Europe, raises many problems. Physicians cannot have a full-time presence. Sanitary education given to the local population by auxiliaries born in the islands or living in, seems the recommendable way to improve the health situation. This on-the-spot basic action must associate Officers from various Departments (Health and Social Welfare, Fisheries, Agriculture, Education).

  7. 2. EAGLE CREEK RECREATION AREA, VIEW OF COMMUNITY KITCHEN. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. EAGLE CREEK RECREATION AREA, VIEW OF COMMUNITY KITCHEN. - Historic Columbia River Highway, Eagle Creek Recreation Area, Historic Columbia River Highway at Eagle Creek, Troutdale, Multnomah County, OR

  8. Community Health Workers: Social Justice and Policy Advocates for Community Health and Well-Being

    PubMed Central

    Pérez, Leda M.; Martinez, Jacqueline

    2008-01-01

    Community health workers are resources to their communities and to the advocacy and policy world on several levels. Community health workers can connect people to health care and collect information relevant to policy. They are natural researchers who, as a result of direct interaction with the populations they serve, can recount the realities of exclusion and propose remedies for it. As natural researchers, they contribute to best practices while informing public policy with the information they can share. In this light, community health workers may also be advocates for social justice. PMID:18048789

  9. The impact of pollution from a mercury processing plant in KwaZulu-Natal, South Africa, on the health of fish-eating communities in the area: an environmental health risk assessment.

    PubMed

    Oosthuizen, J; Ehrlich, R

    2001-03-01

    The objective of this study was to determine the human health risk associated with fish consumption in a contaminated area downstream from a mercury processing plant in KwaZulu-Natal, South Africa. The study population consisted of fish consumers living in close proximity to the u'Mgeni River and the Inanda Dam downstream from the plant. A control group was selected from the area upstream from the mercury plant as far as the Nagle Dam. Total daily mercury consumption per kilogram body weight per day was calculated for each person included in the study. These data were compared with the tolerable daily intake standard published by the World Health Organization, as well as to the United States Environmental Protection Agency's reference dose. Human hair samples obtained from the study population and a control group were analysed for mercury content. The results of the risk estimation indicated that the study population is at risk. Human hair samples, however, indicated that dangerous levels of mercury had not yet been consumed. Humans in this study area could be subject to an excessive health risk from mercury as a result of their fish consumption. Fish mercury levels in the contaminated area should be monitored closely. PMID:11260786

  10. [Community health workers: promoters of interaction between territories].

    PubMed

    da Costa, Samira Lima; de Carvalho, Emílio Nolasco

    2012-11-01

    This article presents reflections originating from a series of meetings with community health workers over a period of ten years. It identifies the consolidation of two existential territories, which are sometimes closer and at other times more distant from each other, namely the territory of technical knowledge about health and the territory of popular knowledge about health. Starting with the analysis of some quotes from health workers and reflections which tally with the theoretical reference in the area, this paper discusses some of the dilemmas and deadlocks of access and affiliation from the perspective of some of these health workers, as well as the strategies devised on a day-to-day basis from the crossovers that take place between these two territories. It identifies the function of community health workers as frontier agents, at times acting as inventors or motivators of contact zones between the territories, and at other times acting as a representative by one territory inside the other.

  11. [Maternal and child health and family planning service coverage in the Community Health Practitioner post].

    PubMed

    Kim, J S; Oh, Y A

    1985-07-01

    Community health practitioners have been working to provide comprehensive health care for rural residents for the last 2 years. The community health practitioners' activities for providing maternal and child health and family planning services were examined because the maternal and child health and family planning practice rate among the eligible population is known to be very low in rural areas. Therefore, a study of new mothers, infants, and pregnant women was carried out. This study aimed to grasp the utilization pattern of health facilities by the target population for receiving maternal and child health and family planning care, and also, indirectly, to assess the community health practitioners' activities. The major findings are: it appeared that attendance at birth by lay persons was higher than that of health professionals; the eligible women's behaviors were not changed by receiving proper prenatal and postnatal care; the child care rate for children under 2 years of age was very low, but the basic immunization rate, such as B.C.G., D.P.T., and poliomyelitis, was greatly increased compared with the rate before the assignment of community health practitioners (this result is not higher than the nationwide rate); and the family planning practice rate was similar to the nationwide practice rate. In conclusion, maternal and child health and family planning services by community health practitioners were improved. Community health practitioners' activities, however, are still required for more improvement of maternal and child health services. To increase the service coverage, a management system for health care, particularly a team work approach for primary health care personnel at various levels should be improved as soon as possible.

  12. The Assessment of a Community's Mental Health Needs.

    ERIC Educational Resources Information Center

    Zautra, Alex; Simons, Lynn Stanley

    In this study social indicators and survey measures were used to predict three-year service utilization rates at a community mental health center on a geographic basis. Ten social indicators were selected from available census tract statistics and seven survey measures were taken from an epidemiological survey of the catchment area of the mental…

  13. Rush Health Systems and Meridian Community College: People Serving People

    ERIC Educational Resources Information Center

    Willis, Jean H.

    2007-01-01

    Meridian Community College and Rush Health Systems are partners in delivering training focused on Rush's mission statement of hospital-wide commitment to "excellence in service management." Rush and MCC have delivered customized classes in the following areas: medical billing, leadership management, computer training, admissions clerk, and…

  14. Indigenous community based participatory research and health impact assessment: A Canadian example

    SciTech Connect

    Kwiatkowski, Roy E.

    2011-07-15

    The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples.

  15. Development and formative evaluation of an innovative mHealth intervention for improving coverage of community-based maternal, newborn and child health services in rural areas of India

    PubMed Central

    Modi, Dhiren; Gopalan, Ravi; Shah, Shobha; Venkatraman, Sethuraman; Desai, Gayatri; Desai, Shrey; Shah, Pankaj

    2015-01-01

    Background A new cadre of village-based frontline health workers, called Accredited Social Health Activists (ASHAs), was created in India. However, coverage of selected community-based maternal, newborn and child health (MNCH) services remains low. Objective This article describes the process of development and formative evaluation of a complex mHealth intervention (ImTeCHO) to increase the coverage of proven MNCH services in rural India by improving the performance of ASHAs. Design The Medical Research Council (MRC) framework for developing complex interventions was used. Gaps were identified in the usual care provided by ASHAs, based on a literature search, and SEWA Rural's1 three decades of grassroots experience. The components of the intervention (mHealth strategies) were designed to overcome the gaps in care. The intervention, in the form of the ImTeCHO mobile phone and web application, along with the delivery model, was developed to incorporate these mHealth strategies. The intervention was piloted through 45 ASHAs among 45 villages in Gujarat (population: 45,000) over 7 months in 2013 to assess the acceptability, feasibility, and usefulness of the intervention and to identify barriers to its delivery. Results Inadequate supervision and support to ASHAs were noted as a gap in usual care, resulting in low coverage of selected MNCH services and care received by complicated cases. Therefore, the ImTeCHO application was developed to integrate mHealth strategies in the form of job aid to ASHAs to assist with scheduling, behavior change communication, diagnosis, and patient management, along with supervision and support of ASHAs. During the pilot, the intervention and its delivery were found to be largely acceptable, feasible, and useful. A few changes were made to the intervention and its delivery, including 1) a new helpline for ASHAs, 2) further simplification of processes within the ImTeCHO incentive management system and 3) additional web-based features for

  16. Korea Community Health Survey Data Profiles.

    PubMed

    Kang, Yang Wha; Ko, Yun Sil; Kim, Yoo Jin; Sung, Kyoung Mi; Kim, Hyo Jin; Choi, Hyung Yun; Sung, Changhyun; Jeong, Eunkyeong

    2015-06-01

    In 2008, Korea Centers for Disease Control and Prevention initiated the first nationwide survey, Korea Community Health Survey (KCHS), to provide data that could be used to plan, implement, monitor, and evaluate community health promotion and disease prevention programs. This community-based cross-sectional survey has been conducted by 253 community health centers, 35 community universities, and 1500 interviewers. The KCHS standardized questionnaire was developed jointly by the Korea Centers for Disease Control and Prevention staff, a working group of health indicators standardization subcommittee, and 16 metropolitan cities and provinces with 253 regional sites. The questionnaire covers a variety of topics related to health behaviors and prevention, which is used to assess the prevalence of personal health practices and behaviors related to the leading causes of disease, including smoking, alcohol use, drinking and driving, high blood pressure control, physical activity, weight control, quality of life (European Quality of Life-5 Dimensions, European Quality of Life-Visual Analogue Scale, Korean Instrumental Activities of Daily Living ), medical service, accident, injury, etc. The KCHS was administered by trained interviewers, and the quality control of the KCHS was improved by the introduction of a computer-assisted personal interview in 2010. The KCHS data allow a direct comparison of the differences of health issues among provinces. Furthermore, the provinces can use these data for their own cost-effective health interventions to improve health promotion and disease prevention. For users and researchers throughout the world, microdata (in the form of SAS files) and analytic guidelines can be downloaded from the KCHS website (http://KCHS.cdc.go.kr/) in Korean. PMID:26430619

  17. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources.

    PubMed

    Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John

    2013-09-01

    Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.

  18. Smart health community: the hidden value of health information exchange.

    PubMed

    Ciriello, James N; Kulatilaka, Nalin

    2010-12-01

    Investments in health information technology are accelerating the digitization of medicine. The value from these investments, however, can grow beyond efficiencies by filling the information gaps between the various stakeholders. New work processes, governance structures, and relationships are needed for the coevolution of healthcare markets and business models. But coevolution is slow, hindered by the scarcity of incentives for legacy delivery systems and constrained by the prevailing patient-healthcare paradigm. The greater opportunity lies in wellness for individuals, families, communities, and society at large: a consumer-community paradigm. Capturing new value from this opportunity can start with investment in health information exchange and the creation of Smart Health Communities. By shifting the focus of exchange from public servant to value-added service provider, these communities can serve as a platform for a wider array of wellness services from consumer care, traditional healthcare, and research. PMID:21314218

  19. The community need index. A new tool pinpoints health care disparities in communities throughout the nation.

    PubMed

    Roth, Richard; Barsi, Eileen

    2005-01-01

    Catholic Healthcare West, San Francisco (CHW), has developed a national Community Need Index (CNI) in partnership with Solucient, an information products company, to help health care organizations, not-for-profits, and policymakers identify and address barriers to health care access in their communities. The CNI aggregates five socioeconomic indicators long known to contribute to health disparity--income, culture/language, education, housing status, and insurance coverage--and applies them to every zip code in the United States. Each zip code is then given a score ranging from 1.0 (low need) to 5.0 (high need). Residents of communities with the highest CNI scores were shown to be twice as likely to experience preventable hospitalization for manageable conditions--such as ear infections, pneumonia or congestive heart failure--as communities with the lowest CNI scores. The CNI provides compelling evidence for addressing socioeconomic barriers when considering health policy and local health planning. The tool highlights health care disparities between geographic regions and illustrates the acute needs of several notable geographies, including inner city and rural areas.Further, it should enable health care providers, policymakers, and others to allocate resources where they are most needed, using a standardized, quantitative tool. The CNI provides CHW with an important means to strategically allocate resources where it will be most effective in maintaining a healthy community.

  20. Emergency preparedness training of tribal community health representatives.

    PubMed

    Hites, Lisle S; Granillo, Brenda S; Garrison, Edward R; Cimetta, Adriana D; Serafin, Verena J; Renger, Ralph F; Wakelee, Jessica F; Burgess, Jefferey L

    2012-04-01

    This study describes the development and evaluation of online Public Health Emergency Preparedness (PHEP) training adapted to the learning styles and needs of tribal Community Health Representatives (CHRs). Working through a university-tribal community college partnership, the Arizona Center for Public Health Preparedness at the University of Arizona and Diné College of the Navajo Nation delivered a blended online and face-to-face public health preparedness certificate program based on core public health emergency preparedness competencies. This program was carefully adapted to meet the environmental and learning needs of the tribal CHRs. The certificate program was subsequently evaluated via a scenario-based decision-making methodology. Significant improvements in five of six competency areas were documented by comparison of pre- and post-certificate training testing. Based on statistical support for this pedagogical approach the cultural adaptations utilized in delivery of the certificate program appear to be effective for PHEP American Indian education. PMID:21240557

  1. Emergency preparedness training of tribal community health representatives.

    PubMed

    Hites, Lisle S; Granillo, Brenda S; Garrison, Edward R; Cimetta, Adriana D; Serafin, Verena J; Renger, Ralph F; Wakelee, Jessica F; Burgess, Jefferey L

    2012-04-01

    This study describes the development and evaluation of online Public Health Emergency Preparedness (PHEP) training adapted to the learning styles and needs of tribal Community Health Representatives (CHRs). Working through a university-tribal community college partnership, the Arizona Center for Public Health Preparedness at the University of Arizona and Diné College of the Navajo Nation delivered a blended online and face-to-face public health preparedness certificate program based on core public health emergency preparedness competencies. This program was carefully adapted to meet the environmental and learning needs of the tribal CHRs. The certificate program was subsequently evaluated via a scenario-based decision-making methodology. Significant improvements in five of six competency areas were documented by comparison of pre- and post-certificate training testing. Based on statistical support for this pedagogical approach the cultural adaptations utilized in delivery of the certificate program appear to be effective for PHEP American Indian education.

  2. Volunteers in Community Mental Health.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Bethesda, MD.

    This booklet gives detailed accounts of mental health programs in operation around the nation. A total of nine different types of activities is included. "Helping Children" describes a program whereby students from nearby colleges give troubled children, at home, an experience in friendship by serving as big brothers or sisters. "Helping the…

  3. Community health workers--an evolving force.

    PubMed

    Ramprasad, V

    1988-01-01

    An assessment was made in Indian villages of the performance of community health workers in primary care projects supported by funding agencies. In general these workers were neither adequately trained nor properly integrated into the programs to which they were attached, and the results left much to be desired. In some of the projects the training of health workers was invariably seen by the projects as a way of ensuring funding rather than of meeting a need. The only knowledge transfer between trainers and health workers occurred at monthly meetings. Manuals and teaching materials were scarce in many programs and those used were sometimes considered inappropriate. It was often observed that community health workers were very willing to offer assistance to patients and fellow-workers. They had a good grasp of theory and technical detail and were fully capable of performing allotted tasks. However, most of the projects lacked any system for evaluating the community health workers and consequently there was very little scope for upgrading their skills. Nevertheless, valuable experience was gained and it has been possible to draw up guidelines for organizing future programs in which community health workers should be able to realize their full potential.

  4. Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions.

    PubMed

    Alaimo, Katherine; Beavers, Alyssa W; Crawford, Caroline; Snyder, Elizabeth Hodges; Litt, Jill S

    2016-09-01

    The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions. PMID:27379424

  5. Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions.

    PubMed

    Alaimo, Katherine; Beavers, Alyssa W; Crawford, Caroline; Snyder, Elizabeth Hodges; Litt, Jill S

    2016-09-01

    The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions.

  6. Applications of Community Psychology in Fostering the Development of Health Systems Agencies.

    ERIC Educational Resources Information Center

    Bunker, Douglas R.

    The Health Systems Agencies created to plan and coordinate the development of health care systems in 205 health service areas across the states have a need to be legitimized and operationalized in community contexts in order to achieve their purpose. Community psychologists have both research and consultation roles to play in contributing to…

  7. Community and environmental health effects of concentrated animal feeding operations.

    PubMed

    Kirkhorn, Steven R

    2002-10-01

    High-density concentrated animal feeding operations (CAFOs) have become an increasing source of concern with respect to their impact on health, the environment, and quality of life in the communities in which they are located. A growing body of literature has identified a number of potential adverse effects, including the development of antimicrobial resistance patterns, groundwater contamination, and occupational respiratory disease. The odor associated with CAFOs has had a detrimental effect on the quality of life of rural residents, and there may also be associated adverse health effects. Physicians in rural areas may be asked to assess patients with concerns related to neighboring CAFOs and may be drawn into a political battle regarding the authorization of the development of additional CAFOs. This article reviews current research on the community, environmental, and occupational health effects associated with high-density animal production facilities. It also discusses recommendations for evaluating patients affected by CAFO odors and steps to decrease occupational and community exposure.

  8. Therapeutic Communities and Mental Health System Reform

    PubMed Central

    Dickey, Barbara; Ware, Norma C.

    2009-01-01

    Topic The contemporary relevance of therapeutic communities as a treatment modality in mental health is described. Methods This paper builds upon on a qualitative study to provide a case illustration of a working therapeutic community for persons with serious mental illness. Sources Used The data are seventeen interviews conducted with staff and residents and observations carried out during four days of field work by the research team. Conclusions Studies are needed to determine whether therapeutic communities strengthen consumer capacity for social integration and thus contribute to empowerment and the larger recovery agenda. PMID:18840564

  9. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

    PubMed Central

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

    2012-01-01

    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  10. Community health nursing advocacy: a concept analysis.

    PubMed

    Ezeonwu, Mabel C

    2015-01-01

    The purpose of this article is to present an in-depth analysis of the concept of community health nursing (CHN) advocacy. Walker and Avant's (2010) 8-step concept analysis methodology was used. A broad inquiry into the literature between 1994 and 2014 resulted in the identification of the uses, defining attributes, empirical referents, antecedents, and consequences, as well as the articulation of an operational definition of CHN advocacy. Model and contrary cases were identified to demonstrate the concept's application and to clarify its meaning. This analysis contributes to the advancement of knowledge of CHN advocacy and provides nurse clinicians, educators, and researchers with some conceptual clarity to help improve community health outcomes.

  11. The influence of Community Access to Child Health (CATCH) program on community pediatrics.

    PubMed

    Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David

    2014-01-01

    The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.

  12. Developing community mental health services for children in South Africa.

    PubMed

    Pillay, A L; Lockhat, M R

    1997-11-01

    As a result of South Africa's Apartheid history, mental health care for black people, especially in rural areas, has been grossly inadequate and even non-existent in many areas. Children have been severely neglected in this regard. This paper describes an attempt by clinical psychologists to develop a community intervention programme for children with emotional problems. From their hospital base the authors set out, on a monthly basis, to outlying areas up to 250 km away to (1) train primary care nurses and other personnel in the basic techniques of identifying and dealing with uncomplicated psychological problems of childhood, and (2) render consultations to psychologically disturbed children. The paper argues the need to provide primary care workers with mental health skills and thus integrate childhood mental health care into the primary care structure. Such a move could make mental health care accessible to all inhabitants, thus deviating from the policies of the past.

  13. Community participation in rural health: a scoping review

    PubMed Central

    2013-01-01

    Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice

  14. Community-based health insurance and social capital: a review

    PubMed Central

    2012-01-01

    Community-Based Health Insurance (CBHI) is an emerging concept for providing financial protection against the cost of illness and improving access to quality health services for low-income rural households who are excluded from formal insurance. CBHI is currently being provided in some rural areas in developing countries and there is ongoing research about its impact on the well-being of the poor in these areas. However, the success of CBHI revolves around the existence of social capital in the community. This has led researchers to explore the impact of CBHI on the well-being of the poor in rural areas, especially as it relates to social capital. The overall objective of this paper is to review recent developments that address the link between CBHI and social capital. Policy implications are also discussed. JEL Classification C10, I15 PMID:22828204

  15. Health training intervention for community elderly

    PubMed Central

    McDougall, Graham J.; Becker, Heather; Acee, Taylor W.; Vaughan, Phillip W.; Pituch, Keenan; Delville, Carol

    2009-01-01

    This paper describes the outcomes of a psychosocial intervention that tested whether health training could improve health and functional ability in a group community-residing elders. The health training intervention consisted of eight, 90-minute lecture and discussion classes conducted twice a week for one month. In 3 months following the post-test, an additional 4 booster sessions were delivered once per week for one month. Participants received a total of 20 hours of health training. The NIH-funded SeniorWISE© (Wisdom Is Simply Exploration) study was advertised in the community as a program to learn strategies for successful aging. We describe the health curriculum, and the health and functional outcomes for a 6-month period at pre-intervention, post-intervention, and post-booster sessions. Complete data were available for 110 individuals. There was a statistically significant change on the Direct Assessment of Functional Status (DAFS) (F = 4.69 (2, 107), p < .012). Health variables remained stable over time. This intervention demonstrated that health training has the potential for noticeable improvement in IADL function. PMID:20303452

  16. The Natural Area: Teaching Tool and Community Catalyst

    ERIC Educational Resources Information Center

    Davis, Roger M.; Grimm, Floyd M., III

    1973-01-01

    Discusses the properties desirable in a natural area to be used as a teaching tool in college courses such as general biology, botany, zoology, entomology, and ecology. Describes the use of a natural area at Harford Community College, Maryland, and outlines the community involvement in planning and utilizing the area. (JR)

  17. Conducting Community Health Needs Assessments in rural communities: lessons learned.

    PubMed

    Becker, Karin L

    2015-01-01

    The Affordable Care Act of 2010 requires all nonprofit hospitals in the United States to conduct a Community Health Needs Assessment (CHNA) at least every 3 years. With this law in its infancy, the best practice to conduct an assessment that complies with the law is unknown. Research designs vary across states and agencies, and little is known about the reliability or representativeness of results. The rural community group model (RCGM) is a newly developed model designed for conducting assessments in rural communities. Key components of the model are disseminating surveys, conducting key informant interviews, facilitating focus groups, and integrating secondary data of county-level health behaviors and outcomes. It has been used to conduct CHNAs on more than half the critical access hospitals in North Dakota (58%). Given this large sample size, which used the same methodology, this article provides an evaluation of the model focusing on lessons learned and challenges encountered in the conduct of CHNAs. Particular strategies for assessment planners are warding off group think, monitoring against bias creep in data collection, and integrating multiple data sources to inform decision making. The model is recommended for replication in rural settings to provide meaningful feedback that allows a hospital to match long-term planning with community needs.

  18. [Community health centers: an alternative for the health system

    PubMed

    Fernandes; Monteiro

    1997-01-01

    Reflecting on the current reorganization of the relationship between the state and civil society, the health care field is involved in an intense debate over the organization and use of government and private health services. The authors propose an alternative, consisting of the implementation of primary health care clinics, managed by local institutions and funded by the Unified Health System. To support this proposition, they report on the current experience at the Rocinha slum in Rio de Janeiro, where a community health center was built by the neighborhood association 12 years ago and has been managed by the community since then. The hospital referral rate at the clinic, requests for laboratory tests, and use of precriptions have been considerably limited, although these services are available. These low rates are attributed to the possibility of closer social control by the community, as well as to the geographical features of the center, favoring a broader perception of both health problems and treatment. In order to provide more substantial support to the proposed centers, some suggestions are presented, like the implementation of direct agreements between the government and neighborhood associations (not allowed under current legislation) and expanding potential sources of funding for the health centers, currently restricted to government programs. PMID:10886837

  19. Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities

    PubMed Central

    West, Jenny S.; Price, Matthew; Gros, Kirstin Stauffacher; Ruggiero, Kenneth J.

    2014-01-01

    Objective We examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health. Methods A representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support. A series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples. Results Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants. Conclusions Community support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. PMID:24274123

  20. Canadian community pharmacists’ use of digital health technologies in practice

    PubMed Central

    Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen

    2016-01-01

    Background: In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. Methods: In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Results: Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. Discussion: There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Conclusion: Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx. PMID:26798376

  1. Engaging students in community health: a public health advocacy curriculum.

    PubMed

    Curran, Nell; Ned, Judith; Winkleby, Marilyn

    2014-03-01

    Individual risk assessment and behavior change dominate the content of high school health education instruction whereas broader social, political, and economic factors that influence health-known as upstream causes-are less commonly considered. With input from instructors and students, we developed a 10-lesson experiential Public Health Advocacy Curriculum that uses classroom-based activities to teach high school students about the upstream causes of health and engages them in community-based health advocacy. The Curriculum, most suitable for health- or advocacy-related elective classes or after-school programs, may be taught in its entirety or as single lessons integrated into existing coursework. Although students at many schools are using the Curriculum, it has been formally evaluated with 110 predominantly Latino students at one urban and one semirural public high school in Northern California (six classes). In pre-post surveys, students showed highly significant and positive changes in the nine questions that covered the three main Curriculum domains (Upstream Causes, Community Exploration, and Public Health Advocacy), p values .02 to <.001. The Curriculum is being widely disseminated without charge to local, national, and international audiences, with the objective of grooming a generation of youth who are committed to the public health perspective to health. PMID:23975798

  2. Community development for health and identity politics.

    PubMed

    Allen, C F

    1997-08-01

    Community development for health (CD4H) is defined as the mobilization of communities actually or potentially suffering from a health problem to eliminate its causes or alleviate its consequences. This paper links this with questions of social identity, focusing on issues of ethnicity and 'race', in health promotion. When combined with notions of ethnicity and 'race'. CD4H is frequently a reaction to inequalities which are communally experienced and believed to increase risk of ill-health for the group. This paper theorizes the link between communal experience and activity to promote health, by drawing on sociological theory linking structure and agency. It examines how discourses of belonging and exclusion are enacted in struggles for health. Via examples from the Caribbean and the UK, instances of 'identity politics' in CD4H are identified, viewed as the use of essentialist, binary notions of self and other in the attempt to gain an advantage over the other. It is argued that such instances should not be considered in isolation, but should be viewed as responses to experience, particularly, in the UK context, the experience of racism in the Health Service.

  3. Community health nursing vision for 2020: shaping the future.

    PubMed

    Schofield, Ruth; Ganann, Rebecca; Brooks, Sandy; McGugan, Jennifer; Dalla Bona, Kim; Betker, Claire; Dilworth, Katie; Parton, Laurie; Reid-Haughian, Cheryl; Slepkov, Marlene; Watson, Cori

    2011-12-01

    As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence.

  4. Community health nursing vision for 2020: shaping the future.

    PubMed

    Schofield, Ruth; Ganann, Rebecca; Brooks, Sandy; McGugan, Jennifer; Dalla Bona, Kim; Betker, Claire; Dilworth, Katie; Parton, Laurie; Reid-Haughian, Cheryl; Slepkov, Marlene; Watson, Cori

    2011-12-01

    As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence. PMID:20660926

  5. How community mental health centers are coping.

    PubMed

    Okin, R L

    1984-11-01

    Many community mental health centers have had to operate with less funding in the past several years, especially since the advent of block grant funding. Evidence is now accumulating that some centers have had to decrease their overall level of services and staffing. Others have attempted to adjust by increasing their clinician caseloads, closing their satellite facilities, and de-emphasizing services that fail to generate adequate fees and third-party reimbursements, such as consultation and education, partial hospitalization, and programs for children and the elderly. In contrast, and partly as a result of the increased authority of the states over the community mental health centers program, services for the severely and chronically mentally ill appear to be receiving higher priority. This development will require that centers improve their access to the general health care sector, maintain and improve their relationships with academic institutions, and increase the number, responsibilities, and rewards of the psychiatrists they employ. PMID:6500524

  6. Multiculturalism, Medicine and Health Part V: Community Considerations

    PubMed Central

    Masi, R.

    1989-01-01

    In this article the author examines multicultural health issues from a community perspective, dealing with relationships between cultural communities and health-care systems in terms of: hospitals and health-care institutions, family and social supports, social norms, and community-health programs. PMID:21248882

  7. Institutionalization of Community Partnerships: The Challenge for Academic Health Centers

    PubMed Central

    Magwood, Gayenell S.; Andrews, Jeannette O.; Zapka, Jane; Cox, Melissa J.; Newman, Susan; Stuart, Gail W.

    2014-01-01

    Summary Current public health priorities emphasize the elimination of health disparities, translational research, and transdisciplinary and community alliances. The Center for Community Health Partnerships is a proactive initiative to address new paradigms and priorities in health care through institutionalization of community-university partnerships. This report highlights innovative strategies and lessons learned. PMID:23698666

  8. Perceptions of one African American community about its' health, health status and safety.

    PubMed

    Stringfield, Y N

    2000-01-01

    African Americans remain at the low end of the socio-economic stratum, have less health care access, and have the highest mortality from illnesses. This supports a need for African American nurses to enter African American communities to offer health education/literacy sessions. This project conducted a survey to determine the health status of African Americans living in a select section eight housing area and their perception of their health, health status and safety. Participants identified their health and health status as good. They had a high concern about safety in their neighborhood. Earlier reports from the county and state do not support the respondents' belief about their health or health status. These same reports do support the respondents concern for safety.

  9. Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system.

    PubMed

    Tichy, N M; Taylor, J I

    1976-01-01

    This article presents the case of Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of control, namely, management, without experiencing destructive conflicts and the deterioration of health services.

  10. Economic evaluation in primary health care: the case of Western Kenya community based health care project.

    PubMed

    Wang'ombe, J K

    1984-01-01

    This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country. PMID:6427933

  11. The health of the school nurse community: a framework.

    PubMed

    Christeson, Elisabeth P

    2003-04-01

    School nursing is based on a conceptual foundation of community health nursing. Using community health nursing as a reference point, this article describes a viewpoint of school nurses as the population of care. With this perspective, school nurses will better understand how to foster the health of their community. Developed on the basis of McKenzie, Pinger, and Kotecki's community health model, the Health of the School Nurse Community Framework has been designed to (a) facilitate understanding of the concept of "school nurse community" and (b) organize the factors that affect the health of the school nurse community. Essential to its use is the identification of the school nurse community's assets and capacities as well as its needs. Application of the framework to strive to improve the health of one state's school nurse community is also presented.

  12. Guidelines for Training Community Health Workers in Nutrition. WHO Offset Publication No. 59.

    ERIC Educational Resources Information Center

    World Health Organization, Geneva (Switzerland).

    Designed for trainers of community health workers, these guidelines are intended to help them instruct, in a practical way, those workers in how to improve nutrition in their areas. The book is divided into nine modules, each concerned with a different aspect of the community health worker's training. Each module first sets forth the learning…

  13. Community Involvement and Adolescent Mental Health: Moderating Effects of Race/Ethnicity and Neighborhood Disadvantage

    ERIC Educational Resources Information Center

    Hull, Pamela; Kilbourne, Barbara; Reece, Michelle; Husaini, Baqar

    2008-01-01

    Social development and stress process theories suggest that participation in one's community can function as a protective factor for mental health, especially for youth from socioeconomically disadvantaged areas. However, the effects of community involvement on adolescent mental health could vary across racial/ethnic groups and levels of…

  14. Dimensions of Leadership among Community College Health Career Program Department Chairs and Implications for Leadership Development

    ERIC Educational Resources Information Center

    Platz-Wiechert, Lynn Marie

    2010-01-01

    Given the growth in community colleges, the projected need for health career workers, and the central position of the department chair in higher education, this study explored dimensions of leadership as identified by health career department chairs in five Illinois community colleges. Areas of study included: (a) professional profiles of health…

  15. Community Health Nursing through a Global Lens.

    PubMed

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia

    2015-01-01

    Community Health Nursing (N456) is a required senior clinical course in the undergraduate nursing curriculum at the University of Michigan in which students learn to assess and address the health of populations and communities. In 2012, we began our efforts to internationalize the curriculum using a globally engaged nursing education framework. Our goal is for all students to have an intercultural learning experience understanding that all students are unable to travel internationally. Therefore, this intercultural learning was implemented through a range of experiences including actual immersion, virtual activities (videoconferencing) and interventions with local vulnerable populations. Grants were obtained to provide immersion experiences in Quito, Ecuador and New Delhi, India. Several technologies were initiated with partner nursing schools in Leogane, Haiti and New Delhi, India. Weekly videoconferencing utilizing BlueJeans software and exchange of knowledge through the Knowledge Gateway facilitated intercultural exchange of knowledge and culture. Local clinical groups work with a variety of vulnerable populations. A private blog was developed for all sections to share community assessment data from local and international communities. Qualitative evaluation data was collected for local and international students to begin to assess cultural competence and student learning. Analysis of data documented increased awareness of culture and identified the many positive benefits of interaction with a global partner. PMID:25980716

  16. Community health planning from an interorganizational perspective.

    PubMed Central

    Cohen, P D

    1982-01-01

    Planning agencies do not have control over health care resources in the community. Resources are concentrated in a number of provider organizations, associations, and government agencies, which have common goals as well as a diversity of individual objectives, and therefore enter into networks of relationships to accomplish their overlapping service missions. Interorganizational research shows that it is important to enhance the interdependence and benefits of cooperation between organizations and at the same time maintain the identity and distinctive qualities of each organization. Thus, in addition to the important role to provide information for decisions, planners have a role to manage the interdependencies and identities among organizations in the health system. Research shows that in situations where only methods, data, and analysis were emphasized by health planners, they had less impact on community decisions than in situations where planners also emphasized the development of the interorganizational system of decision-making. In a neutral position with respect to competing forces, planners can more effectively use their leverage from their information processing role and from their regulatory powers to facilitate the balancing of interorganizational interests and to enhance cooperative benefits to the community. PMID:7091463

  17. Creating community-academic partnerships for cancer disparities research and health promotion.

    PubMed

    Meade, Cathy D; Menard, Janelle M; Luque, John S; Martinez-Tyson, Dinorah; Gwede, Clement K

    2011-05-01

    To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community-academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships. PMID:19822724

  18. Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

    PubMed

    Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

    2013-01-01

    In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

  19. Perceptions of Health, Health Care and Community-Oriented Health Interventions in Poor Urban Communities of Kinshasa, Democratic Republic of Congo

    PubMed Central

    Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

    2013-01-01

    In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city’s major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

  20. The Health of the School Nurse Community: A Framework

    ERIC Educational Resources Information Center

    Christeson, Elisabeth P.

    2003-01-01

    School nursing is based on a conceptual foundation of community health nursing. Using community health nursing as a reference point, this article describes a viewpoint of school nurses as the population of care. With this perspective, school nurses will better understand how to foster the health of their community. Developed on the basis of…

  1. Community College Student Mental Health: A Comparative Analysis

    ERIC Educational Resources Information Center

    Katz, Daniel Seth; Davison, Karen

    2014-01-01

    This study explores community college student mental health by comparing the responses of California community college and traditional university students on the American College Health Association-National College Health Assessment II (ACHA-NCHA II). Using MANOVA, we compared community college and traditional university students, examining…

  2. Integrating the environment, the economy, and community health: a Community Health Center's initiative to link health benefits to smart growth.

    PubMed

    McAvoy, Peter V; Driscoll, Mary Beth; Gramling, Benjamin J

    2004-04-01

    The Sixteenth Street Community Health Center (SSCHC) in Milwaukee, Wis, is making a difference in the livability of surrounding neighborhoods and the overall health of the families it serves. SSCHC is going beyond traditional health care provider models and working to link the environment, the economy, and community health through urban brownfield redevelopment and sustainable land-use planning. In 1997, SSCHC recognized that restoration of local air and water quality and other environmental conditions, coupled with restoring family-supporting jobs in the neighborhood, could have a substantial impact on the overall health of families. Recent events indicate that SSCHC's pursuit of smart growth strategies has begun to pay off. PMID:15053995

  3. Telemedicine: Health Care for Isolated Areas.

    ERIC Educational Resources Information Center

    Development Communication Report, 1977

    1977-01-01

    The lead article discusses the results of a series of experiments in rural Alaska in which telemedicine was used to improve the delivery of health care to isolated populations. The author, Dennis Foote, also discusses the implications of these experiments for planning telemedicine systems in other areas. Satellite communication and a centralized…

  4. Exploring Social Quality and Community Health Outcomes: An Ecological Model.

    PubMed

    Jung, Minsoo

    2015-01-01

    Quality of life is widely used as a measure of individual well-being in developed countries. Social quality (SQ), however, describes how favorable the socioenvironmental components are that impact the life chance of an individual. Despite the associations between SQ, including institutional capacity and citizen capacity, and other community indicators, the impact of SQ on community health status has not been fully examined. This study investigated the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea. Under the principles of conceptual suitability, clarity, reliability, consistency, changeability, and comparability, a total of 81 SQ indicators were collected, and 19 indicators of the 81 indicators were selected. The 19 indicators were transformed by the imputation of missing values, standardization, and geographic information system transformation. It was found that the health outcome of local government was superior as social welfare, political participation, and education were higher. According to the result of the regression analysis based on the regional type, social welfare had the most influence on the health level of local government in both metropolises and small-/medium-sized cities. In addition, education and political participation had a positive effect on the health indicator of local metropolis government. However, SQ indicators did not have any meaningful influence at the county level. Therefore, small- and medium-sized cities need to promote the collective health of the local government through improving social welfare, and metropolises need to consider the complex relationship among other indicators while increasing the level of social welfare and education. Meanwhile, counties need to develop health indicators that reflect aged population characteristics and social environment of rural areas

  5. Health journalists' perceptions of their communities and implications for the delivery of health information in the news.

    PubMed

    Friedman, Daniela B; Tanner, Andrea; Rose, India D

    2014-04-01

    Journalists have a unique opportunity to educate the community about public health and health care. In order for health communication messages to be effective, characteristics of the intended audience must be considered. Limited attention has been given to health journalists' perceptions of their target communities and little is known about how journalists' perceptions may impact the delivery of health information in the news. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographic regions and media market sizes. Interview questions examined health journalists' perceptions of their target communities, the content and delivery of their health-related stories, and the current state of health journalism. Interviews were audio-recorded for transcription and thematic analysis. Health journalists perceived their audiences to be primarily mothers and adults with limited education. Participants reported they often used personal stories and strong headlines to engage their communities. They also stated that their news stories were quite technical and may not have been written at an appropriate reading level for their audience. When asked about the current state of health journalism, participants reported that there were areas for improvement. Journalists stated that increased collaborations with public health practitioners would improve their own understanding of health and medical information and allow them to develop health news content that was more appropriate for their target communities.

  6. Ethnographic approach to community organization and health empowerment.

    PubMed

    Braithwaite, R L; Bianchi, C; Taylor, S E

    1994-01-01

    The purpose of this article is to address pertinent issues relative to the association between community organization and health empowerment methods in ethnic communities of colour. It seeks to address these issues by utilizing ethnographic procedures for documenting community health concerns and by advocating for empowerment for people of colour and their participation in coalition partnerships. Increasingly the importance of citizen participation in the planning, assessment, and implementation of community-based health initiatives has been identified as essential for effective health promotion and disease prevention programs. This article argues for the utility of a community organization approach for achieving health empowerment, and subsequently decreasing the excess deaths in communities of colour. The interface of ethnographic procedures, community organization, and development of community-owned action plans for programming health interventions is discussed.

  7. Spatial Analysis in Support of Community Health Intervention Strategies

    PubMed Central

    Hall, Eric S.; South, Andrew P.; Jones, David E.; Meinzen-Derr, Jareen; Huo, Shuyan; Liu, Lin; Greenberg, James M.

    2012-01-01

    Using vital records and census data representing 165,136 singleton births from 2003–2006, geospatial filtering and density estimates enabled the calculation of preterm birth rates at each geographical point within three urban Ohio counties. Adjusted attributable risk calculations were used to identify risk factors associated with regions of high and low rates of preterm birth. Among the three counties, affected populations varied in size as well as in demographic composition. Variation in the risk factors from one region to another suggests that a single one size fits all intervention strategy would be unlikely to efficiently or effectively impact the complex preterm birth problem. Although more useful in areas with a heterogeneous distribution of preterm birth, application of the presented approach supports the development of efficient community-level health intervention strategies by identifying communities with the highest potential impact and allowing for the prioritization of efforts on specific risk factors within those communities. PMID:23304301

  8. Ethical dilemmas in community mental health care.

    PubMed

    Liégeois, A; Van Audenhove, C

    2005-08-01

    Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care (clients); a life with care versus a life without care (informal carers); stimulation of the client toward greater responsibility versus protection against such responsibility (professionals); budgetary control versus financial incentives (policy makers), and respect for the client versus particular private needs (neighbourhood residents). These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values-namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity.

  9. Community Health Workers as Agents of Health Promotion: Analyzing Thailand's Village Health Volunteer Program.

    PubMed

    Kowitt, S D; Emmerling, D; Fisher, E B; Tanasugarn, C

    2015-08-01

    The village health volunteers (VHVs) have been a regular part of Thailand's health system since the 1960s. Despite widespread recognition, little research has been conducted to describe VHV activities, the settings in which VHVs provide help, how the program is administered, and how changing politics and health problems in Thailand have influenced the program. In order to understand the roles and practices of the VHVs, we conducted in-depth semi-structured interviews and focus groups with VHVs, community leaders and members, and public health officials in three semi-urban communities in central Thailand. Using the Social Ecological Framework, we mapped factors that influenced how the VHVs provided support, including governmental oversight, collaboration with public health officials, and community trust. These influences are discussed as "points of consideration," which help to identify the strengths and tensions within the VHV program and best practices in supporting and assessing community health worker efforts.

  10. Strategies To Empower Communities To Reduce Health Disparities.

    PubMed

    Thompson, Beti; Molina, Yamile; Viswanath, Kasisomayajula; Warnecke, Richard; Prelip, Michael L

    2016-08-01

    Community-based participatory research is a promising approach to reducing health disparities. It empowers individuals and communities to become the major players in solving their own health problems. We discuss the use of community-based participatory research and other strategies to enhance empowerment. We also discuss projects from the Centers for Population Health and Health Disparities that have empowered communities to achieve positive health outcomes aimed at reducing disparities. We offer recommendations to policy makers for involving residents in efforts to achieve health equity. PMID:27503967

  11. Partnerships for health in the African American community: moving toward community-based participatory research.

    PubMed

    Parrill, Rachel; Kennedy, Bernice Roberts

    2011-01-01

    Health disparities related to ethnicity are attributed to the complex interaction of social and physical environments, which influence minority health. The prevalence of health problems such as cardiovascular disease, strokes, diabetes, and maternal and child health outcomes exist among African Americans contributing to health disparities. Extensive support systems within the African American community, however, serve to resist disparities in healthcare and improve the health and well-being of community members. This article is an analytical review of current research addressing key factors of the home, the church, the community, and the healthcare system for creating partnerships to enhance community- based research in the African American community. The results of this literature review provide culturally appropriate approaches to eliminating health disparities by building upon the strengths and resources within the African American community. Best practices involve recognizing the pastor as the entry into the community, utilizing a Community-Based Participatory Research process, and establishing trust through open communication and relationship building.

  12. Psychology in the community: a community psychologist looks at 30 years in community mental health.

    PubMed

    Morgan, John R

    2008-01-01

    I review my 30 years in the community mental health field, emphasizing the personal and historical context that shaped this career. I especially highlight the origins of the values that guided significant career decisions, including family, neighborhood, religious and educational influences. The core guiding value was the belief that public service is both a privilege and an obligation, and that righting social injustice through such service is a noble calling. I trace the evolution of my thoughts and actions reflecting this value, from an early desire to "help children," through preparation to become a child psychologist, and ultimately to practice in a public community mental health setting and a career dedicated first to primary prevention and then to broader safety net services for those in need. I highlight a corresponding intellectual evolution as well, a progressive change in identity from "clinical psychologist in the community" to community psychologist.

  13. Psychology in the community: a community psychologist looks at 30 years in community mental health.

    PubMed

    Morgan, John R

    2008-01-01

    I review my 30 years in the community mental health field, emphasizing the personal and historical context that shaped this career. I especially highlight the origins of the values that guided significant career decisions, including family, neighborhood, religious and educational influences. The core guiding value was the belief that public service is both a privilege and an obligation, and that righting social injustice through such service is a noble calling. I trace the evolution of my thoughts and actions reflecting this value, from an early desire to "help children," through preparation to become a child psychologist, and ultimately to practice in a public community mental health setting and a career dedicated first to primary prevention and then to broader safety net services for those in need. I highlight a corresponding intellectual evolution as well, a progressive change in identity from "clinical psychologist in the community" to community psychologist. PMID:18227052

  14. Retirement Function and Community Growth in Michigan Nonmetropolitan Areas.

    ERIC Educational Resources Information Center

    Wang, Ching-li; Beegle, J. Allan

    In an effort to determine the extent to which the development of the retirement function can contribute to growth and development of rural communities, 42 counties not adjacent to Standard Metropolitan Statistical Areas in Michigan were studied. The retirement function was treated as a specialized community function, parallel to specialization…

  15. Community Support Programs in Rural Areas: Developing Programs without Walls.

    ERIC Educational Resources Information Center

    Sullivan, William Patrick

    1989-01-01

    Describes "program without walls" for developing community services in rural areas. Emphasizes importance of creative collaboration and redesign of traditional support programs to offer comprehensive community services tailored to needs of rural families and individuals. Suggests practical applications of "without walls" model. (Author/TES)

  16. Function Model for Community Health Service Information

    NASA Astrophysics Data System (ADS)

    Yang, Peng; Pan, Feng; Liu, Danhong; Xu, Yongyong

    In order to construct a function model of community health service (CHS) information for development of CHS information management system, Integration Definition for Function Modeling (IDEF0), an IEEE standard which is extended from Structured Analysis and Design(SADT) and now is a widely used function modeling method, was used to classifying its information from top to bottom. The contents of every level of the model were described and coded. Then function model for CHS information, which includes 4 super-classes, 15 classes and 28 sub-classed of business function, 43 business processes and 168 business activities, was established. This model can facilitate information management system development and workflow refinement.

  17. Ethical issues in community health care.

    PubMed

    Sivayogan, S

    1992-06-01

    Health care professionals are expected to base their practice on a set of ethical principles, including truthfulness, beneficence, nonmaleficence, justice, and confidentiality. Dilemmas can arise, however, when a medical professional is called upon to act in opposition to personal values or in cases where the values of patient, health care worker, and sponsoring institution conflict. The author outlines several of the ethical dilemmas that have arisen in community medicine in Sri Lanka. Since preventive medicine is based on the assumption that protection of public health is primary, individual rights and freedom of choice may be overruled, as, for example, in the case of mandatory testing and isolation for communicable diseases. Numerous ethical dilemmas arise in family planning, including whether physicians are mandated to refuse women a permanent method of fertility control when the required spousal consent has not been obtained. In these cases, the physician must weigh the administrative requirement for spousal consent against the principle of physician-patient confidentiality. Physicians are also placed in a difficult situation when patients request Depo-Provera--a contraceptive method that has been banned in the US due to its side effects but remains available in Sri Lanka--or postcoital contraception given the illegality of abortion in the country. Throughout the Third World, physicians constantly encounter challenges to the ethical principle of just, equitable distribution of health care resources.

  18. Developing Interactive Video Resource Materials for Community Dental Health.

    ERIC Educational Resources Information Center

    Bartoli, Claire; And Others

    1986-01-01

    Describes the creation of a series of interactive video modules on dental hygiene at Luzerne County Community College. These modules are intended to supplement instruction in a community dentistry and health education course and to guide students in an assignment to develop and implement dental health projects in their community. (MBR)

  19. John C. Lincoln Health Network recognized for community service. Phoenix institution wins prestigious Foster G. Mcgaw Prize.

    PubMed

    Rees, Tom

    2003-01-01

    John C. Lincoln Health Network, Phoenix, was awarded the Foster G. McGaw Prize for excellence in community service, one of the healthcare field's most prestigious honors. The network serves a broad geographic area and nearly a dozen communities. Those communities most challenged by poverty, hunger, poor housing and crime are the focus of most of the health network's efforts.

  20. Using an academic-community partnership model and blended learning to advance community health nursing pedagogy.

    PubMed

    Ezeonwu, Mabel; Berkowitz, Bobbie; Vlasses, Frances R

    2014-01-01

    This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery.

  1. The religious community as a partner in health care.

    PubMed

    Olson, L M; Reis, J; Murphy, L; Gehm, J H

    1988-01-01

    In-depth structured interviews were conducted with spokespeople for 176 inner-city churches regarding perceptions of existing community problems, number of currently offered church-based social and health programs, and potential interest in church sponsorship of new maternal and child health programs. The sample of respondents represented 78% of the 227 churches located in a low-income, primarily black urban area with 150,000 residents. The typical church participating in the survey was Baptist with a congregation of 100 to 500 people, most of whom were not community residents. The leading community problems identified by the clergy were, in descending order: lack of jobs, teenage pregnancy, gang crime, school drop-outs, and hunger. The perception of community problems matched the church services offered as measured by the number of food and clothing pantries. Few churches had ongoing programs for neighborhood youths. Although many of these same churches expressed interest in expanding services for mothers, adolescents and children, few perceived themselves as having the necessary staff, funds, or technical expertise to conduct such programs. PMID:3235715

  2. Deadly Choices™ community health events: a health promotion initiative for urban Aboriginal and Torres Strait Islander people.

    PubMed

    Malseed, Claire; Nelson, Alison; Ware, Robert; Lacey, Ian; Lander, Keiron

    2014-01-01

    The present study was an evaluation of the effectiveness of Deadly Choices™ community events for improving participants' short-term knowledge of chronic disease and risk factors, and increasing community engagement with local health services. Surveys were completed directly before and after participating in health education activities (pre and post surveys, respectively) assessing knowledge of chronic diseases and risk factors at three Deadly Choices community events and four National Aboriginal and Islander Day Observance Committee (NAIDOC) events in south-east Queensland where Deadly Choices health education activities took place. An audit trail was conducted at two Deadly Choices community events in Brisbane to identify the proportion of participants who undertook a health screen at the event who then followed up for a Medicare-funded health check (MBS item 715) or other appointment at an Aboriginal and Torres Strait Islander clinic in the local area within 2 months. Results were compared with a sample of participants who attended one Deadly Choices community event but did not complete a health screen. There were 472 community members who completed a pre and post survey. All knowledge scores significantly improved between baseline and follow up. Although based on a small sample, the audit trail results suggest individuals who participated in a health screen at the community day were approximately twice as likely to go back to a clinic to receive a full health check or have an alternative appointment compared with attendees who did not participate in a screen. Community events that include opportunities for health education and health screening are an effective strategy to improve chronic disease health literacy skills and appear to have the potential to increase community engagement with local Aboriginal and Torres Strait Islander health services. PMID:25262748

  3. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  4. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  5. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  6. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  7. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  8. Research collaboration in health management research communities

    PubMed Central

    2013-01-01

    Background This study uses scientometrics methodology to reveal the status quo and emerging issues of collaboration in health management. Methods We searched all the articles with the keyword “health management” in the period 1999–2011 in Web of Knowledge, then 3067 articles were found. Methods such as Social network analysis (SNA), co-authorship, co-word analysis were used in this study. Results Analysis of the past 13 years of research in the field of health management indicates that, whether the production of scientific research, or authors, institutions and scientific research collaboration at the national level, collaboration behavior has been growing steadily across all collaboration types. However, the international scientific research cooperation about health management study between countries needs to be further encouraged. 17 researchers can be seen as the academic leaders in this field. 37 research institutions play a vital role in the information dissemination and resources control in health management. The component analysis found that 22 research groups can be regarded as the backbone in this field. The 8 institution groups consisting of 33 institutions form the core of this field. USA, UK and Australia lie in the center by cohesive subgroup analysis; Based on keywords analysis, 44 keywords with high frequency such as care, disease, system and model were involved in the health management field. Conclusions This study demonstrates that although it is growing steadily, collaboration behavior about health management study needs to be enhanced, especially between different institutions or countries/regions, which would promote the progress and internationalization of health management. Besides, researchers should pay attention to the cooperation of representative scholars and institutions, as well as the hot areas of research, because their experience would help us promote the research development of our nation. PMID:23617236

  9. National Study on Community College Health. Research Brief.

    ERIC Educational Resources Information Center

    Ottenritter, Nan

    This is a report on a national survey of community colleges conducted by the American Association of Community Colleges (AACC) in 2000. The survey was designed to identify various community health programs, centers, classes, and services related to HIV/AIDS that community colleges administered, partnered, or sponsored. The study surveyed 1,100…

  10. "Race" and Community Care. "Race," Health and Social Care Series.

    ERIC Educational Resources Information Center

    Ahmad, Waqar I. U., Ed.; Atkin, Karl, Ed.

    This collection offers a wide-ranging introduction to contemporary issues surrounding the health care needs of members of minority ethnic communities within the framework of community care in Britain. The following chapters consider state welfare, minority communities, family structures, and social change: (1) "'Race' and Community Care: An…

  11. Community and environmental health effects of concentrated animal feeding operations.

    PubMed

    Kirkhorn, Steven R

    2002-10-01

    High-density concentrated animal feeding operations (CAFOs) have become an increasing source of concern with respect to their impact on health, the environment, and quality of life in the communities in which they are located. A growing body of literature has identified a number of potential adverse effects, including the development of antimicrobial resistance patterns, groundwater contamination, and occupational respiratory disease. The odor associated with CAFOs has had a detrimental effect on the quality of life of rural residents, and there may also be associated adverse health effects. Physicians in rural areas may be asked to assess patients with concerns related to neighboring CAFOs and may be drawn into a political battle regarding the authorization of the development of additional CAFOs. This article reviews current research on the community, environmental, and occupational health effects associated with high-density animal production facilities. It also discusses recommendations for evaluating patients affected by CAFO odors and steps to decrease occupational and community exposure. PMID:12416314

  12. Evaluating Community-Based Participatory Research to Improve Community-Partnered Science and Community Health

    PubMed Central

    Hicks, Sarah; Duran, Bonnie; Wallerstein, Nina; Avila, Magdalena; Belone, Lorenda; Lucero, Julie; Magarati, Maya; Mainer, Elana; Martin, Diane; Muhammad, Michael; Oetzel, John; Pearson, Cynthia; Sahota, Puneet; Simonds, Vanessa; Sussman, Andrew; Tafoya, Greg; Hat, Emily White

    2013-01-01

    Background Since 2007, the National Congress of American Indians (NCAI) Policy Research Center (PRC) has partnered with the Universities of New Mexico and Washington to study the science of community-based participatory research (CBPR). Our goal is to identify facilitators and barriers to effective community–academic partnerships in American Indian and other communities, which face health disparities. Objectives We have described herein the scientific design of our National Institutes of Health (NIH)-funded study (2009–2013) and lessons learned by having a strong community partner leading the research efforts. Methods The research team is implementing a mixed-methods study involving a survey of principal investigators (PIs) and partners across the nation and in-depth case studies of CBPR projects. Results We present preliminary findings on methods and measures for community-engaged research and eight lessons learned thus far regarding partnership evaluation, advisory councils, historical trust, research capacity development of community partner, advocacy, honoring each other, messaging, and funding. Conclusions Study methodologies and lessons learned can help community–academic research partnerships translate research in communities. PMID:22982842

  13. Identifying Value Indicators and Social Capital in Community Health Partnerships

    ERIC Educational Resources Information Center

    Hausman, Alice J.; Becker, Julie; Brawer, Rickie

    2005-01-01

    Increasingly, public health practice is turning to the application of community collaborative models to improve population health status. Despite the growth of these activities, however, evaluations of the national demonstrations have indicated that community health partnerships fail to achieve measurable results and struggle to maintain integrity…

  14. Appalachian Women's Perceptions of Their Community's Health Threats

    ERIC Educational Resources Information Center

    Schoenberg, Nancy E.; Hatcher, Jennifer; Dignan, Mark B.

    2008-01-01

    Context: Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose: We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to…

  15. Facilitating communities in designing and using their own community health impact assessment tool

    SciTech Connect

    Cameron, Colleen; Ghosh, Sebanti; Eaton, Susan L.

    2011-07-15

    Reducing health inequities and improving the health of communities require an informed public that is aware of the social determinants of health and how policies and programs have an impact on the health of their communities. People Assessing Their Health (PATH) is a process that uses community-driven health impact assessment to build the capacity of people to become active participants in the decisions that affect the well-being of their community. The PATH process is both a health promotion and a community development approach that builds people's ability to bring critical analysis to a situation and to engage in effective social action to bring about desired change. Because it increases analytical skills and provides communities with their own unique tool to assess the potential impact of projects, programs or policies on the health and well-being of their community it is an empowering process. PATH was originally used in three communities in northeastern Nova Scotia, Canada in 1996 when the Canadian health care system was being restructured to a more decentralized system. Since then it has been used in other communities in Nova Scotia and India. This paper will describe the PATH process and the use of the community health impact assessment as well as the methodology used in the PATH process. The lessons learned from PATH's experiences of building capacity among the community in Canada and India will be presented.

  16. Globalization, socioeconomic restructuring, and community health.

    PubMed

    Waters, W F

    2001-04-01

    New trends in global public health have social, economic, and political underpinnings that can be found in three 20th century revolutions: globalization, a new epidemiological transition, and an historical shift in patterns of production and consumption throughout the world. Globalization is more than the internationalization of commerce and manufacture; it represents a new development paradigm that creates new links among corporations, international organizations, governments, communities, and families. Social and economic restructuring is reflected in the emerging health profile in underdeveloped countries, including those in Latin America. This emerging profile defies simple categorization, however; while the prevalence of cardiovascular disease and cancer has increased, the traditional diseases (infectious and respiratory disease) are still the leading cause of death. At the same time, industrialized countries are experiencing the re-emergence of those same traditional diseases. These apparent anomalies can be understood by examining class structures within and among countries and by linking health outcomes at the local level to new patterns of production and consumption in the global system. PMID:11322756

  17. Using Community Health Assessment to Teach and Explore Health Status Disparities

    ERIC Educational Resources Information Center

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  18. Health promotion or community development? Health communication or DevCom? Who's confused?

    PubMed

    James, R W; Howat, P; Binns, C

    1998-01-01

    A high prevalence of xerophthalmia, abnormal dryness of the eyeball, was reduced in a Mumbai (Bombay) squatter area by improving the nutritional status of children under age 5 years and reducing the prevalence of malnutrition among women and children. To achieve these results, the project improved women's status, trained community health workers, motivated and mobilized communities to improve environmental conditions and prevent morbidity, increased women's literacy, taught mothers about nutrition and health care, expanded the sale of vitamin A-enriched vegetables through door-to-door vendors, provided income generation training to enable women to buy vitamin A-rich foods, organized a supplementary feeding program for malnourished children, and maintained horticultural activities such as a demonstration garden to motivate women to grow dark green leaf vegetables. This intervention was supported by locally appropriate IEC activities. The authors consider whether the intervention was community development, health promotion, or both. The core assumptions between community development and health promotion are considered, with discussion of the implications for communication training and practice. 3 priorities for action are suggested. PMID:12295217

  19. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community

    PubMed Central

    Lee, Benjamin J.; So, Chunkit; Chiu, Brandon G.; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-01-01

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  20. Promotores de salud and community health workers: an annotated bibliography.

    PubMed

    WestRasmus, Emma K; Pineda-Reyes, Fernando; Tamez, Montelle; Westfall, John M

    2012-01-01

    For underserved and disenfranchised communities in the United States, affordable, effective health care can be nearly inaccessible, which often leads to the exclusion of these communities from relevant medical information and care. Barriers to care are especially salient in minority communities, where language, traditions and customs, socioeconomics, and access to education can serve as additional roadblocks to accessing health care information and services. These factors have contributed to a national health disparity crisis that unnecessarily places some communities in a vulnerable position without adequate prevention and treatment opportunities. One solution to the exclusion some communities face in the health care system may be the promotores de salud (PdS)/community health worker (CHW), an approach to culturally competent health care delivery whose popularity in the mainstream health care system has been steadily growing in recent decades. Known by a wide variety of names and broad in the spectrum of health issues they address, the PdS/CHW serves as cultural brokers between their own community and the formal health care system and can play a crucial role in promoting health and wellness within their community. This annotated bibliography was created to educate the reader about the history, definition, key features, utility, outcomes, and broad potential of the CHW approach in a variety of populations. Intended to serve as a reference point to a vast body of information on the CHW/PdS approach, this document is a resource for those wishing to effect change in the disparities within the health care system, and to improve the access to, quality, and cost of health care for underserved patients and their communities. Promotores de Salud is a Spanish term that translates to Health Promoter. A female health worker may be referred to as a Promotora, a male as a Promotor, and the plural of both is Promotores. For the purposes of this bibliography, the terms community

  1. A Community Health Education System to meet the health needs of Indo-Chinese women.

    PubMed

    Ratnaike, R N; Chinner, T L

    1992-04-01

    This paper presents a Community Health Education System which is cost-effective, sustainable, strongly community-based, and directed at improving the health status of rural women in Indo-china (Kampuchea, Laos and Vietnam). The system is developed through a series of steps which are concerned with the education of Community Health Education Units (in national ministries of health) and, at the village level, among community health workers, women's groups, and other women. The ultimate aim is the establishment of a community health education program in Indochinese villages. PMID:1602046

  2. Growing urban health: community gardening in South-East Toronto.

    PubMed

    Wakefield, Sarah; Yeudall, Fiona; Taron, Carolin; Reynolds, Jennifer; Skinner, Ana

    2007-06-01

    This article describes results from an investigation of the health impacts of community gardening, using Toronto, Ontario as a case study. According to community members and local service organizations, these gardens have a number of positive health benefits. However, few studies have explicitly focused on the health impacts of community gardens, and many of those did not ask community gardeners directly about their experiences in community gardening. This article sets out to fill this gap by describing the results of a community-based research project that collected data on the perceived health impacts of community gardening through participant observation, focus groups and in-depth interviews. Results suggest that community gardens were perceived by gardeners to provide numerous health benefits, including improved access to food, improved nutrition, increased physical activity and improved mental health. Community gardens were also seen to promote social health and community cohesion. These benefits were set against a backdrop of insecure land tenure and access, bureaucratic resistance, concerns about soil contamination and a lack of awareness and understanding by community members and decision-makers. Results also highlight the need for ongoing resources to support gardens in these many roles.

  3. Diabetes Training for Community Health Workers

    PubMed Central

    Aponte, Judith

    2016-01-01

    Background A 2.5-month diabetes education training for community health workers (CHWs) was developed, implemented, and evaluated. Methods Training methods used included case studies, role-playing, and lectures. Exams were used throughout the training for its evaluation. Teaching was delivered by different ways: a one day American Diabetes Association (ADA) course; a five day Diabetes Self-Management Program (DSMP); Conversation Maps; and a series of seven National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes education booklets. Results Qualitative and quantitative evaluative methods were used during and after the training. The CHWs’ diabetes knowledge was evaluated by a pre- and post-test Diabetes Knowledge Questionnaire (DKQ). The post-test was conducted one week after completing the training. The findings showed that the diabetes knowledge of the CHWs increased. Conclusions Diabetes competencies and evaluative tools need to be developed specific for CHWs as a way to standardize all CHW diabetes trainings. PMID:27110434

  4. Identity Theft in Community Mental Health Patients

    PubMed Central

    Klopp, Jonathon; Konrad, Shane; Yanofski, Jason

    2007-01-01

    Identity theft is a serious problem in the United States, and persons with enduring mental illnesses may be particularly vulnerable to becoming victims of this crime. Victims of identity theft experience a variety of consequences that include financial loss and serious emotional distress. Little is known about the impact of identity theft on individuals with mental illnesses. The two cases from a community mental health center presented in this article demonstrate many of the facets that may be associated with an increased risk for becoming the victim of identity theft. A summary of preventive steps as well as steps involved in resolving the crime once one has become a victim are presented. PMID:20806029

  5. Screening for Antepartum Depression Through Community Health Outreach in Swaziland.

    PubMed

    Målqvist, Mats; Clarke, Kelly; Matsebula, Themba; Bergman, Mattias; Tomlinson, Mark

    2016-10-01

    Maternal depression, including antepartum and postpartum depression, is a neglected public health issue with potentially far-reaching effects on maternal and child health. We aimed to measure the burden of antepartum depression and identify risk factors among women in a peri-urban community in Swaziland. We conducted a cross-sectional study within the context of a community outreach peer support project involving "Mentor Mothers". We used of the Edinburgh Postnatal Depression Scale (EPDS) to screen women for depression during the third trimester of pregnancy, using a cut-off score of ≥13 to indicate depression. We also collected demographic and socioeconomic factors, and assessed the association of these factors with EPDS score using logistic regression models. A total of 1038 pregnant women were screened over a period of 9 months. Almost a quarter (22.7 %) had EPDS scores ≥13 and 41.2 % were HIV positive. A fifth, 17.5 % were teenagers and 73.7 % were unemployed. Depression was not associated with HIV status, age or employment status. However, women with multiple socioeconomic stressors were found to be more likely to score highly on the EPDS. Depression was common among pregnant women in the peri-urban areas of Swaziland. Screening for depression using the EPDS is feasible and can be included in the community health worker standard tool box as a way to improve early detection of depression and to highlight the importance of maternal mental health as a core public health concern.

  6. Boston's Codman Square Community Partnership for Health Promotion.

    PubMed Central

    Schlaff, A L

    1991-01-01

    The Codman Square Community Partnership for Health Promotion is a program designed to promote changes in individual behavior and community relationships to reduce the morbidity and mortality associated with the many problems affecting poor, minority communities in the United States. Problems of particular concern to be addressed by the program include violence, injuries, substance abuse, acquired immunodeficiency syndrome (AIDS), infant mortality, child abuse and neglect, and cardiovascular disease. The failure of traditional health promotion approaches to poor communities has created a literature supporting community-based action directed at broad social forces. The Codman Square Community Partnership for Health Promotion uses a variety of models--community participation, community organization, empowerment education, and community-oriented primary care--to encourage new coalitions that can ameliorate the social isolation and health-averse social norms linked to poverty and poor health. The program uses local residents trained as lay health workers to deliver home-based health services and to help create the necessary partnerships, linkages, and communication networks to foster the reorganization of the community to better address its health problems. PMID:1902312

  7. A model for community health care in rural Java.

    PubMed

    Hendrate, L

    1981-01-01

    This article describes a method of conveying health care to poor villages by training residents for part-time voluntary service, combined with localized health insurance covering both local medicines and the fees for a nearby health center. The project began under the auspices of the Foundation for Christian Hospitals in Hurakarta, in Central Java. The village of Klampok has a population of 5,614, mostly farm workers. Health services are supplied by the Emmanuel Health Center. Although the program was granted funds for jeeps, buildings, instruments, and personnel, the center lacked community participation. Health workers developed a strategy of communication and understanding of the village to encourage participation. Implementation of the strategy included 2 elements: the village health cadre, voluntary workers from the community selected by the community; and the village health insurance scheme, in which each household partially pays for the overall health service, and credit is extended. Rather than being distributors of health care, the project staff sees itself as a stimulant and enabler of the community being able to accept the responsibility of handling its own health problems. This Indonesian experience has proven itself replicable in that health cadre systems have spread to several surrounding villages. To make community health care participation a viable plan both the health personnel and community leaders need to be oriented and motivated to the idea. PMID:12278505

  8. Community-based Teaching about Health Disparities: Combining Education, Scholarship, and Community Service

    PubMed Central

    Peek, Monica E.; Jacobs, Elizabeth; Horowitz, Carol R.

    2010-01-01

    The Institute of Medicine recommends that clinicians receive training to better understand and address disparities. While disparities in health status are primarily due to inequities in social determinants of health, current curricula largely focus on how to teach about disparities within the health care setting. Learners may more fully understand and appreciate how social contextual factors contribute to disparities through instruction about disparities in community settings. Community-based teaching about health disparities may be advantageous for learners, medical institutions, and participating communities. This manuscript aims to guide medical educators in teaching students and residents about health disparities through community-based activities, including service learning and research. PMID:20352507

  9. Communities and health policy: a pathway for change.

    PubMed

    Bell, Judith; Standish, Marion

    2005-01-01

    Improving the health system can reduce the effects of health disparities, but it can do little to eliminate them. An upsurge in new research is documenting the impact of physical, social, and economic environmental factors: air quality, housing conditions, racism, relationship to community institutions, and neighborhood economic conditions, all of which affect health status over time. A combined focus on community and the policies that affect communities' environments presents opportunities for altering and ameliorating the underlying forces at the heart of the determinants of health. This Perspective presents examples of successful community involvement and policy change.

  10. HealthPartners adopts community business model to deepen focus on nonclinical factors of health outcomes.

    PubMed

    Isham, George J; Zimmerman, Donna J; Kindig, David A; Hornseth, Gary W

    2013-08-01

    Clinical care contributes only 20 percent to overall health outcomes, according to a population health model developed at the University of Wisconsin. Factors contributing to the remainder include lifestyle behaviors, the physical environment, and social and economic forces--all generally considered outside the realm of care. In 2010 Minnesota-based HealthPartners decided to target nonclinical community health factors as a formal part of its strategic business plan to improve public health in the Twin Cities area. The strategy included creating partnerships with businesses and institutions that are generally unaccustomed to working together or considering how their actions could help improve community health. This article describes efforts to promote healthy eating in schools, reduce the stigma of mental illness, improve end-of-life decision making, and strengthen an inner-city neighborhood. Although still in their early stages, the partnerships can serve as encouragement for organizations inside and outside health care that are considering undertaking similar efforts in their markets.

  11. Area health education centers and health science library services.

    PubMed Central

    West, R T; Howard, F H

    1977-01-01

    A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication. PMID:884349

  12. Area health education centers and health science library services.

    PubMed

    West, R T; Howard, F H

    1977-07-01

    A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.

  13. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study

    PubMed Central

    Hayter, Arabella K. M.; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

    2015-01-01

    Background Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. Design We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Results Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. Conclusions In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years. PMID:25669238

  14. Using health information technology to engage communities in health, education, and research

    PubMed Central

    Marriott, Lisa K.; Nelson, David A.; Allen, Shauntice; Calhoun, Karen; Eldredge, Christina E.; Kimminau, Kim S.; Lucero, Robert J.; Pineda-Reyes, Fernando; Rumala, Bernice B.; Varanasi, Arti P.; Wasser, June S.; Shannon, Jackilen

    2012-01-01

    The August 2011 Clinical & Translational Science Awards (CTSA) conference Using IT to Improve Community Health: How Health Care Reform Supports Innovation, convened four “think tank” sessions. Thirty individuals, representing various perspectives on community engagement, attended the Health Information Technology (HIT) as a Resource to Improve Community Health and Education session, which focused on using HIT to improve patient health, education, and research involvement. Participants discussed a range of topics using a semi-structured format. This article describes themes and lessons that emerged from that session, with a particular focus on using HIT to engage communities in order to improve health and reduce health disparities in populations. PMID:22301550

  15. Health promotion community development and the tyranny of individualism.

    PubMed

    Shiell, A; Hawe, P

    1996-01-01

    Economic evaluation of health promotion poses few major difficulties when the theoretical approach of the programme and the evaluation of cost and benefits are confined within the context of the individual. Methodological individualism has a long history in economics and the techniques of microeconomics are well suited to the examination of individually focused behaviour change programmes. However, new developments in community health promotion pose special challenges. These programmes have the community, not the individual, as the focus of programme theory and "community' means something completely different from the sum of individuals. Community empowerment and promotion of the community's capacity to deal with health issues are the goals of such programmes. To reflect these notions, sense of community and community competence should be considered as "functionings', an extra-welfarist constituent of well-being. Their inclusion as outcomes of community health promotion requires a shift from individualist utilitarian economics into a communitarian framework which respects the programme's notion of community. If health economics fails to develop new constructs to deal with these new approaches in health promotion, the application of existing techniques to community programmes will mislead health decision makers about their value and potential. PMID:8817298

  16. Health promotion community development and the tyranny of individualism.

    PubMed

    Shiell, A; Hawe, P

    1996-01-01

    Economic evaluation of health promotion poses few major difficulties when the theoretical approach of the programme and the evaluation of cost and benefits are confined within the context of the individual. Methodological individualism has a long history in economics and the techniques of microeconomics are well suited to the examination of individually focused behaviour change programmes. However, new developments in community health promotion pose special challenges. These programmes have the community, not the individual, as the focus of programme theory and "community' means something completely different from the sum of individuals. Community empowerment and promotion of the community's capacity to deal with health issues are the goals of such programmes. To reflect these notions, sense of community and community competence should be considered as "functionings', an extra-welfarist constituent of well-being. Their inclusion as outcomes of community health promotion requires a shift from individualist utilitarian economics into a communitarian framework which respects the programme's notion of community. If health economics fails to develop new constructs to deal with these new approaches in health promotion, the application of existing techniques to community programmes will mislead health decision makers about their value and potential.

  17. Moving health promotion communities online: a review of the literature.

    PubMed

    Sunderland, Naomi; Beekhuyzen, Jenine; Kendall, Elizabeth; Wolski, Malcom

    2013-01-01

    There is a need to enhance the effectiveness and reach of complex health promotion initiatives by providing opportunities for diverse health promotion practitioners and others to interact in online settings. This paper reviews the existing literature on how to take health promotion communities and networks into online settings. A scoping review of relevant bodies of literature and empirical evidence was undertaken to provide an interpretive synthesis of existing knowledge on the topic. Sixteen studies were identified between 1986 and 2007. Relatively little research has been conducted on the process of taking existing offline communities and networks into online settings. However, more research has focused on offline (i.e. not mediated via computer networks); 'virtual' (purely online with no offline interpersonal contact); and 'multiplex' communities (i.e. those that interact across both online and offline settings). Results are summarised under three themes: characteristics of communities in online and offline settings; issues in moving offline communities online, and designing online communities to match community needs. Existing health promotion initiatives can benefit from online platforms that promote community building and knowledge sharing. Online e-health promotion settings and communities can successfully integrate with existing offline settings and communities to form 'multiplex' communities (i.e. communities that operate fluently across both online and offline settings).

  18. Communities within Communities: Changing "Residential" Areas at Cultus Lake, British Columbia.

    ERIC Educational Resources Information Center

    Halseth, Greg

    1993-01-01

    A community survey examined socioeconomic characteristics and community participation patterns in a rural Canadian area in which recreational cottages were being converted to full-time homes by urban retirees. Compared to long-time residents, "converters" were more likely to be older and more educated, to have no children at home, and to have a…

  19. Loneliness, Social Relations and Health and Wellbeing in Deprived Communities

    PubMed Central

    Kearns, Ade; Whitley, Elise; Tannahill, Carol; Ellaway, Anne

    2015-01-01

    There is growing policy concern about the extent of loneliness in advanced societies, and its prevalence among various social groups. This study looks at loneliness among people living in deprived communities, where there may be additional barriers to social engagement including low incomes, fear of crime, poor services and transient populations. The aim was to examine the prevalence of loneliness, and also its associations with different types of social contacts and forms of social support, and its links to self-reported health and wellbeing in the population group. The method involved a cross-sectional survey of 4,302 adults across 15 communities, with the data analysed using multinomial logistic regression controlling for sociodemographics, then for all other predictors within each domain of interest. Frequent feelings of loneliness were more common among those who: had contact with family monthly or less; had contact with neighbours weekly or less; rarely talked to people in the neighbourhood; and who had no available sources of practical or emotional support. Feelings of loneliness were most strongly associated with poor mental health, but were also associated with long-term problems of stress, anxiety and depression, and with low mental wellbeing, though to a lesser degree. The findings are consistent with a view that situational loneliness may be the product of residential structures and resources in deprived areas. The findings also show that neighbourly behaviours of different kinds are important for protecting against loneliness in deprived communities. Familiarity within the neighbourhood, as active acquaintance rather than merely recognition, is also important. The findings are indicative of several mechanisms that may link loneliness to health and wellbeing in our study group: loneliness itself as a stressor; lonely people not responding well to the many other stressors in deprived areas; and loneliness as the product of weak social buffering to

  20. Promoting community based approaches to social infrastructure provision in urban areas in Nigeria.

    PubMed

    Uduku, N O

    1994-10-01

    Inadequate social infrastructure provision--in terms of education, health care facilities, and water and sanitation--has become a critical issue in Nigeria's urban areas. The decline of the Nigerian economy and the introduction of economic structural adjustment have curtailed drastically government spending on these services. Recommended is a return to the regional community-based approaches that prevailed in earlier periods. In precolonial Nigeria, the community help ethic ensured that all societies had adequate social infrastructure. With colonization and the emergence of an urban cash economy, the government took control of service provision in urban areas; in rural areas, neglected by government, self-help efforts continued to flourish. The trend in recent decades has been toward the privatization of urban services, deregulation, and growing inequities between affluent urban dwellers and the urban and rural poor. The recommended localization strategy would involve the creation of regional bodies to provide public utilities and regulate social infrastructure provision. Responsibility for the organization and provision of these services would rest with democratically elected community associations in rural areas and municipal councils in urban areas. The needs of poor communities could be funded by cross-subsidizing utility costs among affluent communities. Such a strategy, although unlikely to be supported by government and urban elites, would revitalize the community responsibility ethos that was lost in the urbanization process. PMID:12289002

  1. Promoting community based approaches to social infrastructure provision in urban areas in Nigeria.

    PubMed

    Uduku, N O

    1994-10-01

    Inadequate social infrastructure provision--in terms of education, health care facilities, and water and sanitation--has become a critical issue in Nigeria's urban areas. The decline of the Nigerian economy and the introduction of economic structural adjustment have curtailed drastically government spending on these services. Recommended is a return to the regional community-based approaches that prevailed in earlier periods. In precolonial Nigeria, the community help ethic ensured that all societies had adequate social infrastructure. With colonization and the emergence of an urban cash economy, the government took control of service provision in urban areas; in rural areas, neglected by government, self-help efforts continued to flourish. The trend in recent decades has been toward the privatization of urban services, deregulation, and growing inequities between affluent urban dwellers and the urban and rural poor. The recommended localization strategy would involve the creation of regional bodies to provide public utilities and regulate social infrastructure provision. Responsibility for the organization and provision of these services would rest with democratically elected community associations in rural areas and municipal councils in urban areas. The needs of poor communities could be funded by cross-subsidizing utility costs among affluent communities. Such a strategy, although unlikely to be supported by government and urban elites, would revitalize the community responsibility ethos that was lost in the urbanization process.

  2. Pharmacy assistance programs in a community health center setting.

    PubMed Central

    Torres, Maxsimo C.; Herman, Debra; Montano, Seferino; Love, Leah

    2002-01-01

    Prescription drug costs represent the fastest growing item in health care and are a driving force in rapidly increasing health care costs. Community health centers serve an indigent population with limited access to pharmaceuticals. Pharmaceutical companies sponsor patient assistance programs. These pharmacy assistance programs can be developed to facilitate the provision of needed pharmaceuticals to this vulnerable population. La Casa de Buena Salud is a rural community health center in eastern New Mexico, which has provided access to a substantial amount of pharmaceuticals to indigent patients through patient assistance programs. Cost savings potential are considerable for a community health center and for patients when a pharmacy assistance program is organized efficiently and employed systematically. Secondary benefits are derived from the entire medical community. While some community health centers currently make effective use of pharmaceutical company-sponsored pharmacy assistance programs, a comprehensive, long-term approach at a national level may be required. PMID:12510707

  3. [Utilisation of community health centres in Koulikoro region, Mali].

    PubMed

    Sidibé, T; Sangho, H; Doumbia, S; Coulibaly, L; Kéïta, H D

    2008-01-01

    In Mali since the adoption of community health center (CSCOM) politics, their number knew a progression remarkable: 370 in 1998 and 660 in the end of 2003. Concerning the health staff, the ratio always remained per capita weak in relation to the international norms. In 2001 for the first level of health center, the quantum was: 1 physician for 14,612 inhabitants (norm being of 1/10,000); 1 nurse for 13,989 inhabitants (WHO norm being of 1/10,000). In spite of the well stocked efforts, the foreseen objectives are far from being reached. For example, the used rate of curative consultation was of 0.19 new contact/year/inhabitant. The foreseen objective is of 0.50. Our survey had as objectives to study the reasons of CSCOM's under frequenting, to identify the reasons and to propose some recommendations to improve the situation. We conducted a cross-sectional study that had taken place in Banamba and Dioïla in the Koulikoro's region in April 19 to May 8, 2004. Interview have been performed with the head of CSCOM, the CSCOM's staff, the persons responsible of community health association (ASACO), the mothers residing in the areas at least six months and having a child less than 5 years and the community leaders. We found that women in Banamba (89%) frequented the CSCOM more that those of Dioïla (60%). The reasons of the CSCOM's under frequenting are especially bound to the staff's instability, the geographical accessibility, to poverty and to the insufficiency of information. We recommend to the different actors to inform and to sensitize the population on the importance of the CSCOM's activities, to the state to take the staff's part in charge to improve their stability, in the ASACO to establish the contracts of work with the staff. PMID:19617149

  4. Lessons Learnt From the Model of Instructional System for Training Community Health Workers in Rural Health Houses of Iran

    PubMed Central

    Rahbar, Mohammadreza; Ahmadi, Mina

    2015-01-01

    Background: Many experts believe that the “health houses” of Iran have had major effects in increasing health status of Iranian rural community. One of the factors, which was critical to this success is the employment of young women and men from rural communities who serve as multipurpose health workers. They participate in a two-year task-oriented training course. Objectives: The purpose of this article was to describe the model of training behvarzes as the community health workers who deliver health services to the health houses of Iran. This description included the specific method of recruiting these CHWs, strategies and methods of their training which is different from general academic education. Materials and Methods: A descriptive study design was utilized for this analysis in six areas. These areas have been selected according to the expert opinions and experiences of the Center for Health Networks Management. Results: The results showed the specific method of student selection and clear objectives and standards of training related to the health needs of the community. Recruitment of native human resources, the relationship between training and performance are the characteristics, which have been made this system more efficient and responsive to the health system needs. Conclusions: Development of the job and task analysis to ensure providing the right training needs, applying more evidences through different studies for reforms, more decentralized equipped system with decision-making tools have been proposed for development. PMID:25838935

  5. Community Management That Works: How to Build and Sustain a Thriving Online Health Community

    PubMed Central

    2013-01-01

    Health care professionals, patients, caregivers, family, friends, and other supporters are increasingly joining online health communities to share information and find support. But social Web (Web 2.0) technology alone does not create a successful online community. Building and sustaining a successful community requires an enabler and strategic community management. Community management is more than moderation. The developmental life cycle of a community has four stages: inception, establishment, maturity, and mitosis. Each stage presents distinct characteristics and management needs. This paper describes the community management strategies, resources, and expertise needed to build and maintain a thriving online health community; introduces some of the challenges; and provides a guide for health organizations considering this undertaking. The paper draws on insights from an ongoing study and observation of online communities as well as experience managing and consulting a variety of online health communities. Discussion includes effective community building practices relevant to each stage, such as outreach and relationship building, data collection, content creation, and other proven techniques that ensure the survival and steady growth of an online health community. PMID:23759312

  6. Lantern parades in the development of arts in community health.

    PubMed

    White, Mike; Robson, Mary

    2015-03-01

    This paper describes the development of two annual lantern parades as case examples of arts in community health, which the authors define as a distinct area of activity operating mainly outside of acute healthcare settings, characterised by the use of participatory arts to promote health. The parades took place in Gateshead 1994-2006 and later in Stockton-on-Tees from 2009 to the present, and the paper reflects on the factors that made for the success of the Gateshead parade and also the problems that led to its demise. It then describes and assesses the Stockton parade, and the benefits and challenges of a workshop ethos of 'positive regard' with reference to interview data gathered from adult volunteers and school staff. It considers the potential of this annual 'tradition' to shape communal memories that identify with place, and it sets out its aspirations for future programme and research.

  7. Community based needs assessment in an urban area; A participatory action research project

    PubMed Central

    2012-01-01

    Background Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment. Methods The method of participatory action research (PAR) was used. The study was carried out in an area of high socio-economic deprivation in Ardabil, a city in the northwest of Iran, which is currently served by a branch of the Social Development Center (SDC). The steering committee of the project was formed by some university faculty members, health officials and delegates form Farhikhteh non-governmental organization and representatives from twelve blocks or districts of the community. Then, the representatives were trained and then conducted focus groups in their block. The focus group findings informed the development of the questionnaire. About six hundred households were surveyed and study questionnaires were completed either during face-to-face interviews by the research team (in case of illiteracy) or via self-completion. The primary question for the residents was: 'what is the most important health problem in your community? Each health problem identified by the community was weighted based on the frequency it was selected on the survey, and steering committee perception of the problem's seriousness, urgency, solvability, and financial load. Results The main problems of the area appeared to be the asphalt problem, lack of easy access to medical centers, addiction among relatives and unemployment of youth. High participation rates of community members in the steering committee and survey suggest that the PAR approach was greatly appreciated by the community and that problems identified through this research truly reflect community opinion. Conclusions Participatory action

  8. Community mental health nurses' perspectives of recovery-oriented practice.

    PubMed

    Gale, J; Marshall-Lucette, S

    2012-05-01

    Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery. PMID:22070737

  9. Exploring perceptions of community health policy in Kenya and identifying implications for policy change

    PubMed Central

    McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

    2016-01-01

    Background: Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. Methods: We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. Results: There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. Conclusion: This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority

  10. Development of the Community Health Improvement Navigator Database of Interventions.

    PubMed

    Roy, Brita; Stanojevich, Joel; Stange, Paul; Jiwani, Nafisa; King, Raymond; Koo, Denise

    2016-02-26

    With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non-health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity.

  11. Developing Learning Communities in Health and Human Performance

    ERIC Educational Resources Information Center

    Butler, Karen L.; Dawkins, Phyllis W.

    2007-01-01

    Learning communities in health and human performance are creative approaches to traditional academic outcomes. Learning communities are becoming increasingly widespread in a variety of contexts, and there is extensive evidence suggesting that effective learning communities have important benefits for students as well as faculty. In this article,…

  12. Emergence of Virtual Communities as Means of Communication: A Case Study on Virtual Health Care Communities

    ERIC Educational Resources Information Center

    Argan, Mehpare Tokay; Argan, Metin; Suher, Idil K.

    2011-01-01

    Like in all areas, virtual communities make their presence felt in the area of healthcare too. Virtual communities play an important role in healthcare in terms of gathering information on healthcare, sharing of personal interests and providing social support. Virtual communities provide a way for a group of peers to communicate with each other.…

  13. Community Mental Health: Issues for Social Work Practice and Education.

    ERIC Educational Resources Information Center

    Katz, Arthur J., Ed.

    Articles by social work educators on some of the critical issues in community mental health are presented. Examined are some conceptual and program developments related to coordination, continuity of care, and the use of teams in planning and service delivery for community mental health (Lawrence K. Berg). The issue of civil commitment to and…

  14. Identifying Rural Health Care Needs Using Community Conversations

    ERIC Educational Resources Information Center

    Moulton, Patricia L.; Miller, Marlene E.; Offutt, Sue M.; Gibbens, Brad P.

    2007-01-01

    Context: Community input can lead to better-defined goals in an organization. With this in mind, the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences embarked on a series of 13 meetings with representatives of organizations serving rural communities, including 5 Native American reservations. Purpose:…

  15. Service Learning and Community Health Nursing: A Natural Fit.

    ERIC Educational Resources Information Center

    Miller, Marilyn P.; Swanson, Elizabeth

    2002-01-01

    Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…

  16. A Community Health Approach to Asthma in the Schools

    ERIC Educational Resources Information Center

    Weiss-Randall, Debra

    2014-01-01

    Asthma is a leading cause of school absenteeism in the United States, especially in poor and minority communities, where prevalence and hospitalization rates are significantly higher than average. A community health approach can help poorer school districts hire full-time nurses and access other health resources.

  17. The Community Mental Health Center as a Matrix Organization.

    ERIC Educational Resources Information Center

    White, Stephen L.

    1978-01-01

    This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

  18. Community Health. Guide to Standards and Implementation. Career & Technology Studies.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

    With this Career and Technology Studies (CTS) curriculum guide, secondary students in Alberta can do the following: develop skills that can be applied in their daily lives; refine career-planning skills; develop technology-related skills in community health; enhance employability skills, especially in community health; and apply and reinforce…

  19. Evaluating community engagement as part of the public health system.

    PubMed

    South, Jane; Phillips, Gemma

    2014-07-01

    Community participation and leadership is a central tenet of public health policy and practice. Community engagement approaches are used in a variety of ways to facilitate participation, ranging from the more utilitarian, involving lay delivery of established health programmes, to more empowerment-oriented approaches. Evaluation methods within public health, adapted from clinical medicine, are most suited to evaluating community engagement as an 'intervention', in the utilitarian sense, focusing on the health impacts of professionally determined programmes. However, as communities are empowered and professional control is relinquished, it is likely to be harder to capture the full effects of an intervention and so the current evidence base is skewed away from knowledge about the utility of these approaches. The aim of this paper is to stimulate debate on the evaluation of community engagement. Building on current understandings of evaluation within complex systems, the paper argues that what is needed is a paradigm shift from viewing the involvement of communities as an errant form of public health action, to seeing communities as an essential part of the public health system. This means moving from evaluation being exclusively focused on the linear causal chain between the intervention and the target population, to seeking to build understanding of whether and how the lay contribution has impacted on the social determinants of health, including the system through which the intervention is delivered. The paper proposes some alternative principles for the evaluation of community engagement that reflect a broader conceptualisation of the lay contribution to public health.

  20. Partnership for Health Care: An Academic Nursing Center in a Rural Community College.

    ERIC Educational Resources Information Center

    LeMone, Priscilla; McDaniel, Roxanne W.; Sullivan, Toni J.

    1998-01-01

    The University of Missouri-Columbia Sinclair School of Nursing collaborates with Moberly Area Community College in providing holistic health care services to rural college students. This academic nursing center is based on nursing models rather than medical models of health. (JOW)

  1. The Influence of Bush Identity on Attitudes to Mental Health in a Queensland Community

    ERIC Educational Resources Information Center

    McColl, Lisa

    2007-01-01

    There are many factors that impact on mental health and the utilization of these services in the bush. The results from a three year ethnographic study in a bush community indicate that attitudes to mental health in this area of Queensland are influenced by bush identity, defined by reference to historical and current characteristics which include…

  2. The role of community health advisors in community-based participatory research.

    PubMed

    Story, Lachel; Hinton, Agnes; Wyatt, Sharon B

    2010-01-01

    Mistrust and fear of research often exist in minority communities because of assumptions, preconceived ideas, and historical abuse and racism that continue to influence research participation. The research establishment is full of well-meaning 'outsider' investigators who recognize discrimination, health disparities, and insufficient health care providers in minority communities, but struggle in breaking through this history of mistrust. This article provides ethical insights from one such 'insider-outsider', community-based participatory research project implemented via community health advisors in the Mississippi Delta. Both community-based participatory research and community health advisors provide opportunities to address the ethical issues of trust, non-maleficence, and justice in minority communities. Implications for ethics-driven nursing research are discussed.

  3. Community Based Information Systems for Education Management in Urban Areas.

    ERIC Educational Resources Information Center

    Khosla, Renu

    Lack of education causes and is caused by poverty. In urban areas, it adds to the vulnerability of the poor, resulting in inaccessible schools and irrelevant curricula. Building urban communities and harnessing social capital can create an environment where the poor will have greater opportunities for making decisions that influence their lives.…

  4. Ethnic Settlement in a Metropolitan Area: A Typology of Communities.

    ERIC Educational Resources Information Center

    Agocs, Carol

    1981-01-01

    Presents a comparative analysis of changing ethnic residential distributions from 1940-1970 to identify recently evolved forms of ethnic settlement in the Detroit (Michigan) metropolitan area. Identifies and classifies contemporary types of ethnic communities to expand the knowledge of ethnic settlement. (MK)

  5. The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2007. The National Survey of Children's Health

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2011

    2011-01-01

    The National Survey of Children's Health (NSCH) provides a unique resource with which to analyze the health status, health care use, activities, and family and community environments experienced by children in rural and urban areas. The NSCH was designed to measure the health and well-being of children from birth through age 17 in the United…

  6. Community Health Risk Assessment of Primary Aluminum Smelter Emissions

    PubMed Central

    Larivière, Claude

    2014-01-01

    Objective: Primary aluminum production is an industrial process with high potential health risk for workers. We consider in this article how to assess community health risks associated with primary aluminum smelter emissions. Methods: We reviewed the literature on health effects, community exposure data, and dose–response relationships of the principal hazardous agents emitted. Results: On the basis of representative measured community exposure levels, we were able to make rough estimates on health risks associated with specific agents and categorize these as none, low, medium, or high. Conclusions: It is possible to undertake a rough-estimate community Health Risk Assessment for individual smelters on the basis of information available in the epidemiological literature and local community exposure data. PMID:24806724

  7. Community involvement in health services at Namayumba and Bobi health centres: A case study

    PubMed Central

    Ndoboli, Fred; Kuule, Julius; Besigye, Innocent

    2014-01-01

    Abstract Background Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services. Aim and Setting The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively. Methods Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes. Results Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services. Conclusion Community involvement is low in health services in both Namayumba and Bobi health centres.

  8. Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

    PubMed Central

    Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

    2013-01-01

    Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study

  9. Species area relationships in mediterranean-climate plant communities

    USGS Publications Warehouse

    Keeley, Jon E.; Fotheringham, C.J.

    2003-01-01

    Aim To determine the best-fit model of species–area relationships for Mediterranean-type plant communities and evaluate how community structure affects these species–area models.Location Data were collected from California shrublands and woodlands and compared with literature reports for other Mediterranean-climate regions.Methods The number of species was recorded from 1, 100 and 1000 m2 nested plots. Best fit to the power model or exponential model was determined by comparing adjusted r2 values from the least squares regression, pattern of residuals, homoscedasticity across scales, and semi-log slopes at 1–100 m2 and 100–1000 m2. Dominance–diversity curves were tested for fit to the lognormal model, MacArthur's broken stick model, and the geometric and harmonic series.Results Early successional Western Australia and California shrublands represented the extremes and provide an interesting contrast as the exponential model was the best fit for the former, and the power model for the latter, despite similar total species richness. We hypothesize that structural differences in these communities account for the different species–area curves and are tied to patterns of dominance, equitability and life form distribution. Dominance–diversity relationships for Western Australian heathlands exhibited a close fit to MacArthur's broken stick model, indicating more equitable distribution of species. In contrast, Californian shrublands, both postfire and mature stands, were best fit by the geometric model indicating strong dominance and many minor subordinate species. These regions differ in life form distribution, with annuals being a major component of diversity in early successional Californian shrublands although they are largely lacking in mature stands. Both young and old Australian heathlands are dominated by perennials, and annuals are largely absent. Inherent in all of these ecosystems is cyclical disequilibrium caused by periodic fires. The

  10. Community benefit: beyond health fairs and form 990.

    PubMed

    Martin, Marty

    2013-01-01

    Hospitals that are committed to a population health strategy should take five steps to address the strategic, cultural, technical, and structural challenges involved in such an effort: Adopt wellness as a strategic priority for the hospital. Challenge those responsible for community health to become more actively involved in actually improving the health of the population the hospital serves. Adopt a wellness philosophy and demonstrate to the community that the organization is committed to that philosophy. Leverage limited charitable resources by collaborating and partnering with community stakeholders. Integrate the agenda, policies, procedures, and systems of clinical care management, quality, and population health functions. PMID:23360059

  11. Developing a health promotion program for faith-based communities.

    PubMed

    Kotecki, Catherine Nuss

    2002-04-01

    The article describes the partnership formed between community outreach programs, a school of nursing, and hospitals to implement Healthy People 2010 goals in urban, faith-based communities. To date this program has provided health promotion programs to 125 people from more than 18 congregations in the context of their faith setting. The program has allowed congregants to develop ministry strategies to meet health care needs within the congregation and community. The article provides overall program goals, specific lesson plans, and evaluation strategies. Outcome measures include an increase in health promotion knowledge, participant satisfaction, and improved health in congregations. PMID:11913228

  12. New Mexico community voices: policy reform to reduce oral health disparities.

    PubMed

    Powell, Wayne; Hollis, Christine; de la Rosa, Mario; Helitzer, Deborah L; Derksen, Daniel

    2006-02-01

    Using a socio-ecological framework to guide the initiative, New Mexico Community Voices developed, with state and local stakeholders, responsive oral health policies to address oral health disparities. Several policy objectives were achieved: increasing awareness of the public health importance of oral health; improving access to dental services for uninsured or underserved populations; enhancing dental services specialty care; and increasing sustainable oral health infrastructure through pipeline development of oral health providers to relieve service shortages and diversify the oral health workforce. Improving access to oral health and augmenting numbers of dental providers in rural areas were also successful. The governor has appointed the New Mexico Oral Health Advisory Council to address state oral health issues. The New Mexico partnerships have demonstrated how effective policy change can generate important incremental shifts in oral health care delivery and provide best practice models that diminish the oral health crisis faced by underserved populations.

  13. The reach and rationale for community health fairs

    PubMed Central

    Murray, Kate; Liang, Annie; Barnack-Tavlaris, Jessica; Navarro, Ana M.

    2013-01-01

    Latinos living in the United States account for one-third of the uninsured population and face numerous cultural, linguistic, and financial barriers to accessing health care services. Community health fairs have developed to address the unmet need for no- and low-cost services that target prevention and education among underserved communities. The current research describes an ongoing effort in a community in southern California and examines the barriers to health care among participants registering to receive free breast health screenings, one of the major services offered at a 2010 health fair. A total of 186 adult Latina women completed a brief questionnaire assessing their health care utilization and self-reported barriers to engaging in preventive and screening services. Approximately two-thirds of participants reported never receiving or having more than 2 years passing since receiving a preventive health check-up. Participants identified cost (64.5%) and knowledge of locations for services (52.3%) as the primary barriers to engaging in routine health care services. Engaging with health professionals represents a leading way in which adults obtain health information and health fairs offering cancer health screenings represent a culturally appropriate venue for increased cancer health equity. Implications of the current research for future health fairs and their role in community cancer education are discussed. PMID:23907787

  14. Health Promotion Intervention for Hygienic Disposal of Children's Faeces in a Rural Area of Nigeria

    ERIC Educational Resources Information Center

    Jinadu, M. K.; Adegbenro, C. A.; Esmai, A. O.; Ojo, A. A.; Oyeleye, B. A.

    2007-01-01

    Objective: Community-based health promotion intervention for improving unhygienic disposal of children's faeces was conducted in a rural area of Nigeria. Setting: The study was conducted in Ife South Local Government area of Osun State, Nigeria. Design: The study was conducted in 10 randomly selected rural villages: five control and five active.…

  15. The contribution of hospitals and health care systems to community health.

    PubMed

    Shortell, Stephen M; Washington, Pamela K; Baxter, Raymond J

    2009-01-01

    This article reviews evidence on hospitals' and health systems' impacts on community health improvement. We begin with an overview of the history of community benefit and then discuss the lack of a widely accepted definition and measurement of community benefit activities as well as the expectations and accountability of tax-exempt not-for-profit hospitals and health systems in community initiatives. We highlight the approaches of two systems and identify strategic, cultural, technical, and structural challenges associated with increasing community benefit and health-improvement activities. We conclude by offering recommendations for policy and practice. PMID:19296780

  16. A statewide approach to health care personnel maldistribution. The California Area Health Education Center System.

    PubMed

    Crowder, J E; Schnepper, J E; Gessert, C

    1984-05-01

    An Area Health Education Center (AHEC) system has been established in California to address the maldistribution of physicians and other health care professionals. The AHEC program uses educational incentives to recruit and retain health care personnel in underserved areas by linking the academic resources of university health science centers with local educational and clinical facilities. The medical schools, working in partnership with urban or rural AHECs throughout the state, are implementing educational programs to attract trainees and licensed professionals to work in underserved communities. The California AHEC project entered its fifth year in October of 1983 with the participation of all eight medical schools and the Charles Drew Postgraduate School of Medicine, 35 other health professions schools, 17 independent AHECs and more than 400 clinical training sites. Educational programs are reaching more than 22,000 students and practicing health professionals throughout California. We review the current status of the California AHEC system and use the AHEC programs at Loma Linda University to illustrate the effect this intervention is having.

  17. Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California

    ERIC Educational Resources Information Center

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel

    2012-01-01

    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

  18. Beyond the sick role: situating community health nursing practice.

    PubMed

    St John, W

    1999-01-01

    This grounded theory research into the role of the community health nurse in Australia identified that moving from the comfort and structure of an institutional setting to the client's turf results in profound changes to the purpose of nursing practice. Data were collected from 17 'excellent' community health nurses practising in a range of community health settings in three states of Australia. Data included transcripts from in-depth interviews, questionnaires, group discussions with participants, job descriptions, agency documentation, professional organisation documentation and focus groups. Data were analysed using constant comparative techniques. In community health nursing practice, the client's role changes from a sick role to a well role and there is a shift in responsibility for outcomes from the nurse to the client. The central purpose of the community health nursing role is to facilitate Situated Health Competence, which the client achieves within the context of going about their everyday life, including work, recreation, relationships and role responsibilities. Situated Health Competence requires families, groups and communities to address their own illnesses, health problems, health issues and health behaviours; have enough knowledge and power to make their own decisions; question matters that impact on their health; and seek out and access appropriate health resources on an ongoing basis. The findings of this study make the intangible motivations of the community health nurse more explicit. The aim of facilitating Situated Health Competence results in an expanded view of the boundaries of nursing practice. The traditional foci of nursing practice are still present, but are incorporated within a broader 'situated' role.

  19. Vegetation communities associated with the 100-Area and 200-Area facilities on the Hanford Site

    SciTech Connect

    Stegen, J.A.

    1994-01-17

    The Hanford Site, Benton County, Washington, lies within the broad semi-arid shrub-steppe vegetation zone of the Columbia Basin. Thirteen different habitat types on the Hanford Site have been mapped in Habitat Types on the Hanford Site: Wildlife and Plant Species of Concern (Downs et al. 1993). In a broad sense, this classification is correct. On a smaller scale, however, finer delineations are possible. This study was conducted to determine the plant communities and estimate vegetation cover in and directly adjacent to the 100 and 200 Areas, primarily in relation to waste sites, as part of a comprehensive ecological study for the Compensation Environmental Response, Compensation, and Liability Act (CERCLA) characterization of the 100 and 200 Areas. During the summer of 1993, field surveys were conducted and a map of vegetation communities in each area, including dominant species associations, was produced. The field surveys consisted of qualitative community delineations. The community delineations described were made by field reconnaissance and are qualitative in nature. The delineations were made by visually determining the dominant plant species or vegetation types and were based on the species most apparent at the time of inspection. Additionally, 38 transects were run in these plant communities to try to obtain a more accurate representation of the community. Because habitat disturbances from construction/operations activities continue to occur in these areas, users of this information should be cautious in applying these maps without a current ground survey. This work will complement large-scale habitat maps of the Hanford Site.

  20. Making health data maps: a case study of a community/university research collaboration.

    PubMed

    Buckeridge, David L; Mason, Robin; Robertson, Ann; Frank, John; Glazier, Richard; Purdon, Lorraine; Amrhein, Carl G; Chaudhuri, Nita; Fuller-Thomson, Esme; Gozdyra, Peter; Hulchanski, David; Moldofsky, Byron; Thompson, Maureen; Wright, Robert

    2002-10-01

    This paper presents the main findings from a collaborative community/university research project in Canada. The goal of the project was to improve access to community health information, and in so doing, enhance our knowledge of the development of community health information resources and community/university collaboration. The project built on a rich history of community/university collaboration in Southeast Toronto (SETO), and employed an interdisciplinary applied research and action design. Specific project objectives were to: (1) develop via active community/university collaboration a geographic information system (GIS) for ready access to routinely collected health data, and to study logistical, conceptual and technical problems encountered during system development; and (2) to document and analyze issues that can emerge in the process of community/university research collaboration. System development involved iteration through community user assessment of need, development or refinement of the GIS, and assessment of the GIS by community users. Collaborative process assessment entailed analysis of archival material, interviews with investigators and participant observation. Over the course of the project, a system was successfully developed, and favorably assessed by users. System development problems fell into four main areas: maintaining user involvement in system development, understanding and integrating data, bringing disparate data sources together, and making use of assembled data. Major themes emerging from the community/university collaborative research process included separate community and university cultures, time as an important issue for all involved, and the impact of uncertainty and ambiguity on the collaborative process.

  1. Lessons learned in developing community mental health care in Europe

    PubMed Central

    SEMRAU, MAYA; BARLEY, ELIZABETH A.; LAW, ANN; THORNICROFT, GRAHAM

    2011-01-01

    This paper summarizes the findings for the European Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. The article presents a description of the region, an overview of mental health policies and legislation, a summary of relevant research in the region, a precis of community mental health services, a discussion of the key lessons learned, and some recommendations for the future. PMID:21991282

  2. 50 CFR Table 21 to Part 679 - Eligible GOA Communities, Halibut IFQ Regulatory Use Areas, and Community Governing Body that...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Eligible GOA Communities, Halibut IFQ Regulatory Use Areas, and Community Governing Body that Recommends the Community Quota Entity 21 Table 21 to..., Table 21 Table 21 to Part 679—Eligible GOA Communities, Halibut IFQ Regulatory Use Areas, and...

  3. Charting the future of community health promotion: recommendations from the National Expert Panel on Community Health Promotion.

    PubMed

    Navarro, Amanda M; Voetsch, Karen P; Liburd, Leandris C; Giles, H Wayne; Collins, Janet L

    2007-07-01

    In the decades since chronic illnesses replaced infectious diseases as the leading causes of death, public health researchers, particularly those in the field of health promotion and chronic disease prevention, have shifted their focus from the individual to the community in recognition that community-level changes will foster and sustain individual behavior change. The former emphasis on individual lifestyle change has been broadened to include social and environmental factors, often without increased resources. To find new ways to support community health promotion at the national level, the National Center for Chronic Disease Prevention and Health Promotion and the Division of Adult and Community Health invited an external panel of experts to participate in the National Expert Panel on Community Health Promotion. This article highlights the process through which the expert panel developed its eight recommendations. The recommendations include issues related to community-based participatory research and surveillance, training and capacity building, new approaches for health and wellness, and changes in federal investments. They illustrate the steps needed to broaden the traditional scope of public health and to advance a new vision for improving community health and wellness.

  4. The voluntary community health movement in India: a strengths, weaknesses, opportunities, and threats (SWOT) analysis.

    PubMed

    Sharma, M; Bhatia, G

    1996-12-01

    There has been a prolific growth of voluntary organizations in India since independence in 1947. One of the major areas of this growth has been in the field of community health. The purpose of this article is to historically trace the voluntary movement in community health in India, analyze the current status, and predict future trends of voluntary efforts. A review of the literature in the form of a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was the method of this study. Some of the key trends which emerged as the priority areas for progress and for strengthening voluntary organizations in the future were enhancing linkages between health and development; building upon collective force; greater utilization of participatory training; establishing egalitarian and effectual linkages for decision making at the international level; developing self-reliant community-based models; and the need for attaining holistic empowerment at individual, organizational, and community levels through "duty consciousness" as opposed to merely asking for rights.

  5. 50 CFR Table 21 to Part 679 - Eligible GOA Communities, Halibut IFQ Regulatory Use Areas and Community Governing Body that...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Regulatory Use Areas and Community Governing Body that Recommends the Community Quota Entity 21 Table 21 to... Governing Body that Recommends the Community Quota Entity Eligible GOA community Community governing body.... Klawock City of Klawock. Metlakatla Metlakatla Indian Village. Meyers Chuck N/A. Pelican City of...

  6. 50 CFR Table 21 to Part 679 - Eligible GOA Communities, Halibut IFQ Regulatory Use Areas and Community Governing Body that...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Regulatory Use Areas and Community Governing Body that Recommends the Community Quota Entity 21 Table 21 to... Governing Body that Recommends the Community Quota Entity Eligible GOA community Community governing body.... Klawock City of Klawock. Metlakatla Metlakatla Indian Village. Meyers Chuck N/A. Pelican City of...

  7. Using Community Health Workers in Community-Based Growth Promotion: What Stakeholders Think

    ERIC Educational Resources Information Center

    Afulani, Patience A.; Awoonor-Williams, John K.; Opoku, Ernest C.; Asunka, Joseph

    2012-01-01

    The Nutrition and Malaria Control for Child Survival Project is a community-based growth promotion project that utilizes Community Health Workers (CHWs), referred to as Community Child Growth Promoters (CCGPs), as the principal change agents. The purpose of this study was to identify perceptions of key stakeholders about the project and the role…

  8. Promoting Healthy Youth, Schools, and Communities: A Guide to Community-School Health Advisory Councils.

    ERIC Educational Resources Information Center

    Larson, Kathlene

    This guide presents a five-step approach to planning, conducting, and evaluating a community-school health advisory council. The five steps are: (1) convening an advisory council (learning about community-school health advisory councils, obtaining support from the school district, identifying potential members, organizing and conducting the first…

  9. Capacity building for health through community based participatory nutrition intervention research in rural communities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Building community capacity for health promotion in small rural communities is essential if health promotion research is to yield sustainable outcomes. Since its inception, capacity-building has been a stated goal of the Delta Nutrition Intervention Research initiative, a tri-state collaboration in ...

  10. Rural Community Leaders’ Perceptions of Environmental Health Risks

    PubMed Central

    Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade

    2015-01-01

    Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621

  11. Anishinabe youth perceptions about community health: toward environmental repossession.

    PubMed

    Big-Canoe, Katie; Richmond, Chantelle A M

    2014-03-01

    This community-based research applied environmental dispossession as a theoretical framework for understanding Anishinabe youth perceptions about health, social relationships and contemporary Anishinabe way of life in Northern Ontario, Canada. Qualitative interviews with 19 youth reveal considerable worry about their community's health. Youth perceive changes in the Anishinabe way of life, including decreased access to their traditional lands, to be central to poor health at the community level. Youth emphasized the importance of social relationships for fostering healthy behaviours and developing community wide initiatives that will provide opportunities for reconnecting to land, and for learning and practicing Indigenous Knowledge. This study builds on the growing body of decolonizing research with Indigenous communities, and it concludes by offering the concept of environmental repossession as a way forward for studies on the Indigenous environment-health interface. PMID:24440804

  12. Environment and health: environmental sanitation and community water supply.

    PubMed

    1997-01-01

    This article identifies important features of two 5-Year Plans in India. Currently, only about 200 cities have even a partial sewage system. Elementary sewage systems are nonexistent in rural villages. In 1990, under 5% of rural population had access to sanitary facilities. The result is widespread soil and water pollution and its accompanying disease. The Rural Water Supply Program was proposed in the 5th Plan, but was implemented in the 7th Plan (1985-90). Construction of latrines is still too low. Resources were insufficiently mobilized for latrine construction. An alternative would be to institute cost recovery and user pays principles. Low cost technology could be substituted. Low cost latrine systems should conform with users' social habits, local culture, and the customs of the community. The system should be affordable to users. The technology should be user-friendly and rely on use of local materials and workers. Over 90% of the population rely on community water supply facilities. Health has not benefited from the access to water supplies. The reasons are low hygienic standards, lack of water quality surveillance, and poor maintenance of equipment. The community does not participate. By 1996, people's access to water was reduced to 1 km in the plains, and 50 m in hilly areas. Surface waters are contaminated by fecal matter, fluoride, nitrate, and arsenic. The Water Quality Surveillance Program lacks an institutional framework and human resource development. There is a need for education about hygiene, unsafe drinking water, and poor sanitation for people and agency staff.

  13. Our environment, our health: a community-based participatory environmental health survey in Richmond, California.

    PubMed

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel

    2012-04-01

    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil refinery and near other industrial and mobile sources of pollution. The Richmond health survey aimed to assess local concerns and perceptions of neighborhood conditions, health problems, mobile and stationary hazards, access to health care, and other issues affecting residents of Richmond. Although respondents thought their neighborhoods were good places to live, they expressed concerns about neighborhood stressors and particular sources of pollution, and identified elevated asthma rates for children and long-time Richmond residents. The Richmond health survey offers a holistic, community-centered perspective to understanding local environmental health issues, and can inform future environmental health research and organizing efforts for community-university collaboratives.

  14. Integrating Healthy Communities concepts into health professions training.

    PubMed Central

    Kinder, G; Cashman, S B; Seifer, S D; Inouye, A; Hagopian, A

    2000-01-01

    To meet the demands of the evolving health care system, health professionals need skills that will allow them to anticipate and respond to the broader social determinants of health. To ensure that these skills are learned during their professional education and training, health professions institutions must look beyond the medical model of caring for communities. Models in Seattle and Roanoke demonstrate the curricular changes necessary to ensure that students in the health professions are adequately prepared to contribute to building Healthy Communities in the 21st century. In addition to these models, a number of resources are available to help promote the needed institutional changes. PMID:10968767

  15. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    PubMed

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  16. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    PubMed

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

  17. A preliminary survey of the health behaviors of community leaders.

    PubMed

    Li-Chun, Chang; I-Chuan, Li; Bi-Ying, Hsiao; Wan-En, Cheng; Shu-Feng, Lin

    2004-06-01

    The purpose of this study was to investigate the health behavior of a town ' s community leaders and other issues associated with that behavior. Structured questionnaires designed by the researchers were used to collect data at a meeting for the announcement of community building; they were filled out in the 10 or 20 minutes before the meeting began and 70 valid responses were received. The SPSS for Window version 10.0 software package was used for data analysis. The results of the study showed that the community leaders demonstrated higher standards of health-protective behaviors (i.e. elder/adult checkups, Pap smear exam and breast self-examination) than others living in the community. Variables such as gender, educational level, self-perceived health status, number of chronic illnesses were correlated with different types of dietary behavior. Subjects who were 40 years old and over, educated to junior high school or lower, who had performed less than one year of community service and were free of chronic illness engaged in relatively regular exercise. Subjects who had performed more than one year of community service were more likely to utilize the preventive services provided by national health insurance. It is recommended that public health nurses improve their cooperation with community leaders over providing health -related activities in order to promote better health behavior on the part of such leaders.

  18. Cooperative Health Occupation Education (Course Outline), The Life Span and Community Health: 3099.10.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    GRADES OR AGES: Grade twlve. SUBJECT MATTER: The physical development and needs, as well as the psychological development and needs of the individual from infancy to old age. The health of the community is studied in terms of communicable diseases, immunology, resources available for the optimal health of any community (including health services…

  19. Neighborhood adversity, child health, and the role for community development.

    PubMed

    Jutte, Douglas P; Miller, Jennifer L; Erickson, David J

    2015-03-01

    Despite medical advances, childhood health and well-being have not been broadly achieved due to rising chronic diseases and conditions related to child poverty. Family and neighborhood living conditions can have lasting consequences for health, with community adversity affecting health outcomes in significant part through stress response and increased allostatic load. Exposure to this "toxic stress" influences gene expression and brain development with direct and indirect negative consequences for health. Ensuring healthy child development requires improving conditions in distressed, high-poverty neighborhoods by reducing children's exposure to neighborhood stressors and supporting good family and caregiver functioning. The community development industry invests more than $200 billion annually in low-income neighborhoods, with the goal of improving living conditions for residents. The most impactful investments have transformed neighborhoods by integrating across sectors to address both the built environment and the social and service environment. By addressing many facets of the social determinants of health at once, these efforts suggest substantial results for children, but health outcomes generally have not been considered or evaluated. Increased partnership between the health sector and community development can bring health outcomes explicitly into focus for community development investments, help optimize intervention strategies for health, and provide natural experiments to build the evidence base for holistic interventions for disadvantaged children. The problems and potential solutions are beyond the scope of practicing pediatricians, but the community development sector stands ready to engage in shared efforts to improve the health and development of our most at-risk children. PMID:25733725

  20. Marine protected areas increase resilience among coral reef communities.

    PubMed

    Mellin, Camille; Aaron MacNeil, M; Cheal, Alistair J; Emslie, Michael J; Julian Caley, M

    2016-06-01

    With marine biodiversity declining globally at accelerating rates, maximising the effectiveness of conservation has become a key goal for local, national and international regulators. Marine protected areas (MPAs) have been widely advocated for conserving and managing marine biodiversity yet, despite extensive research, their benefits for conserving non-target species and wider ecosystem functions remain unclear. Here, we demonstrate that MPAs can increase the resilience of coral reef communities to natural disturbances, including coral bleaching, coral diseases, Acanthaster planci outbreaks and storms. Using a 20-year time series from Australia's Great Barrier Reef, we show that within MPAs, (1) reef community composition was 21-38% more stable; (2) the magnitude of disturbance impacts was 30% lower and (3) subsequent recovery was 20% faster that in adjacent unprotected habitats. Our results demonstrate that MPAs can increase the resilience of marine communities to natural disturbance possibly through herbivory, trophic cascades and portfolio effects.

  1. Marine protected areas increase resilience among coral reef communities.

    PubMed

    Mellin, Camille; Aaron MacNeil, M; Cheal, Alistair J; Emslie, Michael J; Julian Caley, M

    2016-06-01

    With marine biodiversity declining globally at accelerating rates, maximising the effectiveness of conservation has become a key goal for local, national and international regulators. Marine protected areas (MPAs) have been widely advocated for conserving and managing marine biodiversity yet, despite extensive research, their benefits for conserving non-target species and wider ecosystem functions remain unclear. Here, we demonstrate that MPAs can increase the resilience of coral reef communities to natural disturbances, including coral bleaching, coral diseases, Acanthaster planci outbreaks and storms. Using a 20-year time series from Australia's Great Barrier Reef, we show that within MPAs, (1) reef community composition was 21-38% more stable; (2) the magnitude of disturbance impacts was 30% lower and (3) subsequent recovery was 20% faster that in adjacent unprotected habitats. Our results demonstrate that MPAs can increase the resilience of marine communities to natural disturbance possibly through herbivory, trophic cascades and portfolio effects. PMID:27038889

  2. Community Health Workers and Their Value to Social Work

    ERIC Educational Resources Information Center

    Spencer, Michael S.; Gunter, Kathryn E.; Palmisano, Gloria

    2010-01-01

    Community health workers (CHWs) play a vital and unique role in linking diverse and underserved populations to health and social service systems. Despite their effectiveness, as documented by empirical studies across various disciplines including public health, nursing, and biomedicine, the value and potential role of CHWs in the social work…

  3. American Indian health. Providers, communities surmount profound problems.

    PubMed

    Moriarity, J

    1992-07-01

    Minnesota's urban and rural Indian communities today face a similar set of complex and daunting health problems. No one overriding issue exists, nor does an overall solution. While staff shortages, a dire lack of Indian health professionals, and inadequate financial resources play a role, poverty, racism, lifestyle, alcoholism, and cultural change and conflict all further complicate health problems for Indian people.

  4. Sexual and Reproductive Health Behaviors of California Community College Students

    ERIC Educational Resources Information Center

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp

    2011-01-01

    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  5. Facilitating Health Data Sharing Across Diverse Practices and Communities

    PubMed Central

    Lin, Ching-Ping; Black, Robert A.; LaPlante, Jay; Keppel, Gina A.; Tuzzio, Leah; Berg, Alfred O.; Whitener, Ron J.; Buchwald, Dedra S.; Baldwin, Laura-Mae; Fishman, Paul A.; Greene, Sarah M.; Gennari, John H.; Tarczy-Hornoch, Peter; Stephens, Kari A.

    2010-01-01

    Health data sharing with and among practices is a method for engaging rural and underserved populations, often with strong histories of marginalization, in health research. The Institute of Translational Health Sciences, funded by a National Institutes of Health Clinical and Translational Science Award, is engaged in the LC Data QUEST project to build practice and community based research networks with the ability to share semantically aligned electronic health data. We visited ten practices and communities to assess the feasibility of and barriers to developing data sharing networks. We found that these sites had very different approaches and expectations for data sharing. In order to support practices and communities and foster the acceptance of data sharing in these settings, informaticists must take these diverse views into account. Based on these findings, we discuss system design implications and the need for flexibility in the development of community-based data sharing networks. PMID:21347138

  6. Facilitating health data sharing across diverse practices and communities.

    PubMed

    Lin, Ching-Ping; Black, Robert A; Laplante, Jay; Keppel, Gina A; Tuzzio, Leah; Berg, Alfred O; Whitener, Ron J; Buchwald, Dedra S; Baldwin, Laura-Mae; Fishman, Paul A; Greene, Sarah M; Gennari, John H; Tarczy-Hornoch, Peter; Stephens, Kari A

    2010-03-01

    Health data sharing with and among practices is a method for engaging rural and underserved populations, often with strong histories of marginalization, in health research. The Institute of Translational Health Sciences, funded by a National Institutes of Health Clinical and Translational Science Award, is engaged in the LC Data QUEST project to build practice and community based research networks with the ability to share semantically aligned electronic health data. We visited ten practices and communities to assess the feasibility of and barriers to developing data sharing networks. We found that these sites had very different approaches and expectations for data sharing. In order to support practices and communities and foster the acceptance of data sharing in these settings, informaticists must take these diverse views into account. Based on these findings, we discuss system design implications and the need for flexibility in the development of community-based data sharing networks.

  7. Policing, Community Fragmentation, and Public Health: Observations from Baltimore.

    PubMed

    Gomez, Marisela B

    2016-04-01

    Studies show that policing, when violent, and community fragmentation have a negative impact on health outcomes. This current study investigates the connection of policing and community fragmentation and public health. Using an embedded case study analysis, semi-structured interviews were conducted with 21 African-American female and male residents, ages 21-64 years of various neighborhoods of high arrest rates and health and socioeconomic depravation in Baltimore City, MD. Baltimore residents' perceptions of policing, stress, community fragmentation, and solutions are presented. Analysis of the perceptions of these factors suggests that violent policing increases community fragmentation and is a public health threat. Approaches to address this public health threat are discussed.

  8. The Willow Hill Community Health Assessment: Assessing the Needs of Children in a Former Slave Community.

    PubMed

    Alfonso, Moya L; Jackson, Gayle; Jackson, Alvin; Hardy, DeShannon; Gupta, Akrati

    2015-10-01

    The overall purpose of this community needs assessment was to explore the perceptions of health and educational needs among youth residing in a rural Georgia community, document existing assets that could be utilized to meet those needs, and to identify socioeconomic barriers and facilitators in health education. A sequential mixed method design was used. Intercept surveys were conducted followed by individual, key informant interviews and a focus group. Survey data was entered into an Excel spreadsheet and SPSS for analysis and descriptive statistics including means and frequencies were calculated. For qualitative interviews, full transcripts were created from audio-recordings and uploaded into NVivo for content analysis. Several health issues were highlighted by the Willow Hill/Portal Georgia community members, including teachers, parents, youth and Willow Hill Heritage and Renaissance Center board members. Some of the health issues identified by youth in the community were low levels of physical activity, obesity, diabetes, lack of healthy food choices, and access to health care services. Including the issues identified by youth, the parents, teachers and board members identified additional health issues in the community such as asthma, hygiene and lack of dental and eye care facilities. Overall, there is a need for better infrastructure and awareness among community members. Utilizing identified assets, including active community leaders, involved faith-based organizations, commitment of community members, presence of land resources, and commitment to physical activity and sports, could modify the current community landscape. PMID:26264907

  9. The Willow Hill Community Health Assessment: Assessing the Needs of Children in a Former Slave Community.

    PubMed

    Alfonso, Moya L; Jackson, Gayle; Jackson, Alvin; Hardy, DeShannon; Gupta, Akrati

    2015-10-01

    The overall purpose of this community needs assessment was to explore the perceptions of health and educational needs among youth residing in a rural Georgia community, document existing assets that could be utilized to meet those needs, and to identify socioeconomic barriers and facilitators in health education. A sequential mixed method design was used. Intercept surveys were conducted followed by individual, key informant interviews and a focus group. Survey data was entered into an Excel spreadsheet and SPSS for analysis and descriptive statistics including means and frequencies were calculated. For qualitative interviews, full transcripts were created from audio-recordings and uploaded into NVivo for content analysis. Several health issues were highlighted by the Willow Hill/Portal Georgia community members, including teachers, parents, youth and Willow Hill Heritage and Renaissance Center board members. Some of the health issues identified by youth in the community were low levels of physical activity, obesity, diabetes, lack of healthy food choices, and access to health care services. Including the issues identified by youth, the parents, teachers and board members identified additional health issues in the community such as asthma, hygiene and lack of dental and eye care facilities. Overall, there is a need for better infrastructure and awareness among community members. Utilizing identified assets, including active community leaders, involved faith-based organizations, commitment of community members, presence of land resources, and commitment to physical activity and sports, could modify the current community landscape.

  10. A community health worker intervention to address the social determinants of health through policy change.

    PubMed

    Ingram, Maia; Schachter, Ken A; Sabo, Samantha J; Reinschmidt, Kerstin M; Gomez, Sofia; De Zapien, Jill Guernsey; Carvajal, Scott C

    2014-04-01

    Public policy that seeks to achieve sustainable improvements in the social determinants of health, such as income, education, housing, food security and neighborhood conditions, can create positive and sustainable health effects. This paper describes preliminary results of Acción para la Salud, a public health intervention in which Community health workers (CHWs) from five health agencies engaged their community in the process of making positive systems and environmental changes. Academic-community partners trained Acción CHWs in community advocacy and provided ongoing technical assistance in developing strategic advocacy plans. The CHWs documented community advocacy activities through encounter forms in which they identified problems, formulated solutions, and described systems and policy change efforts. Strategy maps described the steps of the advocacy plans. Findings demonstrate that CHWs worked to initiate discussions about underlying social determinants and environment-related factors that impact health, and identified solutions to improve neighborhood conditions, create community opportunities, and increase access to services. PMID:24363179

  11. Strand IV Environmental and Community Health, World Health, Grades 7, 8, and 9.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

    The interweaving of personal and community health with world health are referred to in this prototype curriculum, to show students in grades 7-9 that health problems of individual nations are health problems of the world. Specific curriculum content studies: (1) factors influencing world health (population, culture, family structure, economic…

  12. Using community-based participatory mixed methods research to understand preconception health in African American communities of Arizona.

    PubMed

    Hussaini, Khaleel S; Hamm, Eric; Means, Toni

    2013-12-01

    The article discusses Arizona's strategic implementation and evaluation of the first time motherhood initiative grant (FTMI) to understand preconception health among African American men and women in Arizona. Longitudinal focus groups assessed whether African American men and women in the targeted areas comprehended and recalled the messages related to preconception health. Matched pre and posttests assessed community members' knowledge of preconception as well as physicians' perceptions on preconception health and care. Focus-group data were transcribed and coded by independent coders to conduct content analyses. Inter-rater reliability and agreement among coders, bivariate and multivariate statistics were conducted for quantitative matched pre and posttests data using SAS v9.2 (SAS Institute, Cary, NC). The social marketing campaign had limited impact in recall and comprehension of the preconception health message among African American men and women. Data from focus groups revealed that African American men and women perceived preconception health to be vital. And results from the pretest and posttests of community-based presentations, further supported this finding. Evidence from Grand Round presentations indicated that practitioners and health care providers had diverging views on preconception health. Use of community-based participatory mixed methods research can facilitate better understanding of the efficacy of strategic interventions such as FTMI and can provide valuable information on preconception health. Cost limitations often prohibit extensive evaluation of social marketing campaigns, hence, evaluators and researchers should assess the feasibility of conducting an efficacy study versus an effectiveness study in evaluating social marketing campaigns.

  13. Health care challenge in coal mines community.

    PubMed

    Golay, M S

    1992-01-01

    The present paper depicts salient features of environment and living conditions with the comparison of various diseases prevalent among underground coal miners, surface workers, asbestos mine workers and general population of Jharia-Dhanbad coalfield as conducted by CMRS during the past few years. The investigations on coal miners' community comprise of different morbid conditions with respiratory (22%), Pneumoconiosis (11.6%), Skin (35%), Eye (29%), Intestinal parasitic infestation (44.6%), Anaemia (42%), Immunostatus (V.D.R.L. Positive-19.9%), Status of injuries and Blood pressure, Water-borne diseases, housing facilities and excreta disposal. The paper also includes the analysis of disease pattern obtained from hospital records of two coal mines which depicts 19.1%, 24.7% and 16% members of coal miners' families suffering from disorder with respiratory, gastro-intestinal and fever respectively. With speedy industrialization of the country, the mining of coal resource comes first in the chain of socio-economic development. The speedy human industrial activities are based on 80% steam, metallurgical and thermal electrical energy which hinges on coal wings. The coal has also gradually occupied all the phases of social life, our clothes, books, newspapers, cooking gas, chemical paints, dye stuff, oil phenyl, Benzene, Naphthalene, Coal tar, scents and various types of unaccountable products come out from coal derivatives and pushed to serve in the today's market for our daily exigencies. Every day one finds a new coal based industry is coming up in the area. The coal is utilized in two hundred ways in our various walks of social life.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10130926

  14. Health care challenge in coal mines community.

    PubMed

    Golay, M S

    1992-01-01

    The present paper depicts salient features of environment and living conditions with the comparison of various diseases prevalent among underground coal miners, surface workers, asbestos mine workers and general population of Jharia-Dhanbad coalfield as conducted by CMRS during the past few years. The investigations on coal miners' community comprise of different morbid conditions with respiratory (22%), Pneumoconiosis (11.6%), Skin (35%), Eye (29%), Intestinal parasitic infestation (44.6%), Anaemia (42%), Immunostatus (V.D.R.L. Positive-19.9%), Status of injuries and Blood pressure, Water-borne diseases, housing facilities and excreta disposal. The paper also includes the analysis of disease pattern obtained from hospital records of two coal mines which depicts 19.1%, 24.7% and 16% members of coal miners' families suffering from disorder with respiratory, gastro-intestinal and fever respectively. With speedy industrialization of the country, the mining of coal resource comes first in the chain of socio-economic development. The speedy human industrial activities are based on 80% steam, metallurgical and thermal electrical energy which hinges on coal wings. The coal has also gradually occupied all the phases of social life, our clothes, books, newspapers, cooking gas, chemical paints, dye stuff, oil phenyl, Benzene, Naphthalene, Coal tar, scents and various types of unaccountable products come out from coal derivatives and pushed to serve in the today's market for our daily exigencies. Every day one finds a new coal based industry is coming up in the area. The coal is utilized in two hundred ways in our various walks of social life.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Aspects of health education: a neglected area.

    PubMed

    Kodagoda, N

    1988-01-01

    Much of human suffering is attributable to preventable causes. The area of family health is particularly important in this respect. Ignorance of simple facts relating to one's structure and development, unquestioning acceptance of tradition, belief in misconcepts, and indiscreet yielding to peer and social pressures are often causative of such suffering, particularly among young people. At present, the situation does not appear to be remedied by the influence of school teachers; and, even less by parents. This is the case for a sound programme of Family Life Education (FLE) in schools, for the implementation of which 'gatekeeper' co-operation, curriculum development and teacher training are paramount. A school's FLE programme by itself will not respond to the needs of all young people; for, in the developing world in particular, the rate of drop-out from the formal school education stream is high. These drop-outs cannot often be reached through the usual employment channels. It is therefore necessary to identify means of reaching them in an effective manner. Mass media and traditional educational material are unlikely to fulfill this need. Therefore, special print material has to be developed. For this purpose, well-focussed objectives have to be drawn up, and instructional content has to be compiled. Presentation methodologies have to be evolved in an innovative manner. These need necessarily be locality-specific, based on the findings of behavioural and sociological studies conducted on and around specific target populations.

  16. 10. Looking northwest at the "community" area at the center ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. Looking northwest at the "community" area at the center of the store, and beyond at the main sales counters along the west wall; metal sheathing to protect the wood floor from the former heating stove can be seen in the foreground, and a wooden drawer unit for seeds is beyond the chairs - Horsepasture Store, U.S. Route 58 & State Route 687, Horse Pasture, Henry County, VA

  17. Health politics meets post-modernism: its meaning and implications for community health organizing.

    PubMed

    Rosenau, P V

    1994-01-01

    In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics.

  18. Jails, prisons, and the health of urban populations: a review of the impact of the correctional system on community health.

    PubMed

    Freudenberg, N

    2001-06-01

    This review examined the interactions between the correctional system and the health of urban populations. Cities have more poor people, more people of color, and higher crime rates than suburban and rural areas; thus, urban populations are overrepresented in the nation's jails and prisons. As a result, US incarceration policies and programs have a disproportionate impact on urban communities, especially black and Latino ones. Health conditions that are overrepresented in incarcerated populations include substance abuse, human immunodeficiency virus (HIV) and other infectious diseases, perpetration and victimization by violence, mental illness, chronic disease, and reproductive health problems. Correctional systems have direct and indirect effects on health. Indirectly, they influence family structure, economic opportunities, political participation, and normative community values on sex, drugs, and violence. Current correctional policies also divert resources from other social needs. Correctional systems can have a direct effect on the health of urban populations by offering health care and health promotion in jails and prisons, by linking inmates to community services after release, and by assisting in the process of community reintegration. Specific recommendations for action and research to reduce the adverse health and social consequences of current incarceration policies are offered. PMID:11419576

  19. Bacterial community structure in the Sulu Sea and adjacent areas

    NASA Astrophysics Data System (ADS)

    Yoshida, Akihiro; Nishimura, Masahiko; Kogure, Kazuhiro

    2007-01-01

    The deep waters of the Sulu Sea are characterized by relatively high and constant water temperatures and low oxygen concentrations. To examine the effect of these characteristics on the bacterial community structure, the culture-independent molecular method was applied to samples from the Sulu Sea and the adjacent areas. DNA was extracted from environmental samples, and the analysis was carried out on PCR-amplified 16S rDNA; fragments were analyzed by denaturing gradient gel electrophoresis (DGGE) and nonmetric multidimensional scaling analysis. Stations in the Sulu Sea and the adjacent areas showed much more prominent vertical stratification of bacterial community structures than horizontal variation. As predominant sequences, cyanobacteria and α-proteobacteria at 10 m depth, δ-proteobacteria at 100 m depth, and green nonsulfur bacteria below 1000 m depth were detected in all sampling areas. High temperatures and low oxygen concentrations are thought to be minor factors in controlling community structure; the quantity and quality of organic materials supplied by the sinking particles, and hydrostatic pressure are believed to be important.

  20. Website Sharing in Online Health Communities: A Descriptive Analysis

    PubMed Central

    Nath, Chinmoy; Huh, Jina; Adupa, Abhishek Kalyan

    2016-01-01

    Background An increasing number of people visit online health communities to seek health information. In these communities, people share experiences and information with others, often complemented with links to different websites. Understanding how people share websites can help us understand patients’ needs in online health communities and improve how peer patients share health information online. Objective Our goal was to understand (1) what kinds of websites are shared, (2) information quality of the shared websites, (3) who shares websites, (4) community differences in website-sharing behavior, and (5) the contexts in which patients share websites. We aimed to find practical applications and implications of website-sharing practices in online health communities. Methods We used regular expressions to extract URLs from 10 WebMD online health communities. We then categorized the URLs based on their top-level domains. We counted the number of trust codes (eg, accredited agencies’ formal evaluation and PubMed authors’ institutions) for each website to assess information quality. We used descriptive statistics to determine website-sharing activities. To understand the context of the URL being discussed, we conducted a simple random selection of 5 threads that contained at least one post with URLs from each community. Gathering all other posts in these threads resulted in 387 posts for open coding analysis with the goal of understanding motivations and situations in which website sharing occurred. Results We extracted a total of 25,448 websites. The majority of the shared websites were .com (59.16%, 15,056/25,448) and WebMD internal (23.2%, 5905/25,448) websites; the least shared websites were social media websites (0.15%, 39/25,448). High-posting community members and moderators posted more websites with trust codes than low-posting community members did. The heart disease community had the highest percentage of websites containing trust codes compared to

  1. Challenges of Introducing Participant Observation to Community Health Research

    PubMed Central

    2014-01-01

    Participant observation elicits unique observation data from both an insider's and an outsider's perspectives. Despite the growing tendency to adopt participant observation strategies in health care research regarding health-related beliefs and types of behavior, the use of participant observation in current research is mostly limited to structured clinical settings rather than community settings. In this paper, we describe how we use participant observation in a community health research study with Chinese-born immigrant women. We document discrepancies between these women's beliefs and types of behavior regarding health and health promotion. We further discuss the ethnical, time, and setting challenges in community health research using participant observation. Possible solutions are also discussed. PMID:24527223

  2. Challenges of introducing participant observation to community health research.

    PubMed

    Zhao, Meng; Ji, Yingchun

    2014-01-01

    Participant observation elicits unique observation data from both an insider's and an outsider's perspectives. Despite the growing tendency to adopt participant observation strategies in health care research regarding health-related beliefs and types of behavior, the use of participant observation in current research is mostly limited to structured clinical settings rather than community settings. In this paper, we describe how we use participant observation in a community health research study with Chinese-born immigrant women. We document discrepancies between these women's beliefs and types of behavior regarding health and health promotion. We further discuss the ethnical, time, and setting challenges in community health research using participant observation. Possible solutions are also discussed.

  3. Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh.

    PubMed

    Puett, Chloe; Sadler, Kate; Alderman, Harold; Coates, Jennifer; Fiedler, John L; Myatt, Mark

    2013-07-01

    This study assessed the cost-effectiveness of adding the community-based management of severe acute malnutrition (CMAM) to a community-based health and nutrition programme delivered by community health workers (CHWs) in southern Bangladesh. The cost-effectiveness of this model of treatment for severe acute malnutrition (SAM) was compared with the cost-effectiveness of the 'standard of care' for SAM (i.e. inpatient treatment), augmented with community surveillance by CHWs to detect cases, in a neighbouring area. An activity-based cost model was used, and a societal perspective taken, to include all costs incurred in the programme by providers and participants for the management of SAM in both areas. Cost data were coupled with programme effectiveness data. The community-based strategy cost US$26 per disability-adjusted life year (DALY) averted, compared with US$1344 per DALY averted for inpatient treatment. The average cost to participant households for their child to recover from SAM in community treatment was one-sixth that of inpatient treatment. These results suggest that this model of treatment for SAM is highly cost-effective and that CHWs, given adequate supervision and training, can be employed effectively to expand access to treatment for SAM in Bangladesh. PMID:22879522

  4. Connecting Allied Health Students to Rural Communities

    ERIC Educational Resources Information Center

    Guion, W. Kent; Mishoe, Shelley C.; Taft, Arthur A.; Campbell, Carol A.

    2006-01-01

    Context: Statewide studies indicate a continuing shortfall of personnel in several allied health disciplines in rural Georgia. National trends indicate lagging enrollment in allied health education programs, suggesting that the workforce shortages will worsen. Purpose: This article describes the efforts of the School of Allied Health Sciences at…

  5. Health Issues in the Latino Community.

    ERIC Educational Resources Information Center

    Aguirre-Molina, Marilyn, Ed.; Molina, Carlos W., Ed.; Zambrana, Ruth Enid, Ed.

    This collection of papers includes 6 parts. Part 1, "Latino Populations in the United States," includes: (1) "Latino Health Policy: Beyond Demographic Determinism" (Angelo Falcon, Marilyn Aguirre-Molina, and Carlos W. Molina); (2) "Latino Health Status" (Olivia Carter-Pokras and Ruth Enid Zambrana); and (3) "Latino Access To Health Care: The Role…

  6. [Characteristics of soil nematode community of different agricultural areas in Jiangsu Province, China].

    PubMed

    Jiao, Jia-guo; Liu, Bei-bei; Mao, Miao; Ye, Cheng-long; Yu, Li; Hu, Feng

    2015-11-01

    This paper investigated the genus diversity of soil nematodes of different agricultural areas in Jiangsu Province, analyzed the relationship between soil nematodes and soil environmental factors, and discussed the roles of soil nematodes as biological indicators of soil health. The results showed that, a total of 41 nematode genera were found in all six agricultural areas, belonging to 19 families, 7 orders, 2 classes. The numbers and community compositions of nematodes were obviously influenced by soil texture, fertilization and tillage practices. In all six agricultural areas, the numbers of nematodes in coastal agricultural area (400 individuals per 100 g dry soil) were significantly larger than that in Xuhuai, Ningzhenyang, and riverside agricultural areas. While the smallest number of nematodes was found in Yanjiang agricultural area (232 individuals per 100 g dry soil), which might be due to the differences in soil texture, annual rainfall and annual air temperature and other factors. The dominant genera of nematodes were similar in the adjacent agricultural areas. Correlation analysis showed that there was a significant positive correlation between the number of soil nematodes and levels of soil nutrients (soil organic matter, total nitrogen, available nitrogen, available potassium and available phosphorus). Redundancy analysis (RDA) indicated the total nitrogen, available potassium and pH obviously affected some soil nematode genera. The analysis of spatial distribution characteristics of soil nematode community in farmland of Jiangsu Province could provide data for health assessment of agricultural ecosystems. PMID:26915207

  7. The public health impacts of concentrated animal feeding operations on local communities.

    PubMed

    Greger, Michael; Koneswaran, Gowri

    2010-01-01

    Large-scale farm animal production facilities, also known as concentrated animal feeding operations (CAFOs), release a significant amount of contaminants into the air and water. Adverse health effects related to exposure to these contaminants among CAFO workers have been well-documented; however, less is known about their impact on the health of residents in nearby communities. Epidemiological research in this area suggests that neighboring residents are at increased risk of developing neurobehavioral symptoms and respiratory illnesses, including asthma. Additional research is needed to better understand community-scale exposures and health outcomes related to the management practices and emissions of CAFOs. PMID:20010001

  8. Does sustained participation in an online health community affect sentiment?

    PubMed

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie

    2014-01-01

    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members' behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members.

  9. Community participation in the field of health and nutrition.

    PubMed

    Dutta, S

    1999-01-01

    This article presents the concept of community participation as a strategy for achieving development. Community assessment, awareness, involvement, participation, and empowerment need to be to ensured before community participation can become a self-dynamic process. From the Integrated Nutrition Health Programme (INHP) in India came the following features that highlighted the community participation process, including: (a) women group formation and/or strengthening, (b) a participatory rural appraisal (PRA) exercise, (c) sub-center level team formation, (d) mother meetings, and (e) service providers with women's groups (WGs). The strategies of the INHP integrate several developmental sectors so as to bring about lasting positive health and nutrition related behavioral changes among the targeted beneficiaries. The Convergent Community Action (CCA) approach, introduced by the Panchayat government, is an updated social action strategy enhancing the capability of the family and the community to meet the needs of children and women.

  10. Does sustained participation in an online health community affect sentiment?

    PubMed

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie

    2014-01-01

    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members' behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members. PMID:25954470

  11. Does Sustained Participation in an Online Health Community Affect Sentiment?

    PubMed Central

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie

    2014-01-01

    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members’ behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members. PMID:25954470

  12. Health Literacy Innovations in California Community College Health Centers

    ERIC Educational Resources Information Center

    Armenia, Joanne Elizabeth

    2013-01-01

    Limited health literacy is a national public health problem contributing to adverse health outcomes and increasing healthcare costs. Both health and educational systems are intervention points for improvement; however, there is paucity in empirical research regarding the role of educational systems. This needs assessment study explored health…

  13. Quality and Electronic Health Records in Community Health Centers

    ERIC Educational Resources Information Center

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  14. Functionalism and holism: community nurses' perceptions of health.

    PubMed

    Long, A; Baxter, R

    2001-05-01

    This paper reports the results of a study that was designed to explore and examine the perceptions of two groups of newly qualified community nurses about the factors they considered to be embedded within the concepts of health, health-enhancing behaviours at individual, family and community levels and their 'innermost self'. The research was exploratory in nature, and included two sample groups: group 1 comprised 16 newly qualified health visitors; group 2 comprised 16 newly qualified community mental health nurses. Purposive sampling was used and data were collected using semi-structured interviews. The group of health visitors perceived health in terms of physical fitness and functional states. At a global level they perceived the need to provide education on health matters. They gave generously to 'charities' and perceived the 'inner self' as 'that part that matters'. The group of community mental health nurses perceived health in terms of holism and being states. Their concept of health was related to listening to each individual's perception of what is 'right' and 'health-enhancing' for them. At a global level they considered the protection of the ozone layer and the promotion of a just and equitable society which focused on the reduction of poverty, to be key health-enhancing activities. They perceived their 'innermost self' to be 'that part of me that makes life worth living', and the soul. The findings have implications for developing new and creative approaches for teaching the holistic concept of health and healing. Educational activities could be designed which strive to ensure that nurses themselves have safe and health embracing opportunities for exploring all the elements that are embedded within the topic of health. Their role in facilitating holistic health promoting activities for all clients also needs to be addressed.

  15. Some Recent Data on Community College Health Service Programs

    ERIC Educational Resources Information Center

    Nichols, Donald Dean

    1973-01-01

    This article discusses the conclusions drawn from descriptive and tabular data collected from 482 public community colleges in an attempt to analyze the content and extent of student health services. (JA)

  16. Exploring community health through the Sustainable Livelihoods Framework

    PubMed Central

    Barnidge, Ellen; Baker, Elizabeth A.; Motton, Freda; Fitzgerald, Teresa; Rose, Frank

    2011-01-01

    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The Sustainable Livelihoods framework, an economic development model, provides a conceptual framework to understand how distribution of these social, economic, and political structural factors affect employment opportunities and community health in rural America. This study uses photo-elicitation interviews, a qualitative, participatory method, to understand community members perceptions of how distribution of structural factors through creation and maintenance of institutional practices and policies, influence employment opportunities and, ultimately, community health for African Americans living in rural Missouri. PMID:21169478

  17. Exploring community health through the Sustainable Livelihoods framework.

    PubMed

    Barnidge, Ellen K; Baker, Elizabeth A; Motton, Freda; Fitzgerald, Teresa; Rose, Frank

    2011-02-01

    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The Sustainable Livelihoods framework, an economic development model, provides a conceptual framework to understand how distribution of these social, economic, and political structural factors affect employment opportunities and community health in rural America. This study uses photo-elicitation interviews, a qualitative, participatory method, to understand community members' perceptions of how distribution of structural factors through creation and maintenance of institutional practices and policies influence employment opportunities and, ultimately, community health for African Americans living in rural Missouri.

  18. The trouble with CHINS (community health information networks).

    PubMed

    Appleby, C

    1995-05-01

    If one had to choose a single acronym that captures both the vision and folly of today's health care industry, it would be "CHIN." The term--which stands for "community health information network"--combines the idealism of community-based health care with the promise of computer automation. Ironically, the acronym may come to be synonymous with "sticking your neck out"; these costly computer networks presuppose a quixotic collaboration among hospitals and health systems long at one another's competitive throats. For CHINs to succeed, they must overcome barriers that many industry insiders say are insurmountable.

  19. Relations between retired agricultural land, water quality, and aquatic-community health, Minnesota River Basin

    USGS Publications Warehouse

    Christensen, Victoria G.; Lee, Kathy E.; McLees, James M.; Niemela, Scott L.

    2012-01-01

    The relative importance of agricultural land retirement on water quality and aquatic-community health was investigated in the Minnesota River Basin. Eighty-two sites, with drainage areas ranging from 4.3 to 2200 km2, were examined for nutrient concentrations, measures of aquatic-community health (e.g., fish index of biotic integrity [IBI] scores), and environmental factors (e.g., drainage area and amount of agricultural land retirement). The relation of proximity of agricultural land retirement to the stream was determined by calculating the land retirement percent in various riparian zones. Spearman's rho results indicated that IBI score was not correlated to the percentage of agricultural land retirement at the basin scale (p = 0.070); however, IBI score was correlated to retired land percentage in the 50- to 400-m riparian zones surrounding the streams (p < 0.05), indicating that riparian agricultural land retirement may have more influence on aquatic-community health than does agricultural land retirement in upland areas. Multivariate analysis of covariance and analysis of covariance models indicated that other environmental factors (such as drainage area and lacustrine and palustrine features) commonly were correlated to aquatic-community health measures, as were in-stream factors (standard deviation of water depth and substrate type). These results indicate that although agricultural land retirement is significantly related to fish communities as measured by the IBI scores, a combination of basin, riparian, and in-stream factors act together to influence IBI scores.

  20. Community Size as a Factor in Health Partnerships in Community Parks and Recreation, 2007

    PubMed Central

    Zimmermann, Jo An M.; Mowen, Andrew J.; Orsega-Smith, Elizabeth; Godbey, Geoffrey C.

    2013-01-01

    Introduction Although partnerships between park and recreation agencies and health agencies are prevalent, little research has examined partnership characteristics and effectiveness among communities of different sizes. The objective of this study was to determine whether park and recreation leaders’ perceptions of partnership characteristics, effectiveness, and outcomes vary by community size. Methods A web-based survey was completed in 2007 by 1,217 National Recreation and Park Association members. Community size was divided into 4 categories: very small, small, medium, and large. Questions measured agencies’ recognition of the need for partnerships, their level of experience, and the effectiveness and outcomes of partnerships. Results Larger communities were significantly more likely to recognize the need for and have more experience with partnerships than smaller communities. Very small and large communities partnered significantly more often with senior services, nonprofit health promotion agencies, and public health agencies than did small and medium ones. Large and small communities were significantly more likely than very small and medium communities to agree that their decision making in partnerships is inclusive and that they have clearly defined goals and objectives. Large communities were significantly more likely than very small communities to report that their partnership helped leverage resources, make policy changes, meet their mission statement, and link to funding opportunities. Conclusion Community size shapes partnership practices, effectiveness, and outcomes. Very small communities are disadvantaged in developing and managing health partnerships. Increasing education, training, and funding opportunities for small and rural park and recreation agencies may enable them to more effectively partner with organizations to address community health concerns. PMID:23886043

  1. Epidemiological measures of participation in community health promotion projects.

    PubMed

    Oddy, W H; Holman, C D; Corti, B; Donovan, R J

    1995-10-01

    The paper is concerned with the use of epidemiological methods to measure the rates at which different strata of a defined population participate in community health promotion projects. The specific aim was to estimate the incidence rates of participation in projects sponsored by the Western Australian Health Promotion Foundation (Healthway), separately for sociodemographic and health-related behavioral subgroups. Data were drawn from Healthway sponsorship projects in 1992. Each sport, arts, and racing project was associated with promotion of a health message and creation of a health promoting environment. The study used a 2-stage sampling design. 13 of 57 large sponsorship projects and 30 of 129 small projects were selected. In the second stage, respondents were randomly surveyed from among project participants. A total of 4060 respondents at least 10 years old was sampled from the 43 selected projects. Population-based incident participation were estimated and were related to person-years at risk. The total participation rate was 4.01 per person-year in people or= 10 years old. The rate was very high at ages 10-14 years and thereafter declined with increasing age. Compared with the least socially disadvantaged 25% of the population, the participation rate fell by around 1/3 in the medium and high disadvantaged groups, but exceeded the baseline by a ratio of 1.85 (95% confidence interval: 1.57-2.18) in the most disadvantaged 10% of the population. The comparatively high rate of participation in the most disadvantaged group occurred only at ages 50 years and the effect was most pronounced at ages 10-19 years. Compared with the least disadvantaged 25%, the rate ratio in the most disadvantaged 10% of the population was 2.50 in the metropolitan area and 1.25 in the country regions of western Australia. Participation was higher in those who smoked, drank alcohol unsafely, reported sunburn, and reported low consumption of fruit and vegetables. Epidemiological methods

  2. Upgrading Health Technology Curriculum: A Community Effort

    ERIC Educational Resources Information Center

    Bramson, Sharon; Merlino, Ann

    1976-01-01

    Describes the phased development of a program in Blood Transfusion Technology at Staten Island Community College of the City University of New York. Presents a detailed outline of the instructional content of the course. (SL)

  3. Community Organization and Mental Health; The Woodlawn Experience.

    ERIC Educational Resources Information Center

    Lewis, Michael D.; Lewis, Judith A.

    A paraprofessional training program designed to provide community controlled mental health services to the Woodlawn community of Chicago, Illinois, is described in this monograph. The neighborhood and The Woodlawn Organization (T.W.O.A), a self help project formed in early 1960, are described from an historical perspective. Some of the areas…

  4. Free health clinic links college, church, and community.

    PubMed

    Carey, Rebekah Albrecht; Fricke, Jonathan

    2011-01-01

    Granville Neighborhood Health Center (GNHC) in Milwaukee, Wisconsin, was conceived out of community need and the vision of Risen Savior Lutheran Church, Wisconsin Lutheran College (WLC), and community leaders. GNHC offers free healthcare services monthly to the uninsured and a service-learning and clinical site for nursing and other students at the college.

  5. Community College Student Mental Health: A Comparative Analysis

    ERIC Educational Resources Information Center

    Katz, Daniel

    2013-01-01

    Though there are at least 12.4 million community college students, accounting for 44% of all undergraduates within the United States (Cohen & Brawer, 2008), little academic research has explored the mental health needs of community college students as a distinct population ( Floyd, 2003; Townsend & LaPaglia, 2000; Townsend, Donaldson,…

  6. Community-wide Implementation of Health Information Technology: The Massachusetts eHealth Collaborative Experience

    PubMed Central

    Goroll, Allan H.; Simon, Steven R.; Tripathi, Micky; Ascenzo, Carl; Bates, David W.

    2009-01-01

    The Massachusetts eHealth Collaborative (MAeHC) was formed to improve patient safety and quality of care by promoting the use of health information technology through community-based implementation of electronic health records (EHRs) and health information exchange. The Collaborative has recently implemented EHRs in a diverse set of competitively selected communities, encompassing nearly 500 physicians serving over 500,000 patients. Targeting both EHR implementation and health information exchange at the community level has identified numerous challenges and strategies for overcoming them. This article describes the formation and implementation phases of the Collaborative, focusing on barriers identified, lessons learned, and policy issues. PMID:18952937

  7. Community health workers for patients with medical and behavioral health needs - Challenges and opportunities.

    PubMed

    Laderman, Mara; Mate, Kedar

    2016-09-01

    Behavioral health integration efforts often focus on the formal health care infrastructure. We performed a non-systematic literature review and expert interviews to identify community-based interventions for patients with medical and behavioral health needs. Community Health Workers (CHWs) are the dominant intervention to support patients outside of the clinic. These interventions do not always optimally meet patients' needs. Organizations should consider the challenges and benefits of CHWs for patients with medical and behavioral health needs. We outline two challenges to successful CHW programs for this population, propose two design considerations for community-based integration, and suggest how quality improvement methods might help with both challenges. PMID:27637818

  8. Mental Health Professional Shortage Areas in Rural Appalachia

    ERIC Educational Resources Information Center

    Hendryx, Michael

    2008-01-01

    Context: Research on health disparities in Appalachia has rarely compared Appalachia to other geographic areas in such a way as to isolate possible Appalachian effects. Purpose: This study tests hypotheses that nonmetropolitan Appalachia will have higher levels of mental health professional shortage areas than other nonmetropolitan areas of the…

  9. Water harvesting techniques for small communities in arid areas.

    PubMed

    Yuen, E; Anda, M; Mathew, K; Ho, G

    2001-01-01

    Limited water resources exist in numerous remote indigenous settlements around Australia. Indigenous people in these communities are still living in rudimentary conditions while their urban counterparts have full amenities, large scale water supplies and behavioral practices which may not be appropriate for an arid continent but are supported by extensive infrastructure in higher rainfall coastal areas. As remote indigenous communities continue to develop, their water use will increase, and in some cases, costly solutions may have to be implemented to augment supplies. Water harvesting techniques have been applied in settlements on a small scale for domestic and municipal purposes, and in the large, broadacre farm setting for productive use of the water. The techniques discussed include swales, infiltration basins, infiltration trenches and "sand dam" basins. This paper reviews the applications of water harvesting relevant to small communities for land rehabilitation, landscaping and flood control. Landscaping is important in these communities as it provides shelter from the sun and wind, reduces soil erosion and hence reduced airborne dust, and in some cases provides food and nutrition. Case studies of water harvesting systems applied in the Pilbara Region, Western Australia for landscaping around single dwellings in Jigalong and Cheeditha, in a permaculture garden in Wittenoon and at a college and carpark in Karratha are described.

  10. Health care for children: a community perspective.

    PubMed

    Callahan, D

    2001-04-01

    There are two puzzles about health care for children that need explanation. Why is it the sentimentality Americans express about children has not been backed by solid health care programs? If children are to have good health care, how can a case for their high priority be made, particularly in light of the fact that their health is the best of all age groups in the country? The first question is explored, but the second question is the focus of this paper. A priority system for health care is proposed, and at the same time an argument is presented for why children should have a high priority despite their generally good health. PMID:11376424

  11. Community mental health care worldwide: current status and further developments

    PubMed Central

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness.

  12. Community mental health care worldwide: current status and further developments

    PubMed Central

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness. PMID:27717265

  13. Development of critically reflective dialogues in communities of health professionals.

    PubMed

    de Groot, Esther; Endedijk, Maaike; Jaarsma, Debbie; van Beukelen, Peter; Simons, Robert-Jan

    2013-10-01

    Critically reflective dialogues (CRD) are important for knowledge sharing and creating meaning in communities. CRD includes different aspects: being open about mistakes, critical opinion sharing, asking for and giving feedback, experimentation, challenging groupthink and research utilisation. In this article we explore whether CRD aspects change over time, through a study of two dialogues each from six different communities of veterinary health professionals. Change was studied from the perspective of observations, through analysing transcripts of dialogues, and from the perspective of community members' perceptions, through an evaluative discussion with members. The results showed that some communities became more open about mistakes, a finding that is related to an increase in trust. Other observed aspects of CRD seemed to be fairly stable over time. Community members perceived research utilisation and asking for and giving feedback to have been increased. From an analysis of perceptions of the community members it emerged that limited interaction could be associated with the epistemological conceptions of community members. PMID:22976456

  14. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.

    PubMed

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Borton, J Elaine; Wright, Merrick; Chase, Charlie; Lindley, Corina

    2010-05-01

    Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization.

  15. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.

    PubMed

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Borton, J Elaine; Wright, Merrick; Chase, Charlie; Lindley, Corina

    2010-05-01

    Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization. PMID:19843702

  16. Responding to rural health needs through community participation: addressing the concerns of children and young adults.

    PubMed

    Jeffery, Vivienne; Ervin, Kaye

    2011-01-01

    A small rural health service undertook a major needs analysis in 2008 to identify gaps in service delivery and duplication of services. This exercise was intended to inform strategic direction but the result was consumer and community consultation and outcomes that far exceeded everyone's expectations. Organisations often pay lip service to the concept of community participation and consultation and the importance of consumer involvement. Turning this rhetoric into action is challenging and requires dedicated staff, organisational support and momentum for it to occur. The project described resulted in targeted, purposeful action regarding community engagement, and the findings and outcomes are reflective of this. The unexpected findings required an organisational shift, which was embraced by the health service and resulted in collaborative partnerships with consumers and organisations that are proving beneficial to the entire community and outlying areas. Few organisations would demonstrate the willingness to accommodate such change, or undertake a needs analysis that is chiefly community driven. PMID:21645466

  17. Child health in Peru: importance of regional variation and community effects on children's height and weight.

    PubMed

    Shin, Heeju

    2007-12-01

    In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas. PMID:18198688

  18. Mental health nurses' contributions to community mental health care: An Australian study.

    PubMed

    Heslop, Brett; Wynaden, Dianne; Tohotoa, Jenny; Heslop, Karen

    2016-10-01

    Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses' experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.

  19. Investigating the myth of the "model minority": a participatory community health assessment of Chinese and Vietnamese adults.

    PubMed

    Tendulkar, Shalini Ahuja; Hamilton, Renée Cammarata; Chu, Chieh; Arsenault, Lisa; Duffy, Kevin; Huynh, Van; Hung, Mei; Lee, Eric; Jane, Shwuling; Friedman, Elisa

    2012-10-01

    Despite the persistent belief that Asians are the "model minority" there is accumulating evidence of health concerns within Asian subgroups. In this study, we implemented a cross-sectional participatory community health assessment in an urban city in Massachusetts, to understand differences and similarities in demographics, health and healthcare access in Chinese and Vietnamese adults. We gathered qualitative data from community stakeholders to inform the development of a community health assessment tool. The tool elicited information on healthcare access, health status, behavioral health and chronic disease history and treatment. Healthcare access issues and poor health status, particularly among Chinese participants and mental health symptomotology in both groups were areas of concern. These findings revealed important health concerns in two Asian ethnic groups. Studies are needed to better understand these concerns and inform programs and policies to improve health outcomes in these Asian ethnic groups.

  20. Considerations for community-based mHealth initiatives: insights from three Beacon Communities.

    PubMed

    Abebe, Nebeyou A; Capozza, Korey L; Des Jardins, Terrisca R; Kulick, David A; Rein, Alison L; Schachter, Abigail A; Turske, Scott A

    2013-10-15

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs.

  1. Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

    PubMed Central

    2013-01-01

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

  2. Toward a Model of Psychological Health Empowerment: Implications for Health Care in Multicultural Communities.

    ERIC Educational Resources Information Center

    Menon, Sanjay T.

    2002-01-01

    The context for health empowerment includes individuals, health providers, and the regulatory environment. Psychological health empowerment consists of perceived control, perceived competence, and goal internalization. In multicultural communities, barriers to empowerment include locus of control, access to health care, and language and cultural…

  3. Community Dental Health Promotion for Children: Integrating Applied Behavior Analysis and Public Health.

    ERIC Educational Resources Information Center

    Kramer, Kathryn D.; Geller, E. Scott

    1987-01-01

    The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…

  4. Comparison of Self and Health Professionals' Ratings of the Health of Community-Based Elderly.

    ERIC Educational Resources Information Center

    Wilson, Cindy C.; Netting, F. Ellen

    1987-01-01

    Compared health need perceptions of 269 community-based elderly persons and 80 health-care professionals. Found high degree of incongruence between perceptions of elderly and of professionals. Health professionals were not good predictors of the health status of the elderly, and they did not accurately predict the barriers faced by the elderly…

  5. Climbing the walls: prison mental health and community engagement.

    PubMed

    Caie, Jude

    Until recently, treatment for mental health conditions has focused on medical and psychological therapy. The role and significance of social and community interventions and initiatives in fostering recovery, resilience and a sense of 'flourishing' is now being recognised. This paper seeks to explore how these principles, which are usually community-based, can be successfully applied within a prison setting, and how such interventions may have a positive effect on the mental health of prisoners through successfully engaging them with the communities they are set to return to after release while still in custody. PMID:22875351

  6. Community, service, and policy strategies to improve health care access in the changing urban environment.

    PubMed

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs.

  7. Community, service, and policy strategies to improve health care access in the changing urban environment.

    PubMed

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs. PMID:10846501

  8. Community, service, and policy strategies to improve health care access in the changing urban environment.

    PubMed Central

    Andrulis, D P

    2000-01-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs. PMID:10846501

  9. A Community Health Record: Improving Health Through Multisector Collaboration, Information Sharing, and Technology.

    PubMed

    King, Raymond J; Garrett, Nedra; Kriseman, Jeffrey; Crum, Melvin; Rafalski, Edward M; Sweat, David; Frazier, Renee; Schearer, Sue; Cutts, Teresa

    2016-01-01

    We present a framework for developing a community health record to bring stakeholders, information, and technology together to collectively improve the health of a community. It is both social and technical in nature and presents an iterative and participatory process for achieving multisector collaboration and information sharing. It proposes a methodology and infrastructure for bringing multisector stakeholders and their information together to inform, target, monitor, and evaluate community health initiatives. The community health record is defined as both the proposed framework and a tool or system for integrating and transforming multisector data into actionable information. It is informed by the electronic health record, personal health record, and County Health Ranking systems but differs in its social complexity, communal ownership, and provision of information to multisector partners at scales ranging from address to zip code. PMID:27609300

  10. A Community Health Record: Improving Health Through Multisector Collaboration, Information Sharing, and Technology

    PubMed Central

    Garrett, Nedra; Kriseman, Jeffrey; Crum, Melvin; Rafalski, Edward M.; Sweat, David; Frazier, Renee; Schearer, Sue; Cutts, Teresa

    2016-01-01

    We present a framework for developing a community health record to bring stakeholders, information, and technology together to collectively improve the health of a community. It is both social and technical in nature and presents an iterative and participatory process for achieving multisector collaboration and information sharing. It proposes a methodology and infrastructure for bringing multisector stakeholders and their information together to inform, target, monitor, and evaluate community health initiatives. The community health record is defined as both the proposed framework and a tool or system for integrating and transforming multisector data into actionable information. It is informed by the electronic health record, personal health record, and County Health Ranking systems but differs in its social complexity, communal ownership, and provision of information to multisector partners at scales ranging from address to zip code. PMID:27609300

  11. Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

    PubMed

    Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

    2013-01-01

    As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

  12. Health Education Community Health Teaching Supports. Grade 9.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    This handbook contains suggested teaching activities, student worksheets, background information, and a list of basic resources for teachers of health education. Topics covered are mortality rate, health promotion, sexually transmitted diseases, Acquired Immune Deficiency Syndrome (AIDS), and major dimensions of health. Included in the handbook is…

  13. Health Education Community Health Teaching Supports. Grade 8.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    This handbook contains suggested teaching activities, student worksheets, background information, and a list of basic resources for teachers of health education. Topics covered are mortality rate, health promotion, the circulatory system, heart disease, majors dimensions of health, and Acquired Immune Deficiency Syndrome (AIDS). Included in the…

  14. Community health nursing and the AIDS pandemic: case report of one community's response.

    PubMed

    Kuehnert, P L

    1991-01-01

    The World Health Organization (WHO) currently projects that there may be a cumulative total of 30 million cases of Acquired Immune Deficiency Syndrome (AIDS) worldwide by the year 2000 ("WHO Predicts," 1991). Community health nurses (CHNs), particularly those employed by local and state health departments, have a major role to play in the worldwide public health effort being mounted in response to the AIDS pandemic. CHN roles may include: direct caregiver, advocate, case manager, health educator, program planner, program coordinator, and policy advocate. How CHNs contribute to the effort against AIDS in various CHN roles is illustrated through a case report of a Midwestern U.S. suburban community's response to AIDS. The community's response was fostered and an AIDS program developed and implemented by CHNs employed by the community's health department. In addition to enabling this community to respond to AIDS in a humane and caring manner, the CHN initiatives have resulted in positive community feelings about the health department, and enhanced the image of CHNs as innovators and facilitators of change.

  15. Translating Community Connectedness to Practice: A Qualitative Study of Midlevel Health Workers in Rural Guatemala

    PubMed Central

    Hernández, Alison; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

    2012-01-01

    Background. The performance of midlevel health workers is a critical lever for strengthening health systems and redressing inequalities in underserved areas. Auxiliary nurses form the largest cadre of health workers in Guatemala. In rural settings, they provide essential services to vulnerable communities, and thus have great potential to address priority health needs. This paper examines auxiliary nurses' motivation and satisfaction, and the coping strategies they use to respond to challenges they confront in their practice. Methods. Semistructured interviews were conducted with 14 auxiliary nurses delivering health services in Alta Verapaz, Guatemala. Results. Community connectedness was central to motivation in this rural Guatemalan setting. Participants were from rural communities and conveyed a sense of connection to the people they were serving through shared culture and their own experiences of health needs. Satisfaction was derived through recognition from the community and a sense of valuing their work. Auxiliary nurses described challenges commonly faced in low-resource settings. Findings indicated they were actively confronting these challenges through their own initiative. Conclusions. Strategies to support the performance of midlevel health workers should focus on mechanisms to make training accessible to rural residents, support problem-solving in practice, and emphasize building relationships with communities served. PMID:23097715

  16. Acceptability and Trust of Community Health Workers Offering Maternal and Newborn Health Education in Rural Uganda

    ERIC Educational Resources Information Center

    Singh, Debra; Cumming, Robert; Negin, Joel

    2015-01-01

    When trusted, Community Health Workers (CHWs) can contribute to improving maternal and newborn health outcomes in low- and middle-income countries through education. Issues of acceptability of CHWs by communities were explored through experiences gained in a qualitative study that is part of a cluster randomized trial in East Uganda. Initially,…

  17. Small-area health comparisons using health-adjusted life expectancies: a Bayesian random-effects approach.

    PubMed

    Jonker, Marcel F; Congdon, Peter D; van Lenthe, Frank J; Donkers, Bas; Burdorf, Alex; Mackenbach, Johan P

    2013-09-01

    Health-adjusted life expectancy (HALE) is one of the most attractive summary measures of population health. It provides balanced attention to fatal as well as non-fatal health outcomes, is sensitive to the severity of morbidity within the population, and can be readily compared between areas with very different population age structures. HALE, however, cannot be calculated at the small-area level using traditional life table methodology. Hence we propose a Bayesian random-effects modeling approach that recognizes correlations and pools strength between sexes, age-groups, geographical areas, and health outcomes. This approach allows for the calculation of HALE for areas as small as 2000 person years at risk and with relatively modest health state survey sample sizes. The feasibility of the Bayesian approach is illustrated in a real-life example, which also shows how differences in areas' health performances can be adequately quantified. Such information can be invaluable for the appropriate targetting and subsequent evaluation of urban regeneration, neighborhood renewal, and community-based initiatives aimed at improving health and reducing health inequalities. PMID:23778148

  18. Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom

    PubMed Central

    Kang, Changhyun; Shin, Jihyung; Matthews, Bob

    2015-01-01

    Objectives The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). Methods The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. Results The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. Conclusion When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives. PMID:26981341

  19. Design of an online health-promoting community: negotiating user community needs with public health goals and service capabilities

    PubMed Central

    2013-01-01

    Background An online health-promoting community (OHPC) has the potential to promote health and advance new means of dialogue between public health representatives and the general public. The aim of this study was to examine what aspects of an OHPC that are critical for satisfying the needs of the user community and public health goals and service capabilities. Methods Community-based participatory research methods were used for data collection and analysis, and participatory design principles to develop a case study OHPC for adolescents. Qualitative data from adolescents on health appraisals and perspectives on health information were collected in a Swedish health service region and classified into categories of user health information exchange needs. A composite design rationale for the OHPC was completed by linking the identified user needs, user-derived requirements, and technical and organizational systems solutions. Conflicts between end-user requirements and organizational goals and resources were identified. Results The most prominent health information needs were associated to food, exercise, and well-being. The assessment of the design rationale document and prototype in light of the regional public health goals and service capabilities showed that compromises were needed to resolve conflicts involving the management of organizational resources and responsibilities. The users wanted to discuss health issues with health experts having little time to set aside to the OHPC and it was unclear who should set the norms for the online discussions. Conclusions OHPCs can be designed to satisfy both the needs of user communities and public health goals and service capabilities. Compromises are needed to resolve conflicts between users’ needs to discuss health issues with domain experts and the management of resources and responsibilities in public health organizations. PMID:23826944

  20. Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan.

    PubMed

    Memon, Zahid; Zaidi, Shehla; Riaz, Atif

    2015-11-03

    Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers.

  1. Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan

    PubMed Central

    Memon, Zahid; Zaidi, Shehla; Riaz, Atif

    2016-01-01

    Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers. PMID:26925902

  2. Health Literacy and Happiness: A Community-Based Study

    ERIC Educational Resources Information Center

    Angner, Erik; Miller, Michael J.; Ray, Midge N.; Saag, Kenneth G.; Allison, Jeroan J.

    2010-01-01

    The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: "How confident are you in filling out medical forms by yourself?" Happiness was measured using an adapted…

  3. A Community Project in Religion and Mental Health.

    ERIC Educational Resources Information Center

    Indiana Univ., Indianapolis. Medical Center.

    Supported by the National Institue of Mental Health and Lilly Endowment, Inc., a demonstration program in continuing education for clergy and related professions in the field of mental health was conducted from 1964 to 1967. The purpose was to provide clinical pastoral education within the clergtman's home community where he could learn to work…

  4. Art in the Community for Potentially Vulnerable Mental Health Groups

    ERIC Educational Resources Information Center

    Argyle, Elaine; Bolton, Gillie

    2005-01-01

    Purpose: Drawing on literature and the evaluation of a UK community Arts in Health project, this article aims first to demonstrate that, in spite of the common association in mental health practice between art and the use of psychotherapeutic techniques, involvement in art creation can, in itself, have a sustained and positive impact on the mental…

  5. Papago Indian Modernization: A Community Scale for Health Research

    ERIC Educational Resources Information Center

    Patrick, Ralph; Tyroler, H. A.

    1972-01-01

    An index of the modernization of Papago communities was developed to test whether social and cultural processes are involved in the determination of human health and whether rapid social change affects health. An earlier version of this paper was presented at the annual meeting of the American Anthropological Association, Detroit, 1964. (FF)

  6. The Impact of Economic Stress on Community Mental Health Services.

    ERIC Educational Resources Information Center

    Hagan, Brian J.; And Others

    1982-01-01

    Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)

  7. An Informatics Approach to Establishing a Sustainable Public Health Community

    ERIC Educational Resources Information Center

    Kriseman, Jeffrey Michael

    2012-01-01

    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  8. Corruption of Client Advocacy in a Community Mental Health System.

    ERIC Educational Resources Information Center

    Denner, Bruce

    This speech discusses client advocacy, a paraprofessional service offered in many community mental health centers to help bridge the gap between therapist and client. While having an advocate on the mental health team is an attractive idea, these client advocates are quite susceptible to "corruption." The author discusses two major causes of this…

  9. Exploring Community Health through the Sustainable Livelihoods Framework

    ERIC Educational Resources Information Center

    Barnidge, Ellen K.; Baker, Elizabeth A.; Motton, Freda; Fitzgerald, Teresa; Rose, Frank

    2011-01-01

    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The…

  10. Process and impact evaluation of a legal assistance and health care community partnership.

    PubMed

    Teufel, James A; Brown, Stephen L; Thorne, Woody; Goffinet, Diane M; Clemons, Latesha

    2009-07-01

    Community health partnerships have increased in popularity, but their effectiveness is often not evaluated. Through secondary data analysis, this study evaluates a program that offered access to legal services to address health-related issues, such as Medicaid reimbursement, Social Security benefits, medication coverage, and divorce. Based on the analysis reimbursements to expenditures, the health and law program appears to be cost-effective and thereby economically sustainable. The cost-effectiveness of this program increases the likelihood that it will be institutionalized and/or expanded. This program evaluation is used to exemplify how community stakeholders could partner to leverage resources to establish a sustainable community health and law program to address the needs of people living in medically underserved areas. PMID:18408120

  11. Process and impact evaluation of a legal assistance and health care community partnership.

    PubMed

    Teufel, James A; Brown, Stephen L; Thorne, Woody; Goffinet, Diane M; Clemons, Latesha

    2009-07-01

    Community health partnerships have increased in popularity, but their effectiveness is often not evaluated. Through secondary data analysis, this study evaluates a program that offered access to legal services to address health-related issues, such as Medicaid reimbursement, Social Security benefits, medication coverage, and divorce. Based on the analysis reimbursements to expenditures, the health and law program appears to be cost-effective and thereby economically sustainable. The cost-effectiveness of this program increases the likelihood that it will be institutionalized and/or expanded. This program evaluation is used to exemplify how community stakeholders could partner to leverage resources to establish a sustainable community health and law program to address the needs of people living in medically underserved areas.

  12. [A method of education at a distance for nurses' aides in the community area of Guatemala].

    PubMed

    García Pastor de Domínguez, E; Robles de Sandoval, A; Martínez Chopen, O

    1988-01-01

    The authors describe in detail a self-tutorial system that has been used for some ten years in Guatemala to train auxiliary nursing personnel. This model addressed both training and service objectives, and it proved to be consistent with a health policy of integrating teaching and service which the country was implementing at the time. The system involved a national effort to develop self-tutorial units and materials on basic subjects such as nursing procedures, mother and child health, first aid, management, guided therapy, community development and health education. Materials were divided into three categories: for self-tutorial instruction, for recording, supervision and evaluation, and for coordination and feedback within the system. Lastly, greater detail is given on the functions and tasks performed at the different levels of staff involved in managing the system, and the mechanisms which were implemented in the country's health areas are described.

  13. [A method of education at a distance for nurses' aides in the community area of Guatemala].

    PubMed

    García Pastor de Domínguez, E; Robles de Sandoval, A; Martínez Chopen, O

    1988-01-01

    The authors describe in detail a self-tutorial system that has been used for some ten years in Guatemala to train auxiliary nursing personnel. This model addressed both training and service objectives, and it proved to be consistent with a health policy of integrating teaching and service which the country was implementing at the time. The system involved a national effort to develop self-tutorial units and materials on basic subjects such as nursing procedures, mother and child health, first aid, management, guided therapy, community development and health education. Materials were divided into three categories: for self-tutorial instruction, for recording, supervision and evaluation, and for coordination and feedback within the system. Lastly, greater detail is given on the functions and tasks performed at the different levels of staff involved in managing the system, and the mechanisms which were implemented in the country's health areas are described. PMID:3168883

  14. The health needs of the Somali community in Bristol.

    PubMed

    Ingram, Jenny

    2009-12-01

    Refugees and asylum-seekers have many health needs, and access to health services is often complicated by language barriers and a lack of properly trained interpreters and health advocates. This study aimed to identify the health needs of the Somali community in Bristol by conducting 10 semistructured interviews with community representatives and healthcare professionals, and two focus groups with Somali residents.The findings were validated and discussed at a workshop with local residents, teachers, primary healthcare team members and stakeholders. Priorities were agreed and translated into action. Three interrelated themes were identified--access to health promotion information, communication needs and service provision. Suggestions were made to establish groups, drop-in sessions and health awareness days. The findings for the Bristol Somali community could apply to most newly arrived refugee communities in the UK. Understanding where people have come from, their healthcare needs and the social factors that characterise exile will help healthcare professionals to improve the services offered to these communities.

  15. Environment and health: environmental sanitation and community water supply.

    PubMed

    1997-01-01

    This article identifies important features of two 5-Year Plans in India. Currently, only about 200 cities have even a partial sewage system. Elementary sewage systems are nonexistent in rural villages. In 1990, under 5% of rural population had access to sanitary facilities. The result is widespread soil and water pollution and its accompanying disease. The Rural Water Supply Program was proposed in the 5th Plan, but was implemented in the 7th Plan (1985-90). Construction of latrines is still too low. Resources were insufficiently mobilized for latrine construction. An alternative would be to institute cost recovery and user pays principles. Low cost technology could be substituted. Low cost latrine systems should conform with users' social habits, local culture, and the customs of the community. The system should be affordable to users. The technology should be user-friendly and rely on use of local materials and workers. Over 90% of the population rely on community water supply facilities. Health has not benefited from the access to water supplies. The reasons are low hygienic standards, lack of water quality surveillance, and poor maintenance of equipment. The community does not participate. By 1996, people's access to water was reduced to 1 km in the plains, and 50 m in hilly areas. Surface waters are contaminated by fecal matter, fluoride, nitrate, and arsenic. The Water Quality Surveillance Program lacks an institutional framework and human resource development. There is a need for education about hygiene, unsafe drinking water, and poor sanitation for people and agency staff. PMID:12293893

  16. Community Engagement and Data Disclosure in Environmental Health Research

    PubMed Central

    Haynes, Erin N.; Elam, Sarah; Burns, Roxanne; Spencer, Alonzo; Yancey, Elissa; Kuhnell, Pierce; Alden, Jody; Walton, Mike; Reynolds, Virgil; Newman, Nicholas; Wright, Robert O.; Parsons, Patrick J.; Praamsma, Meredith L.; Palmer, Christopher D.; Dietrich, Kim N.

    2016-01-01

    Summary: Federal funding agencies increasingly support stakeholder participation in environmental health studies, and yet there is very little published research on engagement of community members in the development of data disclosure (DD) strategies. The Ohio Environmental Protection Agency reported airborne manganese (Mn) concentrations in East Liverpool, Ohio, 30 times higher than the reference concentration, which led to an academic–community research partnership to address community concern about Mn exposure, particularly among children. Children and their families were recruited to participate in a pilot study. Samples of blood and hair were collected from the children and analyzed for metals. DD mechanisms were developed using an iterative approach between community and academic partners. Individual DD letters were mailed to each participating family, and a community meeting was held. A post-meeting survey was administered to gauge community perception of the DD strategies. The purpose of this article is to demonstrate the effectiveness of engaging community partners in the conduct of environmental health research and in the development of DD strategies for individuals and the community at large. Scientists should include community partners in the development of DD strategies to enhance translation of the research findings and support the right of study participants to know their individual results. PMID:26829152

  17. Empowering Minority Communities with Health Information - WSSU

    SciTech Connect

    McMurray, L. and W. Templin-Branner

    2010-11-10

    Environmental health focus with training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine HBCU ACCESS Project at Winston-Salem State University, NC on November 10, 2010.

  18. Mental Health Service Delivery in Rural Areas: Organizational and Clinical Issues.

    ERIC Educational Resources Information Center

    Wagenfeld, Morton O.; Murray, J. Dennis; Mohatt, Dennis F.; DeBruyn, Jeanne C.

    The rural community mental health center tends to serve a large geographic area, have decentralized service delivery, require its professionals to function as generalists, and coordinate closely with other agencies. The last decade has seen an increasing strain placed on this pattern. As block grant and fee-for-service shifts resulting from the…

  19. Performance of female volunteer community health workers in Dhaka urban slums.

    PubMed

    Alam, Khurshid; Tasneem, Sakiba; Oliveras, Elizabeth

    2012-08-01

    Volunteer community health workers (CHWs) are one approach to addressing the health workforce crisis in developing countries. BRAC, a large Bangladeshi NGO, a pioneer in this area, uses female volunteer CHWs as core workers in its health programs. After 25 years of implementing the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through its community-based mother, newborn and child health interventions. However, the program experienced suboptimal performance among CHWs, with a high percentage of them remaining in their positions but becoming "inactive", not truly participating in daily community health activities. This suggests a need to better understand the relative importance of factors affecting their active participation and to recommend strategies for improving their participation. This mixed-method study included a descriptive correlational design to assess factors relating to level of activity of CHWs and focus group discussions to explore solutions to these problems. A sample of 542 current female CHWs from project areas participated in the survey. Financial incentives were the main factor linked to the activity of CHWs. CHWs who thought that running their families would be difficult without CHW income had more than three times greater odds to become active. In addition, social prestige and positive community feedback to the CHWs were important non-financial factors associated with level of activity. In order to improve volunteer CHWs' performance, a combination of financial and non-financial incentives should be used. PMID:22595068

  20. Performance of female volunteer community health workers in Dhaka urban slums.

    PubMed

    Alam, Khurshid; Tasneem, Sakiba; Oliveras, Elizabeth

    2012-08-01

    Volunteer community health workers (CHWs) are one approach to addressing the health workforce crisis in developing countries. BRAC, a large Bangladeshi NGO, a pioneer in this area, uses female volunteer CHWs as core workers in its health programs. After 25 years of implementing the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through its community-based mother, newborn and child health interventions. However, the program experienced suboptimal performance among CHWs, with a high percentage of them remaining in their positions but becoming "inactive", not truly participating in daily community health activities. This suggests a need to better understand the relative importance of factors affecting their active participation and to recommend strategies for improving their participation. This mixed-method study included a descriptive correlational design to assess factors relating to level of activity of CHWs and focus group discussions to explore solutions to these problems. A sample of 542 current female CHWs from project areas participated in the survey. Financial incentives were the main factor linked to the activity of CHWs. CHWs who thought that running their families would be difficult without CHW income had more than three times greater odds to become active. In addition, social prestige and positive community feedback to the CHWs were important non-financial factors associated with level of activity. In order to improve volunteer CHWs' performance, a combination of financial and non-financial incentives should be used.

  1. Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda.

    PubMed

    Musoke, David; Ekirapa-Kiracho, Elizabeth; Ndejjo, Rawlance; George, Asha

    2015-05-01

    Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. From the study, known health systems problems including inadequate transport, long distance to health facilities, long waiting times at facilities and poor quality of care were confirmed, but other aspects that needed to be addressed were also established. These included key gender-related determinants of maternal health, such as domestic violence, low contraceptive use and early teenage pregnancy, as well as problems of unclean water, poor sanitation and women's lack of income. Community members appreciated learning about the research findings precisely hence designing and implementing appropriate solutions to the problems identified because they could see photographs from their own local area. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders.

  2. Using Public Health and Community Partnerships to Reduce Density of Alcohol Outlets

    PubMed Central

    Sparks, Michael; Yang, Evelyn; Schwartz, Randy

    2013-01-01

    Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets — the number of physical locations in which alcoholic beverages are available for purchase either per area or per population — through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms. We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska. Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems. PMID:23578401

  3. Using public health and community partnerships to reduce density of alcohol outlets.

    PubMed

    Jernigan, David H; Sparks, Michael; Yang, Evelyn; Schwartz, Randy

    2013-01-01

    Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets - the number of physical locations in which alcoholic beverages are available for purchase either per area or per population - through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms. We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska. Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.

  4. Community perspectives on post-Katrina mental health recovery in New Orleans.

    PubMed

    Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

    2011-01-01

    Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

  5. Partnering with Communities to Address the Mental Health Needs of Rural Veterans

    ERIC Educational Resources Information Center

    Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

    2011-01-01

    Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

  6. Disabled Village Children. A Guide for Community Health Workers, Rehabilitation Workers, and Families. First Edition.

    ERIC Educational Resources Information Center

    Werner, David

    This heavily illustrated volume is a reference book intended to bring together basic information to help community health workers, rehabilitation workers, and families in rural areas of developing countries meet the needs of village children with a wide range of disabilities. Part 1, "Working with the Child and Family," reviews the prevention of…

  7. Implementation of the principles of primary health care in a rural area of South Africa

    PubMed Central

    Schneider, Marguerite

    2014-01-01

    Background The philosophy of primary healthcare forms the basis of South Africa's health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas. Objectives The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa. Method A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis. Results Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, health-worker attitudes, referral services and the management of complex conditions. Conclusion The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcare services and increasing the doctors’ hours. PMID:26245391

  8. Community participation for transformative action on women’s, children’s and adolescents’ health

    PubMed Central

    Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony

    2016-01-01

    Abstract The Global strategy for women’s, children’s and adolescents’ health (2016–2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals. PMID:27152056

  9. Community participation for transformative action on women's, children's and adolescents' health.

    PubMed

    Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda

    2016-05-01

    The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.

  10. Predictors and a Framework for Fostering Community Advocacy as a Community Health Worker Core Function to Eliminate Health Disparities

    PubMed Central

    Ingram, Maia; Reinschmidt, Kerstin M.; Schachter, Kenneth; Jacobs, Laurel; Guernsey de Zapien, Jill; Robinson, Laurie; Carvajal, Scott

    2013-01-01

    Objectives. Using a mixed-method, participatory research approach, we investigated factors related to community health worker (CHW) community advocacy that affect social determinants of health. Methods. We used cross-sectional survey data for 371 CHWs to assess demographics, training, work environment, and leadership qualities on civic, political, and organizational advocacy. We present advocacy stories to further articulate CHW activities. The data reported are from the recently completed National Community Health Workers Advocacy Study. Results. CHWs are involved in advocacy that is community-focused, although advocacy differs by intrinsic leadership, experience, training, and work environment. We propose a framework to conceptualize, support, and evaluate CHW advocacy and the iterative processes they engage in. These processes create opportunities for community voice and action to affect social and structural conditions that are known to have wide-ranging health effects on communities. Conclusions. The framework presented may have utility for CHWs, their training programs, and their employers as well as funders and policymakers aiming to promote health equity. PMID:23678904

  11. 50 CFR Table 21 to Part 679 - Eligible Communities, Halibut IFQ Regulatory Area Location, Community Governing Body That...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Regulatory Area Location, Community Governing Body That Recommends the CQE, and the Fishing Programs and..., Community Governing Body That Recommends the CQE, and the Fishing Programs and Associated Areas Where a CQE... assigned in the GOA groundfish regulatory area Central GOA Western GOA Akhiok 3A City of Akhiok X X X 7...

  12. Needs Assessment for Mobilization in Community Health Education: A Review and Case Study.

    ERIC Educational Resources Information Center

    Umble, Karl E.

    The Planned Approach to Community Health (PATCH) program was designed by the Centers for Disease Control as a tool to help communities plan, implement, and evaluate health promotion and health education programs. PATCH consists of three components: community mobilization, community diagnosis, and community intervention. The implementation of…

  13. Electronic Health Records and Community Health Surveillance of Childhood Obesity

    PubMed Central

    Flood, Tracy L.; Zhao, Ying-Qi; Tomayko, Emily J.; Tandias, Aman; Carrel, Aaron L.; Hanrahan, Lawrence P.

    2015-01-01

    Background Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. Purpose To demonstrate the feasibility of estimating childhood obesity rates using de-identified electronic health records for the purpose of public health surveillance and health promotion. Methods Data were extracted from the Public Health Information Exchange (PHINEX) database. PHINEX contains de-identified electronic health records from patients primarily in south central Wisconsin. Data on children and adolescents (aged 2–19 years, 2011–2012, n=93,130) were transformed in a two-step procedure that adjusted for missing data and weighted for a national population distribution. Weighted and adjusted obesity rates were compared to the 2011–2012 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in 2014. Results The weighted and adjusted obesity rate was 16.1% (95% CI=15.8, 16.4). Non-Hispanic white children and adolescents (11.8%, 95% CI=11.5, 12.1) had lower obesity rates compared to non-Hispanic black (22.0%, 95% CI=20.7, 23.2) and Hispanic (23.8%, 95% CI=22.4, 25.1) patients. Overall, electronic health record–derived point estimates were comparable to NHANES, revealing disparities from preschool onward. Conclusions Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts. PMID:25599907

  14. The role of non-governmental organizations in the mental health area: differences in understanding

    PubMed Central

    Pahor, Majda

    2016-01-01

    Abstract Introduction The contribution’s aim is highlighting the differences in understanding non-governmental organizations’ (NGOs) role in the mental health area within the public support network for patients with mental health problems from various viewpoints, in order to achieve progress in supporting patients with mental health problems in local communities. Methods Qualitative data gathered as a part of a cross-sectional study of NGOs in the support network for patients with mental health problems in two Slovenian health regions (56 local communities), carried out in 2013 and 2014, were used. Qualitative analysis of interviews, focus groups and answers to an open survey question was performed. Results There are differences in understanding NGOs’ role in the support network for patients with mental health problems, which stem from the roles of stakeholders (local community officials, experts, care providers, and patients) within this system and their experience. Discussion and conclusion The actual differences need to be addressed and overcome in order to provide integrated community care. The importance of knowing the current state of NGOs in their life cycle and the socio-chronological context of the local community support network is evident. PMID:27703545

  15. Community participation in a rural community health trust: the case of Lawrence, New Zealand.

    PubMed

    Eyre, Rachel; Gauld, Robin

    2003-09-01

    Since the mid-1980s, the New Zealand health sector has been in a state of continual change. The most radical changes were in the early-1990s, with the creation of an internal market system for public health care delivery. Rural health services, seen to be unviable, were given the option of establishing themselves as 'community trusts', owning and running their own services. Community trusts have since become a feature of rural health care in New Zealand. An expectation was that community trusts would facilitate community participation. This article reports on a study of participation in a rural community health trust. The 'pentagram model' of Rifkin and coworkers, with its five dimensions of participation-needs assessment, leadership, resource mobilization, management and organization-was applied. High levels of participation were found across each of these dimensions. The research revealed additional dimensions that could be added to the framework, including 'sustainability of participation', 'equity in participation' and 'the dynamic socio-political context'. In this regard, it supports recent theoretical work by Laverack (2001) and Laverack and Wallerstein (2001). Finally, the article comments on the future of rural health trusts in the current round of health sector restructuring. PMID:12920139

  16. Community health and socioeconomic issues surrounding concentrated animal feeding operations.

    PubMed

    Donham, Kelley J; Wing, Steven; Osterberg, David; Flora, Jan L; Hodne, Carol; Thu, Kendall M; Thorne, Peter S

    2007-02-01

    A consensus of the Workgroup on Community and Socioeconomic Issues was that improving and sustaining healthy rural communities depends on integrating socioeconomic development and environmental protection. The workgroup agreed that the World Health Organization's definition of health, "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity," applies to rural communities. These principles are embodied in the following main points agreed upon by this workgroup. Healthy rural communities ensure a) the physical and mental health of individuals, b) financial security for individuals and the greater community, c) social well-being, d ) social and environmental justice, and e) political equity and access. This workgroup evaluated impacts of the proliferation of concentrated animal feeding operations (CAFOs) on sustaining the health of rural communities. Recommended policy changes include a more stringent process for issuing permits for CAFOs, considering bonding for manure storage basins, limiting animal density per watershed, enhancing local control, and mandating environmental impact statements. PMID:17384786

  17. Community Health and Socioeconomic Issues Surrounding Concentrated Animal Feeding Operations

    PubMed Central

    Donham, Kelley J.; Wing, Steven; Osterberg, David; Flora, Jan L.; Hodne, Carol; Thu, Kendall M.; Thorne, Peter S.

    2007-01-01

    A consensus of the Workgroup on Community and Socioeconomic Issues was that improving and sustaining healthy rural communities depends on integrating socioeconomic development and environmental protection. The workgroup agreed that the World Health Organization’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” applies to rural communities. These principles are embodied in the following main points agreed upon by this workgroup. Healthy rural communities ensure a) the physical and mental health of individuals, b) financial security for individuals and the greater community, c) social well-being, d ) social and environmental justice, and e) political equity and access. This workgroup evaluated impacts of the proliferation of concentrated animal feeding operations (CAFOs) on sustaining the health of rural communities. Recommended policy changes include a more stringent process for issuing permits for CAFOs, considering bonding for manure storage basins, limiting animal density per watershed, enhancing local control, and mandating environmental impact statements. PMID:17384786

  18. Health Education Planning And Community Perceptions Of Local Health Problems

    ERIC Educational Resources Information Center

    Newman, Ian M.; Mayshark, Cyrus

    1973-01-01

    An essay on the status of health education in one state which illustrates some of the apparent inconsistencies in the health education process which we should recognize are not limited to one state alone. This report was presented to the Research Council of the 46th annual meeting of ASHA, San Diego, California, October 1972. (Author)

  19. Racism and Mental Health: Essays. Contemporary Community Health Series.

    ERIC Educational Resources Information Center

    Willie, Charles V., Ed.; And Others

    These 15 essays by leading psychiatrists, sociologists, educators, demographers, and health administrators are organized into four parts: "Overview,""Clinical Context,""Social Context," and "Action Context." Part I includes: "Racism and Mental Health as a Field of Thought and Action," Bernard M. Kramer; and, "Historical Perspectives on Mental…

  20. Iran's disaster risk: now is the time for community-based public health preparedness.

    PubMed

    Ardalan, Ali; Mowafi, Hani; Burkle, Frederick M

    2013-10-01

    The Bandar Bushehr, Iran earthquake of April 9, 2013 gravely illustrates how disaster-prone areas of the world are compounding their risk of disaster and major public health emergencies when there is a geographical convergence of natural and technological hazards. Scientists must emphasize to policy makers that ever-increasing regional industrialization and the broader introduction of nuclear facilities, especially in the Middle East, must parallel sound prevention and community-level public health preparedness planning.

  1. Health, Traffic, and Environmental Justice: Collaborative Research and Community Action in San Francisco, California

    PubMed Central

    Sciammas, Charlie; Seto, Edmund; Bhatia, Rajiv; Rivard, Tom

    2009-01-01

    Health impacts on neighborhood residents from transportation systems can be an environmental justice issue. To assess the effects of transportation planning decisions, including the construction of an intraurban freeway, on residents of the Excelsior neighborhood in southeast San Francisco, PODER (People Organizing to Demand Environmental and Economic Rights), a local grassroots environmental justice organization; the San Francisco Department of Public Health; and the University of California, Berkeley, collaborated on participatory research. We used our findings regarding traffic-related exposures and health hazards in the area to facilitate community education and action to address transportation-related health burdens on neighborhood residents. PMID:19890147

  2. Racism, health status, and birth outcomes: results of a participatory community-based intervention and health survey.

    PubMed

    Carty, Denise C; Kruger, Daniel J; Turner, Tonya M; Campbell, Bettina; DeLoney, E Hill; Lewis, E Yvonne

    2011-02-01

    Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N = 629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.

  3. Modeling Area-Level Health Rankings

    PubMed Central

    Courtemanche, Charles; Soneji, Samir; Tchernis, Rusty

    2015-01-01

    Objective Rank county health using a Bayesian factor analysis model. Data Sources Secondary county data from the National Center for Health Statistics (through 2007) and Behavioral Risk Factor Surveillance System (through 2009). Study Design Our model builds on the existing county health rankings (CHRs) by using data-derived weights to compute ranks from mortality and morbidity variables, and by quantifying uncertainty based on population, spatial correlation, and missing data. We apply our model to Wisconsin, which has comprehensive data, and Texas, which has substantial missing information. Data Collection Methods The data were downloaded from www.countyhealthrankings.org. Principal Findings Our estimated rankings are more similar to the CHRs for Wisconsin than Texas, as the data-derived factor weights are closer to the assigned weights for Wisconsin. The correlations between the CHRs and our ranks are 0.89 for Wisconsin and 0.65 for Texas. Uncertainty is especially severe for Texas given the state's substantial missing data. Conclusions The reliability of comprehensive CHRs varies from state to state. We advise focusing on the counties that remain among the least healthy after incorporating alternate weighting methods and accounting for uncertainty. Our results also highlight the need for broader geographic coverage in health data. PMID:26256684

  4. Public health preparedness of health providers: meeting the needs of diverse, rural communities.

    PubMed Central

    Hsu, Chiehwen Ed; Mas, Francisco Soto; Jacobson, Holly E.; Harris, Ann Marie; Hunt, Victoria I.; Nkhoma, Ella T.

    2006-01-01

    Meeting the needs of public health emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to public health emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of public health emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies. PMID:17128688

  5. 18. Photocopy of architectural drawing (from Albuquerque Area Indian Health ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Photocopy of architectural drawing (from Albuquerque Area Indian Health Service, Division of Health Facilities, Albuquerque, New Mexico) Mayers, Murray, and Phillip, Architects, New York, NY, 1934 Detail sheet - Taos Indian Health Center, 0.3 mile south-southwest of Pueblos Plaza, Taos Pueblo, Taos County, NM

  6. 14. Photocopy of architectural drawing (from Albuquerque Area Indian Health ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of architectural drawing (from Albuquerque Area Indian Health Service, Division of Health Facilities, Albuquerque, New Mexico) Mayers, Murray, and Phillip, Architects, New York, N&, 1934 Foundation Plan - Taos Indian Health Center, 0.3 mile south-southwest of Pueblos Plaza, Taos Pueblo, Taos County, NM

  7. 16 Photocopy of architectural drawing (from Albuquerque Area Indian Health ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16 Photocopy of architectural drawing (from Albuquerque Area Indian Health Service, Division of Health Facilities, Albuquerque, New Mexico) Mayers Murray, and Phillip, Architects, New York, NY, 1934 first floor mechanical plan - heating - Taos Indian Health Center, 0.3 mile south-southwest of Pueblos Plaza, Taos Pueblo, Taos County, NM

  8. 15. Photocopy of architectural drawing (from Albuquerque Area Indian Health ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy of architectural drawing (from Albuquerque Area Indian Health Service, Division of Health Facilities, Albuquerque, New Mexico) Mayers, Murray, and Phillip, Architects, New York, NY, 1934 First Floor - plumbing - Taos Indian Health Center, 0.3 mile south-southwest of Pueblos Plaza, Taos Pueblo, Taos County, NM

  9. 17. Photocopy of architectural drawing (from Albuquerque Area Indian Health ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. Photocopy of architectural drawing (from Albuquerque Area Indian Health Service, Division of Health Facilities, Albuquerque, New Mexico) Mayers, Murray, and Phillip, Architects, New York, NY, 1934 Elevations - Taos Indian Health Center, 0.3 mile south-southwest of Pueblos Plaza, Taos Pueblo, Taos County, NM

  10. Community-based organizations in the health sector: a scoping review.

    PubMed

    Wilson, Michael G; Lavis, John N; Guta, Adrian

    2012-11-21

    Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).Given the range of terms used to describe community

  11. Integrated community education model: breast health awareness to impact late-stage breast cancer.

    PubMed

    Northington, LaDonna; Martin, Tina; Walker, Jean T; Williams, P Renée; Lofton, Susan P; Cooper, Janet R; Luther, Cynthia H; Keller, Sheila D

    2011-08-01

    Race and ethnicity play roles in breast cancer mortality, particularly for African American women. As a result, a three-pronged integrated community education model (i.e., faith-based, community, and state agencies) was generated and tested in a medically underserved area with high mortality rates from breast cancer to increase participation in breast health education, provide early screening and detection practices, and provide access to annual mammograms and referral sources. The model provided three women with life-saving early diagnoses, in addition to providing potentially hundreds of women with a network of breast health, self-monitoring, and referral sources for future issues.

  12. Health outcomes of incarcerated pregnant women and their infants in a community-based program.

    PubMed

    Barkauskas, Violet H; Low, Lisa Kane; Pimlott, Sheryl

    2002-01-01

    An experimental, community-based, residential program, focused on health promotion, was established in 1990 for incarcerated pregnant women with short-term sentences and histories of drug abuse in a large, midwestern metropolitan area in the United States. Infants resided with mothers after birth. Prenatal care, delivery, postpartum, and family-planning services were initiated and provided by a nurse-midwifery service. Community-based health care, job training, and drug rehabilitation were provided for women during pregnancy through the fourth postpartum month. Program participants' prenatal, delivery, postpartum, and neonatal health outcomes are presented and compared with those of incarcerated women in the same state prison system who experienced usual correctional facility care and support. Program participants represented a group of obstetrically high-risk women. Health outcomes for both groups of incarcerated women and their infants were similar and more optimal than would have been expected given their preexisting health conditions and risk factors.

  13. Teaching and addressing health disparities through the family medicine social and community context of care project.

    PubMed

    White, Jordan; Heney, Jessica; Esquibel, Angela Y; Dimock, Camia; Goldman, Roberta; Anthony, David

    2014-09-01

    By training future physicians to care for patients with backgrounds different from their own, medical schools can help reduce health disparities. To address the need for education in this area, the leaders of the Family Medicine Clerkship at the Warren Alpert Medical School of Brown University developed the Social and Community Context of Care project, required of all medical students rotating through this clerkship. Students develop a hypothetical intervention addressing a health issue seen at their preceptor site, and are assessed on their grasp of the social and contextual issues affecting that health issue in their particular community. Some interventions are actualized in later clerkships or independent study projects; one example, a health class for pregnant and parenting teens at Central Falls High School, is described here. If made a routine part of medical education, projects such as these may help medical students address the health disparities they will encounter in future practice.

  14. Empowering Minority Communities with Health Information - UDC

    SciTech Connect

    McMurray, L.; R. Foster; and R. Womble

    2010-11-02

    Training update with Environmental a health focus. Training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine - HBCU ACCESS Project at the University of the District of Columbia, Washington, DC on November 2, 2010.

  15. Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

    PubMed

    Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

    2015-09-01

    The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

  16. Promoting the Health of Families and Communities: A Moral Imperative.

    PubMed

    Mason, Diana J

    2016-09-01

    The Hill Burton Act, which was signed into law in 1946 and ended in 1997, was one of the most significant forces that shaped the health care system we have today. Providing grants and loans for the construction and expansion of hospitals across the country, it required beneficiary hospitals to give some amount of uncompensated care to the poor and uninsured in return. The act not only led to our health care system's current emphasis on the acute-care hospital as the primary site of health care delivery, but it also had a profound effect on nursing, fully involving the profession in an acute-care world. The act created jobs for nurses at an unprecedented level. There are over 3.4 million nurses in the United States, and in 2013, 63 percent of all nurses worked for hospitals. Nursing education continues to emphasize acute care, despite the calls for shifting the curriculum to more community-based content and experiences that focus on health promotion and wellness for individuals, families, and communities. It is my premise that the nursing profession and all who profess to be committed to promoting health have a moral obligation to help the nation adopt a Hill-Burton Act of the twenty-first century that will focus on building healthy communities, supporting families in ways that promote health, and helping individuals to live healthier lives. This would require a shift in resources from a costly health care system to investing in community development, whether job creation, building safe places to play and exercise, providing access to affordable and nutritious foods, advancing the quality of education, or other approaches to addressing and improving the social determinants of health. Making this kind of investment would speak to the principles of beneficence, least harm, and justice, particularly for socioeconomically stressed communities.

  17. Promoting the Health of Families and Communities: A Moral Imperative.

    PubMed

    Mason, Diana J

    2016-09-01

    The Hill Burton Act, which was signed into law in 1946 and ended in 1997, was one of the most significant forces that shaped the health care system we have today. Providing grants and loans for the construction and expansion of hospitals across the country, it required beneficiary hospitals to give some amount of uncompensated care to the poor and uninsured in return. The act not only led to our health care system's current emphasis on the acute-care hospital as the primary site of health care delivery, but it also had a profound effect on nursing, fully involving the profession in an acute-care world. The act created jobs for nurses at an unprecedented level. There are over 3.4 million nurses in the United States, and in 2013, 63 percent of all nurses worked for hospitals. Nursing education continues to emphasize acute care, despite the calls for shifting the curriculum to more community-based content and experiences that focus on health promotion and wellness for individuals, families, and communities. It is my premise that the nursing profession and all who profess to be committed to promoting health have a moral obligation to help the nation adopt a Hill-Burton Act of the twenty-first century that will focus on building healthy communities, supporting families in ways that promote health, and helping individuals to live healthier lives. This would require a shift in resources from a costly health care system to investing in community development, whether job creation, building safe places to play and exercise, providing access to affordable and nutritious foods, advancing the quality of education, or other approaches to addressing and improving the social determinants of health. Making this kind of investment would speak to the principles of beneficence, least harm, and justice, particularly for socioeconomically stressed communities. PMID:27649921

  18. Evaluation of a Lay Health Adviser Training for a Community-Based Participatory Research Project in a Native American Community

    ERIC Educational Resources Information Center

    Watts, Vanessa M.; Christopher, Suzanne; Streitz, Jana L.; McCormick, Alma Knows His Gun

    2005-01-01

    Community-based participatory research directly involves community members and community-based service providers as partners in the research process. It is especially important in Native American communities, where egregious research practices have led some communities and individuals to be wary of researchers. Messengers for Health uses a lay…

  19. Community Engaged Leadership to Advance Health Equity and Build Healthier Communities

    PubMed Central

    Holden, Kisha; Akintobi, Tabia; Hopkins, Jammie; Belton, Allyson; McGregor, Brian; Blanks, Starla; Wrenn, Glenda

    2016-01-01

    Health is a human right. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential. Addressing the multi-faceted health needs of ethnically and culturally diverse individuals in the United States is a complex issue that requires inventive strategies to reduce risk factors and buttress protective factors to promote greater well-being among individuals, families, and communities. With growing diversity concerning various ethnicities and nationalities; and with significant changes in the constellation of multiple of risk factors that can influence health outcomes, it is imperative that we delineate strategic efforts that encourage better access to primary care, focused community-based programs, multi-disciplinary clinical and translational research methodologies, and health policy advocacy initiatives that may improve individuals’ longevity and quality of life. PMID:27713839

  20. Community environmental health assessment strengthens environmental public health services in the Peruvian Amazon.

    PubMed

    Hubbard, Brian; Gelting, Richard; Baffigo, Virginia; Sarisky, John

    2005-01-01

    In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities

  1. Primary Health Care and partnerships: collaboration of a community agency, health department, and university nursing program.

    PubMed

    Leonard, L G

    1998-03-01

    Health care reform proposals emphasize health care that is essential, practical, scientifically sound, coordinated, accessible, appropriately delivered, and affordable. One route to achievement of improved health outcomes within these parameters is the formation of partnerships. Partnerships adopting the philosophy and five principles of Primary Health Care (PHC) focus on health promotion and prevention of illness and disability, maximum community participation, accessibility to health and health services, interdisciplinary and intersectoral collaboration, and use of appropriate technologies such as resources and strategies. A community service agency serving a multicultural population initiated a partnership with a health department and a university undergraduate nursing program. The result was a preschool health fair and there were benefits for each partner-benefits which could not have been realized without the collaboration. The health fair partnership planning, implementation, and evaluation process was guided by a framework shaped by the philosophy and five principles of PHC. The educational process described can be applied to other learning experiences where the goal is to help students understand and apply the concepts of PHC, develop myriad nursing competencies, and form collaborative relationships with the community and health agencies. Community health care dilemmas and nursing education challenges can be successfully addressed when various disciplines and sectors form effective partnerships. PMID:9535233

  2. Soil resources area affects herbivore health.

    PubMed

    Garner, James A; Ahmad, H Anwar; Dacus, Chad M

    2011-06-01

    Soil productivity effects nutritive quality of food plants, growth of humans and animals, and reproductive health of domestic animals. Game-range surveys sometimes poorly explained variations in wildlife populations, but classification of survey data by major soil types improved effectiveness. Our study evaluates possible health effects of lower condition and reproductive rates for wild populations of Odocoileus virginianus Zimmerman (white-tailed deer) in some physiographic regions of Mississippi. We analyzed condition and reproductive data for 2400 female deer from the Mississippi Department of Wildlife, Fisheries, and Parks herd health evaluations from 1991-1998. We evaluated age, body mass (Mass), kidney mass, kidney fat mass, number of corpora lutea (CL) and fetuses, as well as fetal ages. Region affected kidney fat index (KFI), which is a body condition index, and numbers of fetuses of adults (P≤0.001). Region affected numbers of CL of adults (P≤0.002). Mass and conception date (CD) were affected (P≤0.001) by region which interacted significantly with age for Mass (P≤0.001) and CD (P<0.04). Soil region appears to be a major factor influencing physical characteristics of female deer.

  3. Process evaluation of community monitoring under national health mission at Chandigarh, union territory: Methodology and challenges

    PubMed Central

    Tripathy, Jaya Prasad; Aggarwal, Arun Kumar; Patro, Binod Kumar; Verma, Himbala

    2015-01-01

    Background: Community monitoring was introduced on a pilot mode in 36 selected districts of India in a phased manner. In Chandigarh, it was introduced in the year 2009–2010. A preliminary evaluation of the program was undertaken with special emphasis on the inputs and the processes. Methodology: Quantitative methods included verification against checklists and record reviews. Nonparticipant observation was used to evaluate the conduct of trainings, interviews, and group discussions. Health system had trained health system functionaries (nursing students and Village Health Sanitation Committee [VHSC] members) to generate village-based scorecards for assessing community needs. Community needs were assessed independently for two villages under the study area to validate the scores generated by the health system. Results: VHSCs were formed in all 22 villages but without a chairperson or convener. The involvement of VHSC members in the community monitoring process was minimal. The conduct of group discussions was below par due to poor moderation and unequal responses from the group. The community monitoring committees at the state level had limited representation from the non-health sector, lower committees, and the nongovernmental organizations/civil societies. Agreement between the report cards generated by the investigator and the health system in the selected villages was found to be to be fair (0.369) whereas weighted kappa (0.504) was moderate. Conclusion: In spite of all these limitations and challenges, the government has taken a valiant step by trying to involve the community in the monitoring of health services. The dynamic nature of the community warrants incorporation of an evaluation framework into the planning of such programs. PMID:26985413

  4. Using journals for community health students engaged in group work.

    PubMed

    Drevdahl, Denise J; Dorcy, Kathleen Shannon

    2002-01-01

    Teaching students concepts integral to community health nursing, such as collaboration and partnership, while providing clinical practica in community agencies, mandates that students address group process and evaluate self-growth. To facilitate reflection on self-learning in the context of collaborative group work, faculty and students use a structured, graded, weekly journal. This teaching and learning tool serves as a mechanism for assisting students with understanding group process.

  5. Measuring Population Health Using Electronic Health Records: Exploring Biases and Representativeness in a Community Health Information Exchange.

    PubMed

    Dixon, Brian E; Gibson, P Joseph; Frederickson Comer, Karen; Rosenman, Marc

    2015-01-01

    Assessment is a core function of public health. Comprehensive clinical data may enhance community health assessment by providing up-to-date, representative data for use in public health programs and policies, especially when combined with community-level data relevant to social determinants. In this study we examine routinely collected and geospatially-enhanced EHR data to assess population health at various levels of geographic granularity available from a regional health information exchange. We present preliminary findings and discuss important biases in EHR data. Future work is needed to develop methods for correcting for those biases to support routine epidemiology work of public health.

  6. Health impact of small-community water supply reliability.

    PubMed

    Majuru, Batsirai; Michael Mokoena, M; Jagals, Paul; Hunter, Paul R

    2011-03-01

    There is still debate and uncertainty in the literature about the health benefits of community water supply interventions. This paper reports on a changing incidence of self-reported diarrhoea associated with the implementation of two community water supplies. We conducted prospective weekly recording of diarrhoeal disease in three communities. Two of the communities were scheduled to receive an improved water supply and one was expected to continue to rely on an unimproved source during the study period. Data of self-reported diarrhoea was collected from each participating household on a weekly basis for up to 56 weeks, of which some 17 weeks were prior to implementation of the new water supply systems. Data was modelled using Generalized Estimating Equations (GEE) to account for possible clustering within households and within villages. For the two intervention communities in the study, the incidence rate ratio (IRR) for all ages after the intervention was 0.43 (95% CI 0.24-0.79) when compared to the control community (who did not receive an intervention), implying a 57% reduction of diarrhoea. Both of the new water systems were unreliable, one not operating on 4 weeks and the other on 16 weeks. The more reliable of the two intervention systems was also associated with less illness than in the least reliable system (IRR=0.41, 95% CI 0.21-0.80). We also noted anecdotal reports that during supply failures in the new systems some people were starting to use household water treatment. The implementation of improved water systems does appear to have been associated with a reduction of diarrhoeal disease in the communities. However the health impact was most obvious in the community with the more reliable system. Further research needs to be done to determine whether public health gains from community water supply interventions can be leveraged by occasional use of household water treatment (HWT) during supply failures.

  7. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  8. Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia

    PubMed Central

    Nyantekyi, Liza; Legesse, Mengistu; Medhin, Girmay; Animut, Abebe; Tadesse, Konjit; Macias, Chanda; Degarege, Abraham; Erko, Berhanu

    2014-01-01

    Objective To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections. Methods Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique. Results Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years. Conclusions Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area. PMID:25183071

  9. Exploring the meaning of context for health: Community influences on child health in South India

    PubMed Central

    Luke, Nancy; Xu, Hongwei

    2014-01-01

    Much research attention has been devoted to community context and health. Communities are often defined as residential spaces, such as neighborhoods, or as social groupings, such as caste in India. Using data from a group of tea estates in South India, we attempt to address important methodological challenges in the identification of neighborhood effects on child health. We find significant neighborhood effects for weight for age at age one, including a protective role for community-level women's education, but none for birth weight. In contrast to the usual pattern in rural India, caste disparities in child health are also eliminated in this setting. PMID:25484619

  10. Community health nursing practices in contexts of poverty, uncertainty and unpredictability: a systematization of personal experiences.

    PubMed

    Laperrière, Hélène

    2007-01-01

    Several years of professional nursing practices, while living in the poorest neighbourhoods in the outlying areas of Brazil's Amazon region, have led the author to develop a better understanding of marginalized populations. Providing care to people with leprosy and sex workers in riverside communities has taken place in conditions of uncertainty, insecurity, unpredictability and institutional violence. The question raised is how we can develop community health nursing practices in this context. A systematization of personal experiences based on popular education is used and analyzed as a way of learning by obtaining scientific knowledge through critical analysis of field practices. Ties of solidarity and belonging developed in informal, mutual-help action groups are promising avenues for research and the development of knowledge in health promotion, prevention and community care and a necessary contribution to national public health programmers.

  11. Building Sustainable Health and Education Partnerships: Stories From Local Communities

    PubMed Central

    Blank, Martin J

    2015-01-01

    BACKGROUND Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. METHODS Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. RESULTS The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. CONCLUSIONS To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. PMID:26440823

  12. Reimagining community health psychology: maps, journeys and new terrains.

    PubMed

    Campbell, Catherine; Cornish, Flora

    2014-01-01

    This special issue celebrates and maps out the 'coming of age' of community health psychology, demonstrating its confident and productive expansion beyond its roots in the theory and practice of small-scale collective action in local settings. Articles demonstrate the field's engagement with the growing complexity of local and global inequalities, contemporary forms of collective social protest and developments in critical social science. These open up novel problem spaces for the application and extension of its theories and methods, deepening our understandings of power, identity, community, knowledge and social change - in the context of evolving understandings of the spatial, embodied, relational, collaborative and historical dimensions of health.

  13. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    SciTech Connect

    ORAU's Oak Ridge Institute for Science Education

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  14. Helminth communities of fish as ecological indicators of lake health.

    PubMed

    Shah, Humaira Bashir; Yousuf, A R; Chishti, M Z; Ahmad, Fayaz

    2013-03-01

    This paper deals largely with the dynamics and changes in the helminth parasite communities of fish along the trophic gradient of lakes. The use of parasitological community data as a bioindicator of environmental health underlines the need to study parasite communities at comparable localities with known pollution levels. The comparison of the conditions in different habitats might be helpful to differentiate between normal fluctuations in ambient conditions and pollution-mediated effects. Therefore, the present study was designed to examine the community structure of parasites in snow trout (Schizothorax niger Heckel) inhabiting 3 lakes of contrasting trophic status in Kashmir. The idea of selecting the lakes, namely Anchar (strongly hypereutrophic), Dal (eutrophic) and Manasbal (mesotrophic) for this study was intentional as they depict different trophic gradients and exhibit the desirable pattern which was a prerequisite for this study. The findings presented in this article suggest an apparent lake-wise gradient in community structure, as the increase in trematode and cestode infections in Anchar was markedly greater, to levels clearly distinguishable from those in the other two water bodies. We conclude that human-induced eutrophication of lakes modifies the parasite community at component level and community-level studies on parasites may provide information on health status of lakes. PMID:23127258

  15. One Health profile of a community at the wildlife-domestic animal interface, Mpumalanga, South Africa.

    PubMed

    Berrian, Amanda M; van Rooyen, Jacques; Martínez-López, Beatriz; Knobel, Darryn; Simpson, Gregory J G; Wilkes, Michael S; Conrad, Patricia A

    2016-08-01

    We used a community engagement approach to develop a One Health profile of an agro-pastoralist population at the interface of wildlife areas in eastern South Africa. Representatives from 262 randomly-selected households participated in an in-person, cross-sectional survey. Questions were designed to ascertain the participants' knowledge, attitudes, and practices with regard to human health, domestic animal health, and natural resources including wildlife and water. Surveys were conducted within four selected villages by a team of trained surveyors and translators over four weeks in July-August 2013. Questions were a combination of multiple choice (single answer), multiple selection, open-ended, and Likert scale. The study found that nearly three-quarters of all households surveyed reported owning at least one animal (55% owned chickens, 31% dogs, 25% cattle, 16% goats, 9% cats, and 5% pigs). Among the animal-owning respondents, health concerns identified included dissatisfaction with government-run cattle dip facilities (97%) and frequent morbidity and mortality of chickens that had clinical signs consistent with Newcastle disease (49%). Sixty-one percent of participants believed that diseases of animals could be transmitted to humans. Ninety-six percent of respondents desired greater knowledge about animal diseases. With regard to human health issues, the primary barrier to health care access was related to transportation to/from the community health clinics. Environmental health issues revealed by the survey included disparities by village in drinking water reliability and frequent domiciliary rodent sightings positively associated with increased household size and chicken ownership. Attitudes towards conservation were generally favorable; however, the community demonstrated a strong preference for a dichotomous approach to wildlife management, one that separated wildlife from humans. Due to the location of the community, which neighbors the Great Limpopo

  16. One Health profile of a community at the wildlife-domestic animal interface, Mpumalanga, South Africa.

    PubMed

    Berrian, Amanda M; van Rooyen, Jacques; Martínez-López, Beatriz; Knobel, Darryn; Simpson, Gregory J G; Wilkes, Michael S; Conrad, Patricia A

    2016-08-01

    We used a community engagement approach to develop a One Health profile of an agro-pastoralist population at the interface of wildlife areas in eastern South Africa. Representatives from 262 randomly-selected households participated in an in-person, cross-sectional survey. Questions were designed to ascertain the participants' knowledge, attitudes, and practices with regard to human health, domestic animal health, and natural resources including wildlife and water. Surveys were conducted within four selected villages by a team of trained surveyors and translators over four weeks in July-August 2013. Questions were a combination of multiple choice (single answer), multiple selection, open-ended, and Likert scale. The study found that nearly three-quarters of all households surveyed reported owning at least one animal (55% owned chickens, 31% dogs, 25% cattle, 16% goats, 9% cats, and 5% pigs). Among the animal-owning respondents, health concerns identified included dissatisfaction with government-run cattle dip facilities (97%) and frequent morbidity and mortality of chickens that had clinical signs consistent with Newcastle disease (49%). Sixty-one percent of participants believed that diseases of animals could be transmitted to humans. Ninety-six percent of respondents desired greater knowledge about animal diseases. With regard to human health issues, the primary barrier to health care access was related to transportation to/from the community health clinics. Environmental health issues revealed by the survey included disparities by village in drinking water reliability and frequent domiciliary rodent sightings positively associated with increased household size and chicken ownership. Attitudes towards conservation were generally favorable; however, the community demonstrated a strong preference for a dichotomous approach to wildlife management, one that separated wildlife from humans. Due to the location of the community, which neighbors the Great Limpopo

  17. Community mental health nursing in Alberta, Canada: an oral history.

    PubMed

    Boschma, Geertje

    2012-01-01

    Community mental health nurses had a central role in the construction of new rehabilitative practices and community mental health services in the 1960s and 1970s. The purpose of this article is, first, to explore how nurses understood and created their new role and identity in the turbulent context of deinstitutionalization. The development of after care services for patients discharged from Alberta Hospital in Ponoka (AH-Ponoka), a large mental institution in Calgary, in the Canadian province of Alberta, will be used as a case study. I specifically focus on the establishment of outpatient services in a new psychiatric department at Foothills General Hospital in Calgary. Second, I examine how deinstitutionalization itself shaped community mental health nurses' work. Oral history interviews with nurses and other mental health professionals, who had a central role in this transformation process, provide a unique lens through which to explore this social change. The article concludes that new rehabilitative, community-based mental health services can better be understood as a transformation of former institutional practices rather than as a definite break with them.

  18. The effect of an interdisciplinary community health project on student attitudes toward community health, people who are indigent and homeless, and team leadership skill development.

    PubMed

    Rose, Molly A; Lyons, Kevin J; Swenson Miller, Kathleen; Cornman-Levy, Diane

    2003-01-01

    This study examined whether students' attitudes about community health practice, attitudes toward people who are indigent and homeless, and perceived leadership skills changed after participation in a planned interdisciplinary community health experience with an urban homeless or formerly homeless population. Data were collected from medicine, nursing, occupational therapy, physical therapy, and social work students who participated in the community health experiences and from students in these disciplines who did not participate in this curriculum. The interdisciplinary community health curriculum and practicum experiences, based on the Community Health Empowerment Model (CHEM), were designed and implemented by a coalition of community and academic partners. Students in the CHEM project self-selected into the curriculum and initially showed more positive attitudes about community health and indigent and homeless people than their peers not participating. Despite the CHEM students' positive initial attitudes, data from pretests and posttests revealed a significant positive change in their attitudes toward community health practice at the completion of the curriculum.

  19. Rejuvenating health systems for aging communities.

    PubMed

    Paccaud, Fred

    2002-08-01

    Nowadays, about the half of Swiss women die after their 84th birthday. This unprecedented proportion of the population reaching an old age, or even a very old age (25% of women die after 89 years, and 5% after 95 years) is a novel aspect of human demographics, and represents the very last stage of the epidemiological transition, a term coined to describe the transformation of the prevailing health burden in the population, shifting from infectious and communicable pathologies to chronic and degenerative diseases. In developed countries, this epidemiological transition has been well documented during the last century; worldwide, a similar transition is taking place, with some countries still at mid or early stages of transition. A striking aspect of the current transition is its speed. In India, the mean duration of life since 1947 has increased from 32 to 62 years. As a result, India, like many other developing countries, is facing a double burden of disease, i.e., an upsurge of degenerative diseases while the burden from the old agenda (i.e., malaria, tuberculosis) still reaches devastating proportions in the population. This double burden is certainly a crucial problem in developing countries, and probably is the most important health challenge for the coming century. A similar accelerated pace of change is observed with the decline of mortality at old age. Worldwide, the current estimate of centenarians is 100000, i.e., ten time more centenarians than the number estimated in 1960. The downward trend in mortality, which is steeper with increasing age, is now the leading factor to Increase the life expectancy in developed countries. In the United Kingdom, life expectancy increased by 2.5 years between 1971 and 1991; this is equivalent to the increase observed between 1851 and 1961. This accelerated increase will influence public health in two different ways. The first will be the absolute increase in the number of older persons, with a corresponding increase in

  20. Community Health, Community Involvement, and Community Empowerment: Too Much to Expect?

    ERIC Educational Resources Information Center

    Baillie, Lynne; Broughton, Sandra; Bassett-Smith, Joan; Aasen, Wendy; Oostindie, Madeleine; Marino, Betty Anne; Hewitt, Ken

    2004-01-01

    The Primary Prevention of Cancer Program at the British Columbia Cancer Agency Centre for the Southern Interior (BCCA-CSI), known as the Waddell Project, is now five years old and currently is in partnership with fourteen regional communities. Each of these communities has a range of community-developed programs currently in place. The driving…

  1. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    PubMed

    Skerritt, Louise; Moore, Zena

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  2. Industrial Food Animal Production and Community Health.

    PubMed

    Casey, Joan A; Kim, Brent F; Larsen, Jesper; Price, Lance B; Nachman, Keeve E

    2015-09-01

    Industrial food animal production (IFAP) is a source of environmental microbial and chemical hazards. A growing body of literature suggests that populations living near these operations and manure-applied crop fields are at elevated risk for several health outcomes. We reviewed the literature published since 2000 and identified four health outcomes consistently and positively associated with living near IFAP: respiratory outcomes, methicillin-resistant Staphylococcus aureus (MRSA), Q fever, and stress/mood. We found moderate evidence of an association of IFAP with quality of life and limited evidence of an association with cognitive impairment, Clostridium difficile, Enterococcus, birth outcomes, and hypertension. Distance-based exposure metrics were used by 17/33 studies reviewed. Future work should investigate exposure through drinking water and must improve exposure assessment with direct environmental sampling, modeling, and high-resolution DNA typing methods. Investigators should not limit study to high-profile pathogens like MRSA but include a broader range of pathogens, as well as other disease outcomes.

  3. Public Participation in Urban Environmental Management: A Model for Promoting Community-Based Environmental Management in Peri-Urban Areas.

    ERIC Educational Resources Information Center

    Yacoob, May; Brantly, Eugene; Whiteford, Linda

    In October 1992, the Water and Sanitation for Health (WASH) Project held a workshop to explore how the U.S. Agency for International Development (USAID) could incorporate community participation as a core element in projects to improve water supply, sanitation, and other environmental conditions of peri-urban areas in developing countries. The…

  4. Coercion and compulsion in community mental health care.

    PubMed

    Molodynski, Andrew; Rugkåsa, Jorun; Burns, Tom

    2010-01-01

    There is ongoing debate in the UK as to the place of coercion and compulsion in community mental health care. Recent changes in service provision and amendments to the Mental Health Act in England and Wales have increased the scope for compulsion in the community. This has intensified the debate revealing fault lines in the psychiatric and legal professions. Despite powerful arguments from all sides there is little empirical evidence to inform this debate at a clinical or a theoretical level. This review utilizes evidence from articles in peer reviewed journals. Papers were identified from electronic databases, the authors' databases of relevant literature and personal correspondence with experts in the field. The evidence base is relatively small but is expanding. It has been demonstrated that informal coercion is common in USA mental health services and can be experienced negatively by patients. There is evidence that powers of compulsion in community mental health care are used frequently when available and their availability is generally seen as positive by clinicians when practice becomes embedded. The evidence for the effectiveness of compulsion in community mental health care is patchy and conflicting, with randomized or other trials failing to show significant benefits overall even if secondary analyses may suggest positive outcomes in some subgroups. There are widespread regional and international differences in the use of community compulsion. Research examining treatment pressures (or 'leverage') and the subjective patient experience of them appears to be expanding and is increasing our awareness and understanding of these complex issues. There is an urgent need for evidence regarding the usefulness and acceptability of compulsion in the community now that powers have been made available. Trials of the effectiveness of compulsion are needed as is qualitative work examining the experiences of those involved in the use of such orders. These are needed to

  5. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance alternative for community health centers, migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES...

  6. A role for community health promoters in tuberculosis control in the state of Chiapas, Mexico.

    PubMed

    Herce, Michael E; Chapman, Jacob A; Castro, Arachu; García-Salyano, Gabriel; Khoshnood, Kaveh

    2010-04-01

    We conducted a qualitative study employing structured interviews with 38 community health workers, known as health promoters, from twelve rural municipalities of Chiapas, Mexico in order to characterize their work and identify aspects of their services that would be applicable to community-based tuberculosis (TB) control programs. Health promoters self-identify as being of Mayan Indian ethnicity. Most are bilingual, speaking Spanish and one of four indigenous Mayan languages native to Chiapas. They volunteer 11 h each week to conduct clinical and public health work in their communities. Over half (53%) work with a botiquín, a medicine cabinet stocked with essential medicines. Fifty-three percent identify TB as a major problem affecting the health of their communities, with one-fifth (21%) of promoters reporting experience caring for patients with known or suspected TB and 29% having attended to patients with hemoptysis. One-third of health promoters have access to antibiotics (32%) and one-half have experience with their administration; 55% complement their biomedical treatments with traditional Mayan medicinal plant therapies in caring for their patients. We describe how health promoters employ both traditional and allopathic medicine to treat the symptoms and diseases they encounter most frequently which include fever, diarrhea, and parasitic infections. We contend that given the complex sociopolitical climate in Chiapas and the state's unwavering TB epidemic and paucity of health care infrastructure in rural areas, efforts to implement comprehensive, community-based TB control would benefit from employing the services of health promoters. PMID:20033836

  7. Comparison of health conditions treated with traditional and biomedical health care in a Quechua community in rural Bolivia

    PubMed Central

    Vandebroek, Ina; Thomas, Evert; Sanca, Sabino; Van Damme, Patrick; Puyvelde, Luc Van; De Kimpe, Norbert

    2008-01-01

    Background The objective of the present study was to reveal patterns in the treatment of health conditions in a Quechua-speaking community in the Bolivian Andes based on plant use data from traditional healers and patient data from a primary health care (PHC) service, and to demonstrate similarities and differences between the type of illnesses treated with traditional and biomedical health care, respectively. Methods A secondary analysis of plant use data from semi-structured interviews with eight healers was conducted and diagnostic data was collected from 324 patients in the community PHC service. Health conditions were ranked according to: (A) the percentage of patients in the PHC service diagnosed with these conditions; and (B) the citation frequency of plant use reports to treat these conditions by healers. Healers were also queried about the payment modalities they offer to their patients. Results Plant use reports from healers yielded 1166 responses about 181 medicinal plant species, which are used to treat 67 different health conditions, ranging from general symptoms (e.g. fever and body pain), to more specific ailments, such as arthritis, biliary colic and pneumonia. The results show that treatment offered by traditional medicine overlaps with biomedical health care in the case of respiratory infections, wounds and bruises, fever and biliary colic/cholecystitis. Furthermore, traditional health care appears to be complementary to biomedical health care for chronic illnesses, especially arthritis, and for folk illnesses that are particularly relevant within the local cultural context. Payment from patients to healers included flexible, outcome contingent and non-monetary options. Conclusion Traditional medicine in the study area is adaptive because it corresponds well with local patterns of morbidity, health care needs in relation to chronic illnesses, cultural perceptions of health conditions and socio-economic aspects of health care. The quantitative

  8. Strengthening health development at the community level in Thailand: what events should be managed?

    PubMed

    Tanvatanakul, Vasuton; Vicente, Corália; Amado, João; Saowakontha, Sastri

    2007-01-01

    Community action for health development is important for sustaining community health. This study aimed to identify the components and processes for strengthening the community health development process. We used an exploratory, cross-sectional design and focus group discussions in Chonburi, Thailand, between March 2003 and April 2005. We interviewed 422 respondents selected by stratified sampling from various groups involved with community health activities. Interview data was analyzed and then clarified by focus group discussions with representatives of the communities and stakeholders. Results indicated that both study components, namely, community experience in health activities and appearance of health conditions in the community, as well as all of their subcomponents, influence community action for health development. The most influential subcomponent of the community experience in health activities was perception of health information and policy (p < .001; r = .546). The most influential subcomponent of the appearance of health conditions in the community was the impact of health information (p < .001; r = .439). Focus group discussions indicated the communities' potential, ideas and need to activate health development by community mobilization. We recommend that the government encourage and support community action for health development with the subcomponents identified by this study. The process of community empowerment and network of implementation should encourage successful and sustainable health development by the community.

  9. 50 CFR Table 21 to Part 679 - Eligible Communities, Halibut IFQ Regulatory Area Location, Community Governing Body That...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Regulatory Area Location, Community Governing Body That Recommends the CQE, and the Fishing Programs and..., Community Governing Body That Recommends the CQE, and the Fishing Programs and Associated Areas Where a CQE... X X Akhiok 3A City of Akhiok X X X 7 2 Angoon 2C City of Angoon X X X 4 Chenega Bay 3A Chenega...

  10. HIV/AIDS Community Health Information System.

    PubMed

    Fulcher, Christopher L; Kaukinen, Catherine E

    2003-01-01

    Given changes in the faces of AIDS over the last decade, it is crucial that disparities in health and access to healthcare are addressed. An Internet-based GIS was developed using ESRI's Arc Internet Map Server (Arc IMS) to provide users with a suite of tools to interact with geographic data and conduct spatial analyses related to the characteristics that promote or impede the provision of HIV-related services. Internet Mapping allows those engaged in local decision-making to: (1) geographically visualize information via the Internet; (2) Assess the relationship between the distribution of HIV services and spatially referenced socio-economic data; and (3) generate "what if" scenarios" that may direct the allocation of healthcare resources. PMID:14728567

  11. Evaluating complex community-based health promotion: addressing the challenges.

    PubMed

    Jolley, Gwyneth

    2014-08-01

    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations.

  12. Global environmental change: what can health care providers and the environmental health community do about it now?

    PubMed

    Schwartz, Brian S; Parker, Cindy; Glass, Thomas A; Hu, Howard

    2006-12-01

    The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.

  13. Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey.

    PubMed

    Sabo, Samantha; Wennerstrom, Ashley; Phillips, David; Haywoord, Catherine; Redondo, Floribella; Bell, Melanie L; Ingram, Maia

    2015-01-01

    This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field.

  14. Aging, health, and identity in Ecuador's indigenous communities.

    PubMed

    Waters, William F; Gallegos, Carlos A

    2014-12-01

    Middle-income countries like Ecuador are in the process of demographic and epidemiological transitions, and their populations are aging. The challenges associated with providing services to growing numbers of citizens who experience the inevitable deterioration associated with aging are mirrored by the manner in which aging is perceived in a culturally heterogeneous society. This paper presents the results of qualitative research conducted among older men and women in indigenous communities in the Ecuadorian highlands in order to investigate the perceptions regarding the ability of family and community networks to provide adequate and appropriate support for older persons in the context of their perceptions of health, health care, and aging. The principal findings are that: (i) perceptions of aging are shaped by chronic illness, fatigue, deteriorating sensory capacities, and vulnerability to accidents; (ii) barriers to health care are exacerbated among aging members of indigenous communities, although in some cases they can be addressed through traditional alternatives; (iii) the sense of identity shifts as aging people are increasingly unable to work the land and participate in community activities; and (iv) family and community support networks for older adults are not as strong as is generally thought. These findings represent the context within which issues related aging in a culturally heterogeneous society can be best understood and addressed.

  15. VisOHC: Designing Visual Analytics for Online Health Communities

    PubMed Central

    Kwon, Bum Chul; Kim, Sung-Hee; Lee, Sukwon; Choo, Jaegul; Huh, Jina; Yi, Ji Soo

    2015-01-01

    Through online health communities (OHCs), patients and caregivers exchange their illness experiences and strategies for overcoming the illness, and provide emotional support. To facilitate healthy and lively conversations in these communities, their members should be continuously monitored and nurtured by OHC administrators. The main challenge of OHC administrators' tasks lies in understanding the diverse dimensions of conversation threads that lead to productive discussions in their communities. In this paper, we present a design study in which three domain expert groups participated, an OHC researcher and two OHC administrators of online health communities, which was conducted to find with a visual analytic solution. Through our design study, we characterized the domain goals of OHC administrators and derived tasks to achieve these goals. As a result of this study, we propose a system called VisOHC, which visualizes individual OHC conversation threads as collapsed boxes–a visual metaphor of conversation threads. In addition, we augmented the posters' reply authorship network with marks and/or beams to show conversation dynamics within threads. We also developed unique measures tailored to the characteristics of OHCs, which can be encoded for thread visualizations at the users' requests. Our observation of the two administrators while using VisOHC showed that it supports their tasks and reveals interesting insights into online health communities. Finally, we share our methodological lessons on probing visual designs together with domain experts by allowing them to freely encode measurements into visual variables. PMID:26529688

  16. VisOHC: Designing Visual Analytics for Online Health Communities.

    PubMed

    Kwon, Bum Chul; Kim, Sung-Hee; Lee, Sukwon; Choo, Jaegul; Huh, Jina; Yi, Ji Soo

    2016-01-01

    Through online health communities (OHCs), patients and caregivers exchange their illness experiences and strategies for overcoming the illness, and provide emotional support. To facilitate healthy and lively conversations in these communities, their members should be continuously monitored and nurtured by OHC administrators. The main challenge of OHC administrators' tasks lies in understanding the diverse dimensions of conversation threads that lead to productive discussions in their communities. In this paper, we present a design study in which three domain expert groups participated, an OHC researcher and two OHC administrators of online health communities, which was conducted to find with a visual analytic solution. Through our design study, we characterized the domain goals of OHC administrators and derived tasks to achieve these goals. As a result of this study, we propose a system called VisOHC, which visualizes individual OHC conversation threads as collapsed boxes-a visual metaphor of conversation threads. In addition, we augmented the posters' reply authorship network with marks and/or beams to show conversation dynamics within threads. We also developed unique measures tailored to the characteristics of OHCs, which can be encoded for thread visualizations at the users' requests. Our observation of the two administrators while using VisOHC showed that it supports their tasks and reveals interesting insights into online health communities. Finally, we share our methodological lessons on probing visual designs together with domain experts by allowing them to freely encode measurements into visual variables.

  17. Developing a community-based neonatal care intervention: a health facility assessment to inform intervention design.

    PubMed

    Howe, Laura D; Manu, Alexander; Tawiah-Agyemang, Charlotte; Kirkwood, Betty R; Hill, Zelee

    2011-03-01

    Community-based interventions are an important way of improving health in low-income countries. A necessary prerequisite for the design of such interventions is an understanding of the local health system. This will inform intervention design, help ensure the community-intervention forms part of a continuum of care, and provide information about health system strengthening activities that may be necessary for success. Such formative research processes, however, are seldom reported in the literature. We present the results of a health facility assessment used in the design stage of Newhints, a community-based intervention to improve neonatal survival in rural Ghana. We illustrate the methodology, findings and how these were used to inform the design and implementation of Newhints. The assessment involved key informant interviews with staff members at seven health facilities within the study area, including a brief inventory of available drugs and equipment. The key informant interviews identified that practices and health promotion messages at the health facilities were not consistent with one of the key target behaviours of the Newhints intervention - thermal care through delayed infant bathing. Health workers were bathing neonates soon after delivery and also advising women to do the same, which is a potential cause of hypothermia for the newborn. We found that health centres other than large district hospitals were ill-equipped to treat serious complications of labour or illness in the newborn, which had implications for advice on health seeking behaviour within the intervention. As a result of the health facility assessment, it was deemed necessary to undertake both health worker training and sensitisation activities. We demonstrate that important information can be yielded from a relatively simple health facility assessment involving key informant interviews.

  18. Mental Health Services for Children; Focus: The Community Mental Health Center.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Rockville, MD. Center for Studies of Child and Family Mental Health.

    The need to help the emotionally disturbed is discussed with a focus on community mental health centers. Psychiatric services described are diagnosis, inpatient care, day care, outpatient care, emergency care, continuity of care and services, and care adjusted to age groupings ranging from infancy to adolescence. Aspects of the community goal of…

  19. Women's Health Leadership to Enhance Community Health Workers as Change Agents.

    PubMed

    Ingram, Maia; Chang, Jean; Kunz, Susan; Piper, Rosie; de Zapien, Jill Guernsey; Strawder, Kay

    2016-05-01

    Objectives A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women's Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates' leadership skills to the national sample. Results Participants reported statistically significant pre-/postimprovements in all competencies. Interviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities. PMID:27440785

  20. Addressing Health Disparities in the Mental Health of Refugee Children and Adolescents Through Community-Based Participatory Research: A Study in 2 Communities

    PubMed Central

    Frounfelker, Rochelle; Mishra, Tej; Hussein, Aweis; Falzarano, Rita

    2015-01-01

    Objectives. We sought to understand the problems, strengths, and help-seeking behaviors of Somali Bantu and Bhutanese refugees and determine local expressions of mental health problems among youths in both communities. Methods. We used qualitative research methods to develop community needs assessments and identify local terms for child mental health problems among Somali Bantu and Bhutanese refugees in Greater Boston and Springfield, Massachusetts, between 2011 and 2014. A total of 56 Somali Bantu and 93 Bhutanese refugees participated in free list and key informant interviews. Results. Financial and language barriers impeded the abilities of families to assist youths who were struggling academically and socially. Participants identified resources both within and outside the refugee community to help with these problems. Both communities identified areas of distress corresponding to Western concepts of conduct disorders, depression, and anxiety. Conclusions. There are numerous challenges faced by Somali Bantu and Bhutanese youths, as well as strengths and resources that promote resilience. Future steps include using culturally informed methods for identifying those in need of services and developing community-based prevention programs. PMID:25905818

  1. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

    PubMed

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

    2015-01-01

    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed. PMID:26115330

  2. The financial value of services provided by a rural community health fair.

    PubMed

    Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn

    2006-11-01

    There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

  3. Women's empowerment and its differential impact on health in low-income communities in Mumbai, India.

    PubMed

    Moonzwe Davis, Lwendo; Schensul, Stephen L; Schensul, Jean J; Verma, Ravi K; Nastasi, Bonnie K; Singh, Rajendra

    2014-01-01

    This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalised area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy-related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined.

  4. Women's empowerment and its differential impact on health in low income communities in Mumbai, India

    PubMed Central

    Davis, Lwendo Moonzwe; Schensul, Stephen L.; Schensul, Jean J.; Verma, Ravi; Nastasi, Bonnie K.; Singh, Rajendra

    2015-01-01

    This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalized area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined. PMID:24766149

  5. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

    PubMed

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

    2015-01-01

    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

  6. Going "all in" to transform the Tulsa community's health and health care workforce.

    PubMed

    Clancy, Gerard P; Duffy, F Daniel

    2013-12-01

    Oklahoma's health status ranks among the lowest of the states', yet many Oklahomans oppose the best-known aspects of federal health reform legislation. To address this situation, the University of Oklahoma College of Medicine's School of Community Medicine in Tulsa adopted an "all-in," fully committed approach to transform the Tulsa region's health care delivery system and health care workforce teaching environment by leading community-wide initiatives that took advantage of lesser-known health reform provisions. Medical school leaders shared a vision of improved health for the region with a focus on equity in care for underserved populations. They engaged Tulsa stakeholders to implement health system changes to improve care access, quality, and efficiency. A partnership between payers, providers, and health systems transformed primary care practices into patient-centered medical homes (PCMHs) and instituted both community-wide care coordination and a regional health information exchange. To emphasize the importance of these new approaches to improving the health of an entire community, the medical school began to transform the teaching environment by adding several interdependent experiences. These included an annual interdisciplinary summer institute in which students and faculty from across the university could explore firsthand the social determinants of health as well as student-run PCMH clinics for the uninsured to teach systems-based practice, team-based learning, and health system improvement. The authors share lessons learned from these collaborations. They conclude that working across competitive boundaries and going all in are necessary to improve the health of a community. PMID:24128637

  7. Seagrass colonization: Knock-on effects on zoobenthic community, populations and individual health

    NASA Astrophysics Data System (ADS)

    Tu Do, V.; de Montaudouin, Xavier; Lavesque, Nicolas; Blanchet, Hugues; Guyard, Hervé

    2011-12-01

    This study provided evidence that Zostera noltii presence affects macrofauna community structure independently from median sediment grain-size and that the notion of ecosystem health is rather subjective: in the present case, we recorded "good health" in terms of seagrass development, "no impact" in terms of macrobenthic biotic indices and "negative effect" for a given key-population. The occurrence and development of a Z. noltii seagrass bed was surveyed at Banc d'Arguin, Arcachon Bay (France), to estimate the modification of the macrozoobenthic community and of the dynamics of a key-population for the local ecosystem, - the cockle Cerastoderma edule. Even though median grain-size of the sediment decreased only at the very end of the survey, i.e. when seagrass totally invaded the area, most of the macrofauna community characteristics (such as abundance and biomass) increased as soon as Z. noltii patches appeared. The structure of the macrofauna community also immediately diverged between sand and seagrass habitats, without however modifying the tested biotic indices (BENTIX, BOPA, AMBI). The health of the cockle population (growth, abundance, recruitment) was impacted by seagrass development. Related parasite communities slowly diverged between habitats, with more parasites in the cockles from seagrass areas. However, the number of parasites per cockle was always insufficient to alter cockle fitness.

  8. A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

    THOMAS, 113th Congress

    Sen. Moran, Jerry [R-KS

    2013-02-07

    02/07/2013 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S527) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  9. Partnering to enhance mental health care capacity in communities

    PubMed Central

    Murphy, Andrea L.; Gardner, David M.; Martin-Misener, Ruth; Naylor, Ted; Kutcher, Stan P.

    2015-01-01

    Background: Community pharmacists care for and support people with lived experience of mental illness in their communities. We developed a program called More Than Meds to facilitate enhancing capacity of community pharmacists’ roles in mental health care. Methods: We conducted a qualitative study and used a directed content analysis with application of the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework. Results: Ten interviews (n = 6 pharmacists, n = 4 community members) were conducted with participants from the More Than Meds program. Three key themes were identified from the experiences of More Than Meds participants: networking and bridging, stigma, and expectations and permissions. The most frequently coded domains in the data from the Theoretical Domains Framework were social/professional role, skills, beliefs about capabilities, knowledge and environmental context and resources. Conclusions: The More than Meds Program enabled community pharmacists to increase their capabilities, opportunities and motivation in providing mental health care and support. Involving community pharmacists together with people with lived experience of mental illness was identified as an innovative component of the program. PMID:26600823

  10. Management of Communication Channels for Health Information in the Community

    ERIC Educational Resources Information Center

    Tanvatanakul, Vasuton; Amado, Joao; Saowakontha, Sastri

    2007-01-01

    Object: To investigate channels for communication of health information to various groups in the community. Design: An exploratory cross sectional design was used, followed by focus groups of selected participants to confirm and clarify the findings. Setting: Five levels of sub-district administration organizations were selected from different…

  11. Guidelines for Training Community Health Workers in Nutrition. Second Edition.

    ERIC Educational Resources Information Center

    World Health Organization, Geneva (Switzerland).

    This task-oriented manual for the training of community health workers in nutrition presents information and instructions in two parts. The first part consists of three chapters. The first chapter introduces the guidelines; the second deals with teaching skills and is intended to improve teaching. The third chapter presents some basic facts about…

  12. Burnout and Leadership in Community Mental Health Systems.

    ERIC Educational Resources Information Center

    Webster, Linda; Hackett, Rachelle Kisst

    This study investigated the nature of professional burnout, specifically whether aspects of burnout in clinical staff in community mental health agencies were systematically related to aspects of leadership behavior and quality of supervision of clinical supervisors. Burnout was measured by the Maslach Burnout Inventory, leadership behavior in…

  13. The Minnesota Heart Health Program Community Quit and Win Contests.

    ERIC Educational Resources Information Center

    Lando, Harry A.; And Others

    1994-01-01

    The Minnesota Heart Health Program's Quit and Win smoking cessation contests occurred between 1982 and 1989. The contests used large prizes to encourage smokers to quit smoking. Evaluations indicated that the contests succeeded in recruiting relatively large proportions of smokers in entire communities, and abstinence outcomes were encouraging.…

  14. Marketing backgrounds and activities of community mental health center CEOs.

    PubMed

    Whyte, E G; Smith, M; Reidenbach, E N; Sharpe, T R

    1989-01-01

    More than 300 directors of community mental health centers responded to a survey concerning their marketing training and the marketing activities in which their centers had been engaged. Formal marketing training was found to be in the backgrounds of few of the respondents. The majority had not been engaged in a listing of marketing activities.

  15. Community Mental Health in the Social Work Curriculum.

    ERIC Educational Resources Information Center

    Rubin, Allen

    Community mental health curriculum in schools of social work education is discussed. The contents are compiled from a series of empirical studies, interviews, and meetings with social work faculty and students, and from analyses of curriculum materials as part of a three-year study conducted by the Council on Social Work Education. Chapter 1…

  16. Lessons Learned from the Uniontown Community Health Project.

    ERIC Educational Resources Information Center

    Littleton, Mary Ann; Cornell, Carol E.; Dignan, Mark; Brownstein, J. Nell; Raczynski, James M.; Stalker, Varena G.; McDuffie, Kathleen Y.; Greene, Paul G.; Sanderson, Bonnie; Struempler, Barbara Jo.

    2002-01-01

    Examines lessons learned from a 5-year project designed to develop, implement, and evaluate a multifaceted community health advisor-based intervention to reduce the risk of cardiovascular disease among older, rural, African American women. Data from observations surveys, and discussion groups highlight six lessons (e.g., establish personal working…

  17. Building Sustainable Health and Education Partnerships: Stories from Local Communities

    ERIC Educational Resources Information Center

    Blank, Martin J.

    2015-01-01

    Background: Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high…

  18. Infectious Diseases: Current Issues in School and Community Health.

    ERIC Educational Resources Information Center

    Bower, Wilma; And Others

    1986-01-01

    Some children in American schools have known and unknown communicable diseases, including herpes, cytomegalovirus, AIDS, mononucleosis, pinworms, and hepatitis. This article examines major public health issues, school responsibility, preventative measures (like basic hygiene), and the need for more effective community education programs. A disease…

  19. Audit Trail Management System in Community Health Care Information Network.

    PubMed

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio

    2015-01-01

    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system.

  20. Gay Couples, Gay Communities, and HIV: Challenges for Health Education

    ERIC Educational Resources Information Center

    Reece, Michael

    2005-01-01

    For the last 2 decades, researchers and practitioners dedicated to improving the health of gay and bisexual men have largely focused their work on the need to reduce the incidence of HIV infection. This is certainly warranted given the intensity of this particular epidemic in the gay community and the challenges it has presented to the nation's…

  1. Elementary School Counselors' Collaboration with Community Mental Health Providers

    ERIC Educational Resources Information Center

    Moran, Kristen; Bodenhorn, Nancy

    2015-01-01

    Perceptions and experiences of elementary school counselors' collaborative efforts with community mental health providers are examined through this exploratory phenomenological study. Ten participants engaged in two in-depth interviews. Collaboration was considered an effective way to increase services to students and their families. Six themes…

  2. Reproductive, Maternal, Newborn, and Child Health in the Community: Task-sharing Between Male and Female Health Workers in an Indian Rural Context

    PubMed Central

    Elazan, Sara J; Higgins-Steele, Ariel E; Fotso, Jean Christophe; Rosenthal, Mila H; Rout, Dharitri

    2016-01-01

    Background: Male community health workers (CHWs) have rarely been studied as an addition to the female community health workforce to improve access and care for reproductive, maternal, newborn, and child health (RMNCH). Objective: To examine how male health activists (MHAs) coordinated RMNCH responsibilities with existing female health workers in an Indian context. Materials and Methods: Interviews from male and female CHWs were coded around community-based engagement, outreach services, and links to facility-based care. Results: Community-based engagement: MHAs completed tasks both dependent and independent of their gender, such as informing couples on safe RMNCH care in the antenatal and postnatal periods. MHAs motivated males on appropriate family planning methods, demonstrating clear gendered responsibility. Outreach services: MHAs were most valuable traveling to remote areas to inform about and bring mothers and children to community health events, with this division of labor appreciated by female health workers. Link to facility-based services: MHAs were recognized as a welcome addition accompanying women to health facilities for delivery, particularly in nighttime. Conclusion: This study demonstrates the importance of gendered CHW roles and male-female task-sharing to improve access to community health events, outreach services, and facility-based RMNCH care. PMID:26917871

  3. A grassroots movement in bioethics: Community Health Decisions.

    PubMed

    Jennings, Bruce

    1988-01-01

    The author reports on projects funded by the Prudential Foundation for the Community Health Decisions program, which sponsors open community meetings conducted by volunteers trained in bioethics and in group discussion techniques, with the objectives of reaching social consensus on principles that should govern the future of the health care system and of fostering citizen participation in the political arena. The lessons of community organizing that emerge from this movement are analyzed, along with its accomplishments and strengths in creating a neutral and flexible forum in which contrasting views are given a respectful hearing and its weaknesses in lacking a secure institutional base, remaining too dependent on the energy of one or two key leaders, and failing to develop fundraising machinery for long-term viability. A summary of what has been learned, addresses of the projects, and next steps to be taken conclude the report.

  4. Researching mental health in minority ethnic communities: reflections on recruitment.

    PubMed

    Rugkåsa, Jorun; Canvin, Krysia

    2011-01-01

    In this article we reflect on the recruitment of research participants to two related studies of experiences of mental health problems in Black and minority ethnic communities in the United Kingdom. A total of 65 people were recruited via three main strategies: the employment of bicultural recruiters, intensive information sharing about the studies, and work through local community groups. Three main issues seemed to affect recruitment: gatekeepers' attitudes, the (non)payment of participants, and reciprocal arrangements with local community groups. The type of strategy employed resulted in recruits with differing characteristics (although our sample was too small to draw generalizable conclusions). We conclude that to ensure that research participation is accessible to all, researchers must employ flexible recruitment methods that permit adaptation to specific needs arising out of health status, level of involvement with services, culture, and socioeconomic status. Systematic research into this part of the research process is needed. PMID:20682968

  5. Body perceptions and health behaviors in an online bodybuilding community.

    PubMed

    Smith, Aaron C T; Stewart, Bob

    2012-07-01

    In this article we explore the social constructions, body perceptions, and health experiences of a serious recreational and competitive bodybuilder and powerlifter community. Data were obtained from a discussion forum appearing within an online community dedicated to muscular development. Forum postings for a period of 36 months were transposed to QSR NVivo, in which a narrative-based analytical method employing Gee's coding approach was employed. We used a priori codes based on Bourdieu's multipronged conceptual categories of social field, habitus, and capital accumulation as a theoretical frame. Our results expose an extreme social reality held by a devoted muscle-building community with a fanatical obsession with muscular hypertrophy and any accouterment helpful in its acquisition, from nutrition and supplements to training regimes and anabolic androgenic substances. Few health costs were considered too severe in this muscular meritocracy, where the strong commanded deference and the massive dominated the social field.

  6. Building Community for Health: Lessons from a Seven-Year-Old Neighborhood/University Partnership.

    ERIC Educational Resources Information Center

    Flick, Louise H.; And Others

    1994-01-01

    A graduate program for community health nurses formed a partnership with a neighborhood to enhance community health behavior and teach nurses about community organizing. Major conflicts between community groups proved to be both powerful catalysts and potential barriers to the use of Freire's concepts in community organizing. (SK)

  7. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  8. Mental health burden amongst inhabitants of an arsenic-affected area in Inner Mongolia, China.

    PubMed

    Fujino, Yoshihisa; Guo, Xiaojuan; Liu, Jun; You, Lingui; Miyatake, Munetoshi; Yoshimura, Takesumi

    2004-11-01

    Inner Mongolia, China, is an area with high levels of arsenic. The adverse health effects resulting from chronic arsenic exposure include skin keratosis, vascular diseases and cancers. However, the effects of arsenic exposure on mental health have not received much attention. The purpose of this study was to examine the effects of arsenic poisoning on the mental health of the inhabitants of an arsenic-affected area. We performed a cross-sectional study at two villages in Hetao Plain, Inner Mongolia. The populations of both villages were similar in age, sex, lifestyle, socioeconomic conditions, and geographic location. One hundred and thirty four (93.7%) of the 143 inhabitants in the arsenic-affected village and 36 (76.6%) of the 47 inhabitants in the arsenic-free village participated in the study. Subjects with a 30-item version of General Health Questionnaire score of 9 or more were defined as having symptoms of distress. The multiple logistic analyses showed that the mental health of the subjects in the arsenic-affected village was worse than in those in the arsenic-free village (OR=2.5, 95% CI=1.1-6.0). The effect of arsenic on mental health in arsenic-affected areas deserves further investigation. The mental health burden in arsenic-affected areas should be considered in the wider context of public and community health.

  9. Growing your own: community health workers and jobs to careers.

    PubMed

    Farrar, Brandy; Morgan, Jennifer Craft; Chuang, Emmeline; Konrad, Thomas R

    2011-01-01

    This article evaluates the implementation and impact of 5 workforce development programs aimed at achieving skills upgrades, educational advancement, and career development for community health workers (CHWs). Quantitative and qualitative case study data from the national evaluation of the Jobs to Careers: Transforming the Front Lines of Health Care initiative demonstrate that investing in CHWs can achieve measurable worker (eg, raises) and programmatic (eg, more skilled workers) outcomes. To achieve these outcomes, targeted changes were made to the structure, culture, and work processes of employing organizations. These findings have implications for other health care employers interested in developing their CHW workforce.

  10. Community perceptions and utilization of a consumer health center*

    PubMed Central

    Ports, Katie A.; Ayers, Antoinette; Crocker, Wayne; Hart, Alton; Mosavel, Maghboeba; Rafie, Carlin

    2015-01-01

    The purpose of this study was to understand factors that may affect the usage of a consumer health center located in a public library. More specifically, the authors wanted to know what health resources are of interest to the community, what patrons' perceptions of their experience at the center are, and finally, how staff can increase utilization of the center. In general, perceptions of the center were positive. The findings support that participants appreciate efforts to provide health information in the public library setting and that utilization could be improved through marketing and outreach. PMID:25552943

  11. Improving health equity: the promising role of community health workers in Canada.

    PubMed

    Torres, Sara; Labonté, Ronald; Spitzer, Denise L; Andrew, Caroline; Amaratunga, Carol

    2014-01-01

    This article reports findings from an applied case study of collaboration between a community-based organization staffed by community health workers/multicultural health brokers (CHWs/MCHBs) serving immigrants and refugees and a local public health unit in Alberta, Canada. In this study, we explored the challenges, successes and unrealized potential of CHWs/MCHBs in facilitating culturally responsive access to healthcare and other social services for new immigrants and refugees. We suggest that health equity for marginalized populations such as new immigrants and refugees could be improved by increasing the role of CHWs in population health programs in Canada. Furthermore, we propose that recognition by health and social care agencies and institutions of CHWs/MCHBs, and the role they play in such programs, has the potential to transform the way we deliver healthcare services and address health equity challenges. Such recognition would also benefit CHWs and the populations they serve. PMID:25410697

  12. Text Classification for Assisting Moderators in Online Health Communities

    PubMed Central

    Huh, Jina; Yetisgen-Yildiz, Meliha; Pratt, Wanda

    2013-01-01

    Objectives Patients increasingly visit online health communities to get help on managing health. The large scale of these online communities makes it impossible for the moderators to engage in all conversations; yet, some conversations need their expertise. Our work explores low-cost text classification methods to this new domain of determining whether a thread in an online health forum needs moderators’ help. Methods We employed a binary classifier on WebMD’s online diabetes community data. To train the classifier, we considered three feature types: (1) word unigram, (2) sentiment analysis features, and (3) thread length. We applied feature selection methods based on χ2 statistics and under sampling to account for unbalanced data. We then performed a qualitative error analysis to investigate the appropriateness of the gold standard. Results Using sentiment analysis features, feature selection methods, and balanced training data increased the AUC value up to 0.75 and the F1-score up to 0.54 compared to the baseline of using word unigrams with no feature selection methods on unbalanced data (0.65 AUC and 0.40 F1-score). The error analysis uncovered additional reasons for why moderators respond to patients’ posts. Discussion We showed how feature selection methods and balanced training data can improve the overall classification performance. We present implications of weighing precision versus recall for assisting moderators of online health communities. Our error analysis uncovered social, legal, and ethical issues around addressing community members’ needs. We also note challenges in producing a gold standard, and discuss potential solutions for addressing these challenges. Conclusion Social media environments provide popular venues in which patients gain health-related information. Our work contributes to understanding scalable solutions for providing moderators’ expertise in these large-scale, social media environments. PMID:24025513

  13. The maritime environment: a comparison with land-based remote area health care.

    PubMed

    Bull, R M; Boyle, A J

    1998-05-01

    The sea is not often considered when discussing remote area health care; however, when a comparison is made of the challenges posed by this and land-based remote areas and the experiences of people providing health care in both settings, the similarities are striking. Like people living in land-based remote areas, seafarers live in isolated communities, are often in remote geographical locations, and are required to be self-sufficient in the provision of health care, utilising limited medical resources and training in conjunction with radio medical advice. Given the large numbers of small, isolated floating communities that characterise the world shipping industry, some consideration of the quality of and access to health care needs to be made. This paper introduces the marine environment as a remote area, drawing comparisons between it and land-based environments. Issues pertinent to the people providing health care in both environments are discussed. These issues include limited educational preparation, sparse resources and the problems related to distance, isolation, communication, accessibility and weather.

  14. The Tennessee Department of Health WORKshops on Use of Secondary Data for Community Health Assessment, 2012

    PubMed Central

    Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B.

    2014-01-01

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community’s health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county public health departments as trusted leaders in providing population data and engaging community stakeholders in assessments. The Tennessee Department of Health’s Division of Policy, Planning, and Assessment conducted regional 2-day training workshops to explain and guide completion of computer spreadsheets on 12 health topics. Participants from 93 counties extracted data from multiple and diverse sources to quantify county demographics, health status, and resources and wrote problem statements based on the data examined. The workshops included additional staff development through integration of short lessons on data analysis, epidemiology, and social-behavior theory. Participants reported in post-workshop surveys higher degrees of comfort in interpreting data and writing about their findings on county health issues, and they shared their findings with health, hospital, school, and government leaders (including county health council members) in their counties. Completion of the assessments enabled counties and the Tennessee Department of Health to address performance-improvement goals and assist counties in preparing to meet public health accreditation prerequisites. The methods developed for using secondary data for community health assessment are Tennessee’s first-phase response to counties’ request for a statewide structure for conducting such assessments. PMID:24384302

  15. Reducing health disparities in underserved communities via interprofessional collaboration across health care professions

    PubMed Central

    Vanderbilt, Allison A; Dail, Michael D; Jaberi, Parham

    2015-01-01

    Health disparities can negatively impact subsets of the population who have systematically experienced greater socioeconomic obstacles to health. Health disparities are pervasive across the United States and no single health care profession can tackle this national crisis alone. It is essential that all health care providers work collaboratively toward the overarching goal of systematically closing the health disparities gap. Interprofessional collaboration is the foundation needed for health care providers to support patient needs and reduce health disparities in public health. Let us reach across the silos we work within and collaborate with our colleagues. Stand up and begin thinking about our communities, our patients, and the future overall health status of the population for the United States. PMID:25960659

  16. Aboriginal community controlled health services: leading the way in primary care.

    PubMed

    Panaretto, Kathryn S; Wenitong, Mark; Button, Selwyn; Ring, Ian T

    2014-06-16

    The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model; coverage of the Aboriginal population higher than 60% outside major metropolitan centres; consistently improving performance in key performance on best-practice care indicators; and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.

  17. Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?

    PubMed Central

    Schwartz, Brian S.; Parker, Cindy; Glass, Thomas A.; Hu, Howard

    2006-01-01

    The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations. PMID:17185267

  18. Inpatient Mental Health Services in Rural Areas: An Interregional Comparison.

    ERIC Educational Resources Information Center

    Wagenfeld, Morton O.; And Others

    1993-01-01

    A classification of nonmetropolitan counties based on type of economy, socioeconomic level, and land use was applied to inpatient psychiatric services data of the National Institute of Mental Health. The scarce inpatient mental health services in nonmetropolitan areas were located mostly in nonfederal general hospitals in specialized-government…

  19. A Multidimensional Data Warehouse for Community Health Centers.

    PubMed

    Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N

    2015-01-01

    Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise.

  20. Community health workers and their value to social work.

    PubMed

    Spencer, Michael S; Gunter, Kathryn E; Palmisano, Gloria

    2010-04-01

    Community health workers (CHWs) play a vital and unique role in linking diverse and underserved populations to health and social service systems. Despite their effectiveness, as documented by empirical studies across various disciplines including public health, nursing, and biomedicine, the value and potential role of CHWs in the social work practice and research literature has been largely absent. Thus, this article introduces social workers to CHWs, their role in promoting culturally appropriate practice, and their utility in collaboration with social workers in community settings. This integrative review also discusses current challenges identified by the CHW literature, including potential barriers to the expansion of CHW programs, as well as issues of training, certification, and sustainability. The review also discusses the close alignment of CHWs with social work values and principles of social justice, suggesting opportunities for enhanced social work practice and research.