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Sample records for area community health

  1. Providing health care to improve community perceptions of protected areas.

    PubMed

    Chapman, Colin A; van Bavel, Bianca; Boodman, Carl; Ghai, Ria R; Gogarten, Jan F; Hartter, Joel; Mechak, Lauren E; Omeja, Patrick A; Poonawala, Sofia; Tuli, Dan; Goldberg, Tony L

    2015-10-01

    Impoverished communities often turn to illegal extraction of resources from protected areas to alleviate economic pressures or to make monetary gains. Such practices can cause ecological damage and threaten animal populations. These communities also often face a high disease burden and typically do not have access to affordable health care. Here we argue that these two seemingly separate challenges may have a common solution. In particular, providing health care to communities adjacent to protected areas may be an efficient and effective way to reduce the disease burden while also improving local perceptions about protected areas, potentially reducing illegal extraction. We present a case study of a health centre on the edge of Kibale National Park, Uganda. The centre has provided care to c. 7,200 people since 2008 and its outreach programme extends to c. 4,500 schoolchildren each year. Contrasting the provision of health care to other means of improving community perceptions of protected areas suggests that health clinics have potential as a conservation tool in some situations and should be considered in future efforts to manage protected areas.

  2. Providing health care to improve community perceptions of protected areas

    PubMed Central

    van Bavel, Bianca; Boodman, Carl; Ghai, Ria R.; Gogarten, Jan F.; Hartter, Joel; Mechak, Lauren E.; Omeja, Patrick A.; Poonawala, Sofia; Tuli, Dan; Goldberg, Tony L.

    2015-01-01

    Impoverished communities often turn to illegal extraction of resources from protected areas to alleviate economic pressures or to make monetary gains. Such practices can cause ecological damage and threaten animal populations. These communities also often face a high disease burden and typically do not have access to affordable health care. Here we argue that these two seemingly separate challenges may have a common solution. In particular, providing health care to communities adjacent to protected areas may be an efficient and effective way to reduce the disease burden while also improving local perceptions about protected areas, potentially reducing illegal extraction. We present a case study of a health centre on the edge of Kibale National Park, Uganda. The centre has provided care to c. 7,200 people since 2008 and its outreach programme extends to c. 4,500 schoolchildren each year. Contrasting the provision of health care to other means of improving community perceptions of protected areas suggests that health clinics have potential as a conservation tool in some situations and should be considered in future efforts to manage protected areas. PMID:26456977

  3. 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).

  4. A Community-Engaged Approach to Select Geographic Areas for Interventions to Reduce Health Disparities

    PubMed Central

    Cromley, Ellen; Kleinman, Lawrence C.; Ramos, Michelle A.; Arniella, Guedy; Viswanathan, Nalini; Garel, Mischka; Horowitz, Carol R.

    2012-01-01

    Background While neighborhood-based approaches to eliminate health disparities are on the rise, there is little guidance on how researchers may engage with community partners to select geographic areas for interventions to reduce health disparities. We aimed to identify a small geographic area to target interventions to improve diabetes-related outcomes. Objectives We describe lessons learned from a community-engaged approach to specify the geographic area of focus. Methods A community-academic partnership of more than 20 organizations collaborated to develop and employ a 5-stage process to specify a target area for diabetes preventions and control activities. Lessons Learned A coalition with local knowledge and ties to the community can develop criteria and direct a process leading to selection of a geographic area, increased research capacity, and strengthened relationships among partners. Conclusion A participatory approach can be effective in defining a geographic area for targeting interventions to reduce health disparities. PMID:22080778

  5. Online communities of practice to support collaborative mental health practice in rural areas.

    PubMed

    Cassidy, Laurel

    2011-01-01

    The provision of quality mental health services in rural areas continues to be an ongoing challenge for nurses and the patients they serve. The use of computer mediated communication to construct collaborative learning environments similar to those suggested in Wenger's community of practice framework has the potential to mitigate a number of the difficulties faced by rural health care providers. The author presents a brief discussion of social learning theories, the communities of practice framework, and related concepts. Examples of current online communities of practice used as a means for knowledge construction in various professional disciplines are presented in building the case for the fit between online communities of practice and the needs of nurses in rural mental health. Nurses providing mental health care in rural areas have documented needs for interdisciplinary teamwork, access to a collaborative learning environment, and ongoing contact with expert resources. The construction of online communities of practice could potentially address a multitude of concerns identified by nurses practicing mental health care in rural areas.

  6. Community Health

    EPA Pesticide Factsheets

    The Environmental Health Resources for Community Members site provides tools and information to help local leaders and members of the community protect public health by understanding and addressing environmental conditions.

  7. A model for community health service development in depressed rural areas in China

    PubMed Central

    2012-01-01

    Background To introduce a model of community health service organization (as implemented in urban areas) to less developed rural areas in China and evaluate the impact of this model on health care utilization. Methods The intervention involved developing leadership at county level, training rural health practitioners, providing clinical management guidelines and standards, encouraging clinic improvements and providing access to subsidies for public health work. We chose 7 townships and 49 administrative villages in Chongyi County as the intervention sites; 3 townships and 9 administrative villages in Luxi County as the comparison sites. Officers from county health bureaus and postgraduates from School of Public Health, Nanchang University visited each township hospital and village clinic in field together and made observations and interviewed clinic staff. Results There was little change in health facilities or workforce in the two areas. However, there was an increase in the use of public health services at township and village level in the intervention sites in Chongyi. In these, the proportion of clinics which had developed a child health (under the age of 3) management system, maternal postpartum visit and chronic disease management increased from 53%, 51% and 47% to 78%, 73%, and 71% respectively. There was no significant change in the comparison sites. Conclusions The trial demonstrated that it was feasible to implement a model of community health service delivery that was adapted to depressed rural areas because it required little organizational change, additional funding or personnel. The model had a positive impact on the provision of public health programs, a finding which has implications for efforts to improve access to primary health care in rural China. PMID:23244489

  8. Attitudes towards mental illness in the Athens area: implications for community mental health intervention.

    PubMed

    Madianos, M G; Madianou, D; Vlachonikolis, J; Stefanis, C N

    1987-02-01

    Attitudes towards mental illness were measured in a probability sample of 1574 male and female adults, residents of two boroughs in the greater Athens area before the development of community mental health services in the area. The objective of this study was to identify the components of these attitudes, taking into account the fact that public opinions about mental illness influence the utilization of community mental health services and the level of reintegration of the mentally disabled into society. The instrument used to measure attitudinal dimensions was the Cohen and Struening Opinion about Mental Illness (O.M.I.) scale. Factor analysis revealed five attitude dimensions: social discrimination, social restriction, social care, integration, and etiology. Among the socio-demographic variables age, education, occupational status and place of residence up to 18 years of age affected the factors mainly, reflecting social discrimination and restriction. O.M.I. factor scores underlying the need for social care and reintegration of the mentally ill into society were found to be socially invariant, implying the need for social care and more humane treatment methods for mental patients. Certain population groups responded with rejection or suspicion and considerable fear of the mentally ill, indicating the necessity for the planning of appropriate community mental health intervention programs parallel to the development of community mental health services and psychiatric reforms in Greece.

  9. [The cultural aspects of the practice of Community Health Agents in rural areas].

    PubMed

    Lara, Maristela Oliveira; Brito, Maria José Menezes; Rezende, Lilian Cristina

    2012-06-01

    The daily practice of Community Health Agents (CHAs) is permeated with educational interventions aimed at preventive care and health promotion. The sociocultural universe of these professionals can affect the dynamics of their practice within the community, particularly in rural areas, where there is evidence that the population expects to obtain information relative to their health and/or disease by means of cultural rites. Based on a case study, we sought to analyze the influence of the cultural practices of the agents working in a rural area in the interior of the state of Minas Gerais. The analysis revealed the presence of a strong connection between the culture and their activities. Religious beliefs and knowledge developed from the fusion of biomedical information and values based on family tradition regarding the health-disease process have a direct effect on their practices. It is emphasized that they have an important role as facilitators in the practice of health care, with a positive effect stemming from the similarity of their life experiences and inherited cultures with those of the clients, thus making it possible to develop effective interventions.

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

    PubMed

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

    2015-08-01

    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. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. 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

  12. Lack of basic amenities: indicators of health disparities in low-income minority communities and tribal areas.

    PubMed

    Wilson, Omega

    2011-01-01

    North Carolina has numerous low-income minority communities and tribal areas where basic public health amenities are lacking. Disparities in clean air, safe drinking water, and toxin-free soil create human exposures that result in poor health, depressed property value, and more contaminated environments than are present in higher income communities.

  13. Affecting Factors on the Performance of Community Health Workers in Iran's Rural Areas: A Review Article.

    PubMed

    Salehi Zalani, Gholamhossein; Bayat, Mahboubeh; Shokri, Azad; Mirbahaeddin, S Elmira; Rasi, Vahid; Alirezaei, Samira; Manafi, Fatemeh

    2016-11-01

    This study aimed to use a mixed-method approach to investigate affecting factors on the performance of Community Health Workers (CHW) in Iran's villages. This study was conducted during 2014-2015 with a mixed method in three phases of literature review, Delphi technique and developing a rich picture. Overall, in order to finalize the affecting factors and their relationships between qualitative content analysis, Delphi technique, AHP technique and Focus Group Discussion were used, respectively. Affecting factors on CHW performance were divided into four main categories, 10 sub-themes and 35 contents. Increase in the level of people's awareness, disease patterns, demographic structure and lifestyle were placed in four priorities respectively on the basis of importance. To the most extent CHW cannot face current needs of rural communities. It challenges equitable access to healthcare services and also conflicts with the primary philosophy of CHW presence in rural areas. CHW can be used in two forms; either as an assistant to rural family physicians or with the same previous functions.

  14. Geographic variations in sleep duration: a multilevel analysis from the Boston Area Community Health (BACH) Survey

    PubMed Central

    Fang, Shona C; Subramanian, S V; Piccolo, Rebecca; Yang, May; Yaggi, H Klar; Bliwise, Donald L; Araujo, Andre B

    2014-01-01

    Background Sleep plays an important role in health and varies by social determinants. Little is known, however, about geographic variations in sleep and the role of individual-level and neighbourhood-level factors. Methods We used a multilevel modelling approach to quantify neighbourhood variation in self-reported sleep duration (very short <5 h; short 5–6.9 h; normative 7–8.9 h; long ≥9 h) among 3591 participants of the Boston Area Community Health Survey. We determined whether geographic variations persisted with control for individual-level demographic, socioeconomic status (SES) and lifestyle factors. We then determined the role of neighbourhood SES (nSES) in geographic variations. Additional models considered individual health factors. Results Between neighbourhood differences accounted for a substantial portion of total variability in sleep duration. Neighbourhood variation persisted with control for demographics, SES and lifestyle factors. These characteristics accounted for a portion (6–20%) of between-neighbourhood variance in very short, short and long sleep, while nSES accounted for the majority of the remaining between-neighbourhood variances. Low and medium nSES were associated with very short and short sleep (eg, very short sleep OR=2.08; 95% CI 1.38 to 3.14 for low vs high nSES), but not long sleep. Further inclusion of health factors did not appreciably increase the amount of between-neighbourhood variance explained nor did it alter associations. Conclusions Sleep duration varied by neighbourhood in a diverse urban setting in the northeastern USA. Individual-level demographics, SES and lifestyle factors explained some geographic variability, while nSES explained a substantial amount. Mechanisms associated with nSES should be examined in future studies to help understand and reduce geographic variations in sleep. PMID:25199880

  15. 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.

  16. Factors influencing community nursing roles and health service provision in rural areas: a review of literature.

    PubMed

    Barrett, Annette; Terry, Daniel R; Lê, Quynh; Hoang, Ha

    2016-02-01

    This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

  17. Geographic variations in sleep duration: a multilevel analysis from the Boston Area Community Health (BACH) Survey.

    PubMed

    Fang, Shona C; Subramanian, S V; Piccolo, Rebecca; Yang, May; Yaggi, H Klar; Bliwise, Donald L; Araujo, Andre B

    2015-01-01

    Sleep plays an important role in health and varies by social determinants. Little is known, however, about geographic variations in sleep and the role of individual-level and neighbourhood-level factors. We used a multilevel modelling approach to quantify neighbourhood variation in self-reported sleep duration (very short <5 h; short 5-6.9 h; normative 7-8.9 h; long ≥9 h) among 3591 participants of the Boston Area Community Health Survey. We determined whether geographic variations persisted with control for individual-level demographic, socioeconomic status (SES) and lifestyle factors. We then determined the role of neighbourhood SES (nSES) in geographic variations. Additional models considered individual health factors. Between neighbourhood differences accounted for a substantial portion of total variability in sleep duration. Neighbourhood variation persisted with control for demographics, SES and lifestyle factors. These characteristics accounted for a portion (6-20%) of between-neighbourhood variance in very short, short and long sleep, while nSES accounted for the majority of the remaining between-neighbourhood variances. Low and medium nSES were associated with very short and short sleep (eg, very short sleep OR=2.08; 95% CI 1.38 to 3.14 for low vs high nSES), but not long sleep. Further inclusion of health factors did not appreciably increase the amount of between-neighbourhood variance explained nor did it alter associations. Sleep duration varied by neighbourhood in a diverse urban setting in the northeastern USA. Individual-level demographics, SES and lifestyle factors explained some geographic variability, while nSES explained a substantial amount. Mechanisms associated with nSES should be examined in future studies to help understand and reduce geographic variations in sleep. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Indian Health Service: Community Health

    MedlinePlus

    ... Press Releases Reports to Congress Tribal Leader Letters Urban Leader Letters IHS Home Community Health Community Health ... Office of Tribal Self Governance - 08E05 Office of Urban Indian Health Programs - 08E65C Accessibility Budget Contact Information ...

  19. Community Health Worker Handbook.

    ERIC Educational Resources Information Center

    Perales, Aurora Rodriguez

    An experienced community health worker describes her experiences in the field as a basis for recommended guidelines for the role, philosophy, aims, and goals of community health workers. The role of the community health worker as a member of the health care team is explored, and the problem of recognition for community health workers is considered…

  20. Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

    PubMed

    Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica

    2017-01-01

    Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001) and QOL (r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001). Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  1. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    PubMed Central

    Kusambiza-Kiingi, Adrian; Maleka, Douglas

    2017-01-01

    Background Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim To determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001) and QOL (r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001). Conclusion Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services. PMID:28730068

  2. [Outbreak of Trichophyton tonsurans ringworm in a health area of the Community of Madrid (Spain)].

    PubMed

    Durán-Valle, María Teresa; Regodón-Domínguez, Marta; Velasco-Rodríguez, Manuel José; Aragón, Andrés; Gómez-Garcés, José Luis

    2016-01-01

    Trichophyton tonsurans is a dermatophyte fungus that can cause ringworm outbreaks. In our health area in September 2013, two cases of T. tonsurans ringworm were diagnosed in children who lived in a Children's Centre. To determine the origin and extent of the outbreak. Mycological cultures of scalp and skin samples from the contacts of the diagnosed cases were performed, as well as environmental samples from the Children's Centre. The patients started with a treatment for their ringworm, and an environmental disinfection of the centre was performed. Twelve cases of ringworm were detected, along with three asymptomatic scalp carriers of T. tonsurans among 20 children in the Centre. The index case was a resident in whose family, that had just returned from their country of origin, Nigeria, three cases of ringworm were diagnosed. From November 2013 to February 2014 another five cases of ringworm were diagnosed among schoolmates of three cases from the Children's Centre. The antifungal treatment of the children resulted in the mycological and clinical resolution, and from February to November 2014 no other cases of ringworm by T. tonsurans in the same health area were diagnosed. Copyright © 2015 Asociación Española de Micología. Published by Elsevier Espana. All rights reserved.

  3. 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

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

    PubMed

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

    2013-01-01

    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. 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. 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. 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.

  5. [Community diagnosis using qualitative techniques of expectations and experiences in a health area in need of social transformation].

    PubMed

    Ramos Ruiz, Juan Andrés; Pérez Milena, Alejandro; Enguix Martínez, Natalia; Alvarez Nieto, Carmen; Martínez Fernández, M Luz

    2013-01-01

    To know the views, experiences and expectations of care provided by the Andalusian Public Health System (SSPA) of users of an urban area in need of social transformation (ZNTS). Qualitative methodology (exploratory study). Urban basic health zone (16,000 inhabitants, 40% ZNTS). Purposive sampling of users of SSPA and community leaders. Homogeneity criteria: age. Heterogeneity criteria: sex, frequency, active/pensioner, level cultural/economic. Conversational techniques recorded by videotape and moderated by a sociologist (user dicussion groups and in-depth interviews for community leaders). transcription of speeches, coding, categories triangulation and final outcome. Seven groups (43 participants, 58% ZNTS) and 6 leaders. They want continuity of care and choice of professionals, but not the medical change without information and attention's discontinuity primary care/hospital. There's bad physical accesibility by the urban environment in the ZNTS and is criticized admission services and paperwork; the programmed appointment and the electronic prescriptions are improvements but asking more hospital referrals and reviews. There's good appreciation of the professionals (primary care-closer, hospital-greater technical capacity). It needs to improve nursing education and speed of emergency assistance. There's a lack of leadership in the system organization, very fragmented. They know a range of services focusing on the demand for care; other health activities not spread to the users. The SSPA should incorporate the views and expectations of communities in social risk to a real improvement in the quality of care. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  6. Innovations in health care financing: new evidence on the prospect of community health insurance schemes in the rural areas of Ethiopia.

    PubMed

    Asfaw, Abay; von Braun, Joachim

    2005-09-01

    It has become clear that due to market failure, state failure, and other reasons, the conventional sources of finance alone could not solve the health problem of the rural population, particularly that of the socially excluded and disadvantaged groups. Community Based Health Insurance Schemes (CBHIS) are one of the most recently mentioned options to narrow the existing inequalities in access to basic health services. This study assesses the prospect of CBHIS in the rural areas of Ethiopia using a double bounded dichotomous contingent valuation method. The results show that even in one of the poorest countries of the world, there is a promising prospect to introduce CBHIS.

  7. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.

    PubMed

    Das, Susmita; Mia, Mohammad Nahid; Hanifi, Syed Manzoor Ahmed; Hoque, Shahidul; Bhuiya, Abbas

    2017-02-16

    Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh's health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh). HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Chambers of the rural practitioners of allopathic medicine, commonly known as 'village doctors', were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6%) and Union Health and Family Welfare Centres (28.6%). Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively). The top three sources of information for diabetes were neighbours (85.7%), followed by relatives (27.9%) and MBBS (Bachelor of Medicine and Bachelor of Surgery) doctors (20.4%). For hypertension, the sources were neighbours (78.0%), followed by village doctors (38.2%), MBBS doctors (23.2%) and relatives (15%). The proportions of respondents who knew diabetes and hypertension control measures were 40.9% and 28.0%, respectively. More females knew about the

  8. Changing community health service delivery in economically less-developed rural areas in China: impact on service use and satisfaction

    PubMed Central

    Liu, Yong; Yuan, Zhaokang; Liu, Yuxi; Jayasinghe, Upali W; Harris, Mark F

    2014-01-01

    Objective To evaluate the impact of a model of rural community health service (CHS) on the use and acceptability of primary healthcare services. Design Quasi-experimental. Setting Two adjacent rural counties in China. Participants 5842 residents in 2009 and 3807 in 2010 from 980 households in 7 intervention townships and 49 villages; 2232 residents in 2009 and 2315 in 2010 from 628 households in 3 comparison townships and 9 villages. All residents were approached to participate, with no significant differences in age or sex between groups. Intervention Multilevel intervention in 2009 including training rural practitioners, encouraging clinic improvements, providing clinical guidelines, standards and subsidies. Data collection Surveys of community members from randomly sampled households in 2009 and 2010. Primary outcome measures Satisfaction with and utilisation of outpatient and public health services. Analysis Factor analysis confirmed two components of satisfaction. Univariate and multilevel analysis was used. Results Satisfaction scores for intervention county respondents increased from 21.4 (95% CI 21.1 to 21.7) to 22.1 (95% CI 21.7 to 22.4) with no change in comparison area. In multilevel analysis, satisfaction with patient-centred care was associated with chronic disease, shorter waiting times and county. Satisfaction with clinic environment and cost was associated with female gender, shorter waiting times but not county. The proportion of children receiving immunisation in intervention village clinics increased from 42.5% (95% CI 27.9% to 47.1%) to 59.2% (95% CI 53.8% to 64.6%) whereas this decreased in comparison villages (16.5%; 95% CI 10.3% to 22.7% to 6.0%; 95% CI 1.3% to 10.7%). Antenatal visits increased in intervention villages (from 69.0%, 95% CI 65.8% to 73.1% to 75.8%, 95% CI 72.2% to 79.4%) with no change in comparison villages. Conclusions Introduction of a CHS model adapted to economically less-developed rural areas was associated with some

  9. 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

  10. Affecting Factors on the Performance of Community Health Workers in Iran’s Rural Areas: A Review Article

    PubMed Central

    SALEHI ZALANI, Gholamhossein; BAYAT, Mahboubeh; SHOKRI, Azad; MIRBAHAEDDIN, S. Elmira; RASI, Vahid; ALIREZAEI, Samira; MANAFI, Fatemeh

    2016-01-01

    Background: This study aimed to use a mixed-method approach to investigate affecting factors on the performance of Community Health Workers (CHW) in Iran’s villages. Methods: This study was conducted during 2014–2015 with a mixed method in three phases of literature review, Delphi technique and developing a rich picture. Overall, in order to finalize the affecting factors and their relationships between qualitative content analysis, Delphi technique, AHP technique and Focus Group Discussion were used, respectively. Results: Affecting factors on CHW performance were divided into four main categories, 10 sub-themes and 35 contents. Increase in the level of people’s awareness, disease patterns, demographic structure and lifestyle were placed in four priorities respectively on the basis of importance. Conclusion: To the most extent CHW cannot face current needs of rural communities. It challenges equitable access to healthcare services and also conflicts with the primary philosophy of CHW presence in rural areas. CHW can be used in two forms; either as an assistant to rural family physicians or with the same previous functions. PMID:28032057

  11. The Communities First (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities

    PubMed Central

    White, James; Greene, Giles; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Palmer, Stephen; Elliott, Eva; Phillips, Ceri J; Fone, David

    2014-01-01

    Introduction Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. ‘Communities First’ is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents’ mental health and social cohesion. Methods and analysis A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18–74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains. Ethics and dissemination This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in

  12. Surveillance of noncommunicable diseases by community health workers in Kerala: the epidemiology of noncommunicable diseases in rural areas (ENDIRA) study.

    PubMed

    Menon, Jaideep; Joseph, Jacob; Thachil, Ajit; Attacheril, Thankachan V; Banerjee, Amitava

    2014-12-01

    India carries the greatest burden of noncommunicable disease (NCD) globally. However, there are few contemporary, community-based studies of prevalence in India. Given the physician shortages in rural areas, large-scale, region-specific studies of NCD using community health workers (CHW) may offer a feasible means of NCD surveillance. This study sought to conduct a large-scale, population-based, CHW-led study of NCDs in Kerala, India. In rural Kerala, India, a population of 113,462 individuals was defined geographically by 5 panchayats (village councils). The ENDIRA (Epidemiology of Noncommunicable Diseases in Rural Areas) study was conducted via accredited social health activists (ASHA), who are CHW employed by Kerala state government. After training of ASHA, standardized questionnaires were used during 2012 in household interviews of individuals ≥18 years of age to gather sociodemographic, lifestyle, and medical data. ASHA recruited 84,456 adults who were included in the analyses (25.4% were below the poverty line). The prevalence of NCD was comparable to contemporary studies in India: myocardial infarction (MI) 1.4%; stroke 0.3%; respiratory diseases 5.0%; and cancer 1.1%. The dietary habits were as follows: 84.1% of the population was vegetarian; 15.9% ate meat/fish ≥1 day per week; 4.2% had ≥1 alcoholic drink per week; and 8.1% smoked regularly. Compared with men, women were older, had lower body mass index, more likely to be hypertensive, less likely to smoke or drink alcohol, and have diabetes or dyslipidemia (p < 0.0001). NCD were more common in men than women: MI (1.9% vs. 0.9%); stroke (0.5% vs. 0.3%); cancer (1.2% vs. 0.9%); and respiratory diseases (5.9% vs. 4.0%) (p < 0.0001). Age ≥65 years, hypertension, diabetes mellitus, dyslipidemia, smoking, and male sex were strongly associated with MI and stroke. There were high levels of agreement between ASHA and physicians for diagnoses of MI, stroke, hypertension, and diabetes. CHW effectively

  13. Nonsteroidal Antiinflammatory Drug Use and Lower Urinary Tract Symptoms: Results From the Boston Area Community Health Survey

    PubMed Central

    Gates, Margaret A.; Hall, Susan A.; Chiu, Gretchen R.; Kupelian, Varant; FitzGerald, Mary P.; Link, Carol L.; McKinlay, John B.

    2011-01-01

    There is evidence for a role of inflammation in the etiology of lower urinary tract symptoms (LUTS), raising the possibility that use of nonsteroidal antiinflammatory drugs (NSAIDs) may inhibit the development or progression of LUTS. The authors examined the association between use of prescription and over-the-counter NSAIDs and LUTS among 1,974 men and 2,661 women in the Boston Area Community Health Survey (2002–2005). Multivariable-adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals for LUTS, voiding symptoms, storage symptoms, and nocturia. There was no clear association between use of prescription or over-the-counter NSAIDs (compared with no NSAID use) and overall LUTS, voiding symptoms, or nocturia in men or women. However, over-the-counter NSAID use was positively associated with storage symptoms in women (odds ratio = 1.37, 95% confidence interval: 1.03, 1.83), and there was a positive association between over-the-counter NSAID use and overall LUTS among women with a history of arthritis (odds ratio = 2.09, 95% confidence interval: 1.20, 3.64). These results do not provide strong support for an association between NSAIDs and LUTS. However, the associations between over-the-counter NSAID use and certain urologic symptoms, particularly among women with arthritis, and the potential mechanisms involved should be evaluated in future studies. PMID:21357657

  14. Place Matters in Non-Traditional Migration Areas: Exploring Barriers to Healthcare for Latino Immigrants by Region, Neighborhood, and Community Health Center.

    PubMed

    Topmiller, Michael; Zhen-Duan, Jenny; Jacquez, Farrah J; Vaughn, Lisa M

    2016-12-30

    This paper identifies differences in adult Latino immigrant barriers to healthcare in the Cincinnati area in Hamilton County, OH, on three levels: by region, by neighborhood, and by community health center. Secondary data analysis was performed on 439 surveys. Respondents were aggregated by the geographic regions and neighborhoods where they live and by two community health centers where they receive care. Outcome measures included pragmatic and skill barrier indices adapted from the Barriers to Care Questionnaire (BCQ); the pragmatics index consists logistical barriers, including transportation and cost; the skills index is made up of items related to navigating the healthcare system, including communicating with physicians and completing paperwork. The results indicate that immigrant Latinos living in western Cincinnati and northern Hamilton County face significantly higher pragmatic barriers to care, while Latino immigrants going to a community health center in western Cincinnati have significantly fewer pragmatic and skill barriers than immigrants utilizing a nearby community health center. Because healthcare options for undocumented immigrants do not improve with the Affordable Care Act, community health centers will continue to serve as their primary source of care. This is particularly true in non-traditional migration areas, where immigrants tend to be isolated and lack resources. Efforts to improve access to healthcare for immigrant Latinos require place-based approaches that allow for targeted resources to improve care in these locations. This study helps to fill that need by identifying variation in barriers to care on multiple levels and offering strategies to alleviate these barriers.

  15. Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey

    PubMed Central

    López, Lenny; Grant, Richard W.; Marceau, Lisa; Piccolo, Rebecca; McKinlay, John B.; Meigs, James B.

    2016-01-01

    This study assessed the effect of acculturation on type 2 diabetes and whether health literacy may mediate this association. The Boston Area Community Health cohort is a multi-stage stratified random sample of adults from Boston including 744 Latinos. We defined dysglycemia as a HbA1c ≥5.7 %. Multivariable analyses examined the associations between acculturation and health literacy adjusting for demographic and clinical variables. Similar analyses were performed among participants with HbA1c ≥7.0 % to assess the association between acculturation and diabetes control. Among an insured primarily foreign born Spanish speaking Latino population, with a long residence period in the US and good healthcare utilization, higher levels of acculturation were not associated with dysglycemia. Lower levels of acculturation were associated with worse diabetes control. Health literacy level did not modify these associations. Elucidating the components of heterogeneity among Latinos will be essential for understanding the influence of acculturation on diabetes. PMID:26898955

  16. Sexual behaviors, sexual health practices, and community engagement among gay and bisexually identified men living in rural areas of the United States.

    PubMed

    Rosenberger, Joshua G; Schick, Vanessa; Schnarrs, Phillip; Novak, David S; Reece, Michael

    2014-01-01

    Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men's engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.

  17. Community health and foot health.

    PubMed

    Brodie, B S

    1989-01-01

    The limiting factor in health and mobility for many seniors is the state of their feet. The origins of their foot problems can often be traced back to childhood and years of wearing badly fitting or inappropriate footwear. Well-fitting footwear is essential if mobility and independence are to be retained. The chiropodist (or podiatrist) is a health professional specializing in the treatment of conditions of the foot. Some common foot conditions, together with their treatments, are described. Although numbers of chiropodists in Canada are limited, their role is being increasingly recognized in maintaining or restoring mobility, and also their place in the community health team.

  18. 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)

  19. 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)

  20. Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey.

    PubMed

    Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant

    2015-01-01

    Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.

  1. The communities first (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities.

    PubMed

    White, James; Greene, Giles; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Palmer, Stephen; Elliott, Eva; Phillips, Ceri J; Fone, David

    2014-10-14

    Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. 'Communities First' is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents' mental health and social cohesion. A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18-74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains. This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in local and national government, and updates on our study website

  2. Committed to working for the community: experiences of a public health nurse in a remote area during the Great East Japan Earthquake.

    PubMed

    Sato, Mari; Atogami, Fumi; Nakamura, Yasuka; Kusaka, Yuko; Yoshizawa, Toyoko

    2015-01-01

    We examined the experiences of a public health nurse (PHN) in a rural area affected by the Great East Japan Earthquake. We used an ethnographic method to obtain in-depth information about her experiences, from which six themes were developed. The PHN risked her life to protect members of the community, but she remained anxious to see her own young children as soon as possible. Nevertheless, she was strongly committed to helping community members and continued to work for them. We suggest creating a practical system to allow PHNs to obtain information about the safety of their own families during a disaster.

  3. 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…

  4. 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…

  5. Community bioethics: the health decisions community council.

    PubMed

    Gallegos, T; Mrgudic, K

    1993-08-01

    Health care decision making in modern society can pose a variety of complex issues for consideration by individuals, families, and providers. The Health Decisions Community Council (HDCC), a community-based bioethics committee, was established to offer a noninstitutional forum for discussion of difficult health care dilemmas. Social work skills and values for autonomy and self-determination are essential to the formation of the HDCC as a model for community bioethics discussions.

  6. Causative Factors of Social Inequality and its Impact on Community Health: a Neighbourhood Level Study in Midnapore Municipal Area, West Bengal, India

    NASA Astrophysics Data System (ADS)

    Roy, U.

    2016-10-01

    Health is socio-demographic construct of population. In an urban area social, economic and political systems simultaneously operate within a geographically defined space in which the urban dwellers accommodate and act as key player. As such the physical and social factors virtually affect the community health as a consequence of disparity in accessing health. Health disparities in smaller towns of the developing world have drawn serious attention as they are poorly suffering from the problems of `urban penalty'. This paper deals with statistical clustering of neighbourhoods on the basis of quality of life, social deprivation and multiple suffering quantified as the variables derived from measurable parameters. Neighbourhoods inequality has been mapped as per the score received by each neighbourhood in respect to the above three variables. Principal Component Analysis (PCA) has also been employed for grouping the neighbourhoods in social terms. Then it has been tried to examine relationship between health attainment and social status of the neighbourhoods. The study shows that status of health does not merely depend on socio-demographic and political factors but availability of healthcare facilities, health related behaviour, health perception and awareness have played significant roles. The findings of the study may be helpful for setting planning strategies most important of which would be inclusion of local people in catering health services.

  7. Impact of m-health application used by community health volunteers on improving utilisation of maternal, new-born and child health care services in a rural area of Uttar Pradesh, India.

    PubMed

    Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Gupta, Madhu; Thakur, Jarnail Singh

    2017-07-01

    To raise the quality of counselling by community health volunteers resulting in improved uptake of maternal, neonatal and child health services (MNCH), an m-health application was introduced under a project named 'Reducing Maternal and Newborn Deaths (ReMiND)' in district Kaushambi in India. We report the impact of this project on coverage of key MNCH services. A pre- and post-quasi-experimental design was undertaken to assess the impact of intervention. This project was introduced in two community development blocks in Kaushambi district in 2012. Two other blocks from the same district were selected as controls after matching for coverage of two indicators at baseline - antenatal care and institutional deliveries. The Annual Health Survey conducted by the Ministry of Health and Family Welfare in 2011 served as pre-intervention data, whereas a household survey in four blocks of Kaushambi district in 2015 provided post-intervention coverage of key services. Propensity score matched samples from intervention and control areas in pre-intervention and post-intervention periods were analysed using difference-in-difference method to estimate the impact of ReMiND project. We found a statistically significant increase in coverage of iron-folic acid supplementation (12.58%), self-reporting of complication during pregnancy (13.11%) and after delivery (19.6%) in the intervention area. The coverage of three or more antenatal care visits, tetanus toxoid vaccination, full antenatal care and ambulance usage increased in intervention area by 10.3%, 4.28%, 1.1% and 2.06%, respectively; however, the changes were statistically insignificant. Three of eight services which were targeted for improvement under ReMiND project registered a significant improvement as result of m-health intervention. © 2017 John Wiley & Sons Ltd.

  8. 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…

  9. Oral Health in Rural Communities

    MedlinePlus

    ... Health Gateway Evidence-based Toolkits Rural Health Models & Innovations Supporting Rural Community Health Tools for Success Am ... FAQs Resources Organizations Funding & Opportunities News Models and Innovations About This Guide Rural Health Topics & States Topics ...

  10. Community health for Rwandan refugees.

    PubMed

    Plummer, M

    1995-12-01

    Health education and disease prevention programs are essential elements in every health care system. We normally envision community health programs in urban and rural settings across Canada. However, health education and disease prevention have also become a fundamental part of the health care system for refugee communities around the world.

  11. 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

  12. 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.

  13. [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.

  14. Training Community Health Workers to Manage Uncomplicated and Severe Malaria: Experience From 3 Rural Malaria-Endemic Areas in Sub-Saharan Africa

    PubMed Central

    Siribié, Mohamadou; Ajayi, IkeOluwapo O.; Nsungwa-Sabiiti, Jesca; Afonne, Chinenye; Balyeku, Andrew; Falade, Catherine O.; Gansane, Zakaria; Jegede, Ayodele S.; Ojanduru, Lillian; Oshiname, Frederick O.; Kabarungi, Vanessa; Kyaligonza, Josephine; Sanou, Armande K.; Sermé, Luc; Castellani, Joëlle; Singlovic, Jan; Gomes, Melba

    2016-01-01

    Background. Use of community health workers (CHWs) to increase access to diagnosis and treatment of malaria is recommended by the World Health Organization. The present article reports on training and performance of CHWs in applying these recommendations. Methods. Two hundred seventy-nine CHWs were trained for 3–5 days in Burkina Faso, Nigeria, and Uganda, and 19 were certified to diagnose and treat only uncomplicated malaria and 235 to diagnose and treat both uncomplicated and severe malaria. Almost 1 year after training, 220 CHWs were assessed using standard checklists using facility staff responses as the reference standard. Results. Training models were slightly different in the 3 countries, but the same topics were covered. The main challenges noticed were the low level of education in rural areas and the involvement of health staff in the supervision process. Overall performance was 98% (with 99% in taking history, 95% in measuring temperature, 85% for measuring respiratory rates, 98% for diagnosis, 98% for classification, and 99% for prescribing treatment). Young, single, new CHWs performed better than their older, married, more experienced counterparts. Conclusions. Training CHWs for community-based diagnosis and treatment of uncomplicated and severe malaria is possible with basic and refresher training and close supervision of CHWs’ performance. Clinical Trials Registration. ISRCTRS13858170. PMID:27941103

  15. 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.

  16. 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.

  17. Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users - A Cross-Sectional Study.

    PubMed

    Bonney, Andrew; Mayne, Darren J; Jones, Bryan D; Bott, Lawrence; Andersen, Stephen E J; Caputi, Peter; Weston, Kathryn M; Iverson, Don C

    2015-01-01

    Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities. The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable. The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males. It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.

  18. Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users – A Cross-Sectional Study

    PubMed Central

    Bonney, Andrew; Mayne, Darren J.; Jones, Bryan D.; Bott, Lawrence; Andersen, Stephen E. J.; Caputi, Peter; Weston, Kathryn M.; Iverson, Don C.

    2015-01-01

    Background Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities. Materials and Methods The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable. Results The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males. Conclusion It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning. PMID:26317861

  19. 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)

  20. [Community health building: the safe community promotion experience].

    PubMed

    Pai, Lu

    2011-02-01

    Safety and health promotion at the community level involves special concerns and approaches. A community may develop into a safe community or healthy city depending on the focus of relevant promotion efforts. Neither area nor population size should be factors affecting an initial decision to start safe community or healthy city programs. However, one should consider the diversity of issues that may have the potential impact on people with different gender and age or on different environments and situations, and whether a planned program is sustainable. While safe communities and healthy cities may be linked to international networks, the qualifications for joining such networks differ. The Healthy City Alliance emphasizes outcome measures and the International Safe Community Network emphasizes the appropriateness of sustainability mechanisms. While Taiwan communities are eligible for designation as international safe communities, they may are eligible for associate membership only in the Healthy City Alliance. The author has the following recommendations with regard to sustainability in community health building in Taiwan: 1) The relevant infrastructure must involve both public and private sectors; 2) The community should try to receive financial support from diverse sources; 3) involve significant numbers of active volunteers; and 4) charge local health centers with data collection and analysis responsibilities.

  1. Association of African genetic ancestry with fasting glucose and HbA1c levels in non-diabetic individuals: the Boston Area Community Health (BACH) Prediabetes Study

    PubMed Central

    Grant, Richard W.; Piccolo, Rebecca; López, Lenny; Florez, Jose C.; Porneala, Bianca; Marceau, Lisa; McKinlay, John B.

    2017-01-01

    Aims/hypothesis To test among diabetes-free urban community-dwelling adults the hypothesis that the proportion of African genetic ancestry is positively associated with glycaemia, after accounting for other continental ancestry proportions, BMI and socioeconomic status (SES). Methods The Boston Area Community Health cohort is a multi-stage 1:1:1 stratified random sample of self-identified African-American, Hispanic and white adults from three Boston inner city areas. We measured 62 ancestry informative markers, fasting glucose (FG), HbA1c, BMI and SES (income, education, occupation and insurance status) and analysed 1,387 eligible individuals (379 African-American, 411 Hispanic, 597 white) without clinical or biochemical evidence of diabetes. We used three-heritage multinomial linear regression models to test the association of FG or HbA1c with genetic ancestry proportion adjusted for: (1) age and sex; (2) age, sex and BMI; and (3) age, sex, BMI and SES. Results Mean age- and sex-adjusted FG levels were 5.73 and 5.54 mmol/l among those with 100% African or European ancestry, respectively. Using per cent European ancestry as the referent, each 1% increase in African ancestry proportion was associated with an age- and sex-adjusted FG increase of 0.0019 mmol/l ( p=0.01). In the BMI- and SES-adjusted model the slope was 0.0019 ( p=0.02). Analysis of HbA1c gave similar results. Conclusions/interpretation A greater proportion of African genetic ancestry is independently associated with higher FG levels in a non-diabetic community-based cohort, even accounting for other ancestry proportions, obesity and SES. The results suggest that differences between African-Americans and whites in type 2 diabetes risk may include genetically mediated differences in glucose homeostasis. PMID:24942103

  2. Association of African genetic ancestry with fasting glucose and HbA1c levels in non-diabetic individuals: the Boston Area Community Health (BACH) Prediabetes Study.

    PubMed

    Meigs, James B; Grant, Richard W; Piccolo, Rebecca; López, Lenny; Florez, Jose C; Porneala, Bianca; Marceau, Lisa; McKinlay, John B

    2014-09-01

    To test among diabetes-free urban community-dwelling adults the hypothesis that the proportion of African genetic ancestry is positively associated with glycaemia, after accounting for other continental ancestry proportions, BMI and socioeconomic status (SES). The Boston Area Community Health cohort is a multi-stage 1:1:1 stratified random sample of self-identified African-American, Hispanic and white adults from three Boston inner city areas. We measured 62 ancestry informative markers, fasting glucose (FG), HbA1c, BMI and SES (income, education, occupation and insurance status) and analysed 1,387 eligible individuals (379 African-American, 411 Hispanic, 597 white) without clinical or biochemical evidence of diabetes. We used three-heritage multinomial linear regression models to test the association of FG or HbA1c with genetic ancestry proportion adjusted for: (1) age and sex; (2) age, sex and BMI; and (3) age, sex, BMI and SES. Mean age- and sex-adjusted FG levels were 5.73 and 5.54 mmol/l among those with 100% African or European ancestry, respectively. Using per cent European ancestry as the referent, each 1% increase in African ancestry proportion was associated with an age- and sex-adjusted FG increase of 0.0019 mmol/l (p = 0.01). In the BMI- and SES-adjusted model the slope was 0.0019 (p = 0.02). Analysis of HbA1c gave similar results. A greater proportion of African genetic ancestry is independently associated with higher FG levels in a non-diabetic community-based cohort, even accounting for other ancestry proportions, obesity and SES. The results suggest that differences between African-Americans and whites in type 2 diabetes risk may include genetically mediated differences in glucose homeostasis.

  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. 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…

  5. Educating patients at home. Community Health Rap.

    PubMed

    Alemi, F; Stephens, R C; Muise, K; Dyches, H; Mosavel, M; Butts, J

    1996-10-01

    The authors analyzed the impact of home health education by studying the impact of a computer service called Community Health Rap. When patients call this service, the computer records their questions and alerts an expert who records a response. Subsequently, the computer alerts the patient that the question has been addressed. Subjects included a group of 82 pregnant women who had used cocaine during or 1 month before pregnancy (as reported by the woman) and a group of residents of zip code areas with the lowest income in Cleveland. From the drug-using pregnant women, we collected data regarding satisfaction with Community Health Rap, usage of Community Health Rap per month, self-reported health status (using the General Health Survey), and the extent of drug use (using the Addiction Severity Index). Trained coders also classified the nature of questions posed to the Community Health Rap by either the pregnant women who abuse drugs or the members of target households. Among the pregnant women who abuse drugs, we compared the differences between those who used the service and those who did not. To control for baseline differences between the two groups, analysis of co-variance was used with exit values as the dependent variables, the baseline values as the co-variates, and participation in the Community Health Rap as the independent variable. Almost half (45%) of poor, undereducated subjects who lived in inner urban areas used the computer service. Content analysis of Community Health Rap messages revealed that subjects had many questions that were of a social nature (regarding sex, relationships, etc), in addition to medical questions. Analysis showed that poor health status, more frequent drug use, lower education, and age did not affect regular use of Community Health Rap service. No health outcomes or utilization of treatment were associated with regular use of Community Health Rap. One exception, however, was that regular users of Community Health Rap reported

  6. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

    PubMed

    Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

    2017-03-17

    Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. 2011-2012. The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18

  7. 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…

  8. 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…

  9. HIV and STI Risk for Young Blacks in High Prevalence Areas: Implications for Health Equity in Communities Hosting Historically Black Colleges and Universities (HBCUs).

    PubMed

    LeBlanc, Tanya Telfair; Sutton, Madeline Y; Thomas, Peter; Duffus, Wayne A

    2014-01-01

    Every year, thousands of young black, high school graduates who are seeking higher education, attend one of the 105 historically black colleges and universities (HBCUs) located primarily in the south and east. The objective of the research was to examine the geographic proximity of HBCUs to areas of high HIV and STI disease burden among college age people to assess infectivity of potential sex partners in the areas surrounding HBCUs. We examined the 14 states reporting the greatest HIV diagnoses burden among persons age 20-24 years old and STI burden among persons age 15 to 24 years old available for 2010. The Geographic Information System was used to create a spatially referenced data base of state level HIV and STI disease rates and HBCU zip codes to answer the question "How many HBCUs are in this location?" Maps were created to show HBCU locations in states along with the associated HIV and STI disease burden. Results suggest high HIV and STI disease burden in the general population of persons ages 15-24 in 10 states with 4 or more Historically Black Colleges and Universities (HBCU) and an overall high rate of HIV and STI exposure in the pool of potential sex partners. Less risky behavior by minority young adults attending HBCUs could potentially translate to high risk for contracting the diseases because of high prevalence in surrounding communities. Public health agencies may want to consider prioritizing HBCUs for enhanced HIV and STI prevention collaborative efforts in those areas with a high burden of HIV and other STIs.

  10. 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

  11. The contribution of biogeographical ancestry and socioeconomic status to racial/ethnic disparities in type 2 diabetes mellitus: results from the Boston Area Community Health Survey.

    PubMed

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

    2014-09-01

    Racial/ethnic disparities in the incidence of type 2 diabetes mellitus (T2DM) are well documented, and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research was to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. We analyzed data from the Boston Area Community Health Survey, a prospective cohort with approximately equal numbers of black, Hispanic, and white participants. We used 63 ancestry-informative markers to calculate the percentages of participants with West African and Native American ancestry. We used logistic regression with G-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. It is likely that nongenetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The Contribution of Biogeographic Ancestry and Socioeconomic Status to Racial/Ethnic Disparities in Type 2 Diabetes: Results from the Boston Area Community Health (BACH) Survey

    PubMed Central

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

    2014-01-01

    Purpose Racial/ethnic disparities in the incidence of type 2 diabetes (T2DM) are well documented and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research is to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. Methods We analyzed data from the Boston Area Community Health (BACH) Survey, a prospective cohort with approximately equal numbers of Black, Hispanic, and White participants. We used Ancestry Informative Markers to calculate the percentages of West African and Native American ancestry of participants. We used logistic regression with g-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. Results We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to Black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. Conclusions It is likely that non-genetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. PMID:25088753

  13. Community outreach: rural mobile health unit.

    PubMed

    Alexy, B B; Elnitsky, C A

    1996-12-01

    With the increased emphasis on cost containment, hospital administrators are investigating community outreach projects to remain economically viable. The authors describe the planning and implementation of a mobile health unit for rural elderly residents. This project represents an alternative model of healthcare delivery in a rural area with limited resources and healthcare providers.

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

    PubMed Central

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

    2015-01-01

    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 sociodemographics). 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 = 2,764) 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

  15. 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

  16. Brentwood Community Health Care Assessment

    PubMed Central

    Goodman, Melody S.; Gonzalez, Maria; Gil, Sandra; Si, Xuemei; Pashoukos, Judith L.; Stafford, Jewel D.; Ford, Elsa; Pashoukos, Dennis A.

    2015-01-01

    Background The Community Alliance for Research Empowering Social Change (CARES) is an academic–community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. Objectives The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. Methods Using CBPR approaches, the community–academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. Results Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. Conclusions We describe the community–academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County’s most vulnerable communities. PMID:24859100

  17. Evaluation of the change in the knowledge of community regarding infant dental care subsequent to intervention strategies through existing health manpower in rural areas of Haryana (India).

    PubMed

    Tewari, A; Gauba, K; Goyal, A

    1994-03-01

    The knowledge about infant dental care (as a part of primary preventive programme) was delivered by the existing health team of CHC viz. medical doctors, multipurpose workers, health workers, Anganwadi workers (ICDS scheme), after due training from the dental experts, in the rural community of Raipur Rani (Haryana). The knowledge of community regarding infant dental care subsequent to intervention strategies when evaluated and compared to baseline values three years after intervention revealed that 72 percent of the community had the correct knowledge of prolonged breast/bottle feeding causing nursing bottle caries. 94 per cent had correct knowledge about harmful effects of thumb/finger sucking on teeth and jaw bones and 77 percent about harmful effects of mouth breathing. 98 percent of expecting mothers knew when to clean the gum pads and 62 percent how to clean the gum pads in an infant. 100 percent of the expecting mothers had the correct knowledge that pacifiers should not be used in small children.

  18. Community Involvement in Marine Protected Areas.

    ERIC Educational Resources Information Center

    Kaza, Stephanie

    1988-01-01

    Lists several key concepts in developing successful interpretive programs for marine protected areas with community involvement. Identifies educational tools that help foster community involvement in conservation and management. Cites three model programs. Sets standards and goals for international success including leadership, education,…

  19. Community Involvement in Marine Protected Areas.

    ERIC Educational Resources Information Center

    Kaza, Stephanie

    1988-01-01

    Lists several key concepts in developing successful interpretive programs for marine protected areas with community involvement. Identifies educational tools that help foster community involvement in conservation and management. Cites three model programs. Sets standards and goals for international success including leadership, education,…

  20. Community forums promote health awareness.

    PubMed

    Woodrow, M; Wheat, R P

    1978-01-01

    In order to encourage citizens to take a more active role in their health care management, a 464-bed community hospital presented a series of 12 health forums during a two-year period. A multidisciplinary panel of speakers was gathered to discuss specific health-related topics. The following article details the selection of forum topics, the general structure of the forums, use of publicity, audiovisual support, cost, and implications for planning further series.

  1. Soil-transmitted helminthiases and health behaviors among schoolchildren and community members in a west-central border area of Thailand.

    PubMed

    Anantaphruti, Malinee T; Waikagul, Jitra; Maipanich, Wanna; Nuamtanong, Supaporn; Pubampen, Somchit

    2004-06-01

    The prevalence of soil-transmitted helminthic infections and health behaviors related to infections in schoolchildren and villagers of a community (4 hamlets) was studied in Hauy Kayeng subdistrict, Thong Pha Phum district, in the north of Kanchanaburi Province. The intestinal helminth infection rate of the schoolchildren was 15.6%. Hookworm infection was the most prominent (9.8%), followed by Trichuris trichiura (6.2%), and Ascaris lumbricoides (2.2%). The community showed higher prevalence rates and was infected with more types of intestinal helminths than the schoolchildren. Thirty-five point two percent (35.2%) of the residents were infected with soil-transmitted helminths, 30.5% with hookworm, 3.4% with A. lumbricoides and 2.2% with T. trichiura. Almost all hookworm cases (94.3%) were light intensity infections, while only 1.3% were heavy infections. Moreover, the hookworm infection rate in the community was found to be much higher when a stool culture method was used (39.1%). With this technique, 2.3% Strongyloides stercoralis infections were detected in the community population. Examination of the health behavior of the study samples showed that approximately 75% always defecated in a toilet. Schoolchildren who always wore shoes comprised 67%, which was lower than the community, at 85%.

  2. Public health and community medicine instruction and physician practice location.

    PubMed

    Xierali, Imam M; Maeshiro, Rika; Johnson, Sherese; Arceneaux, Taniecea; Fair, Malika A

    2014-11-01

    Experts have historically recommended better integration of public health content into medical education. Whether this adoption is associated with physician practice location has not been studied. To examine the association between medical student perception of their public health and community medicine instruction and practice location in a Health Professional Shortage Area. Descriptive analysis and a regression model assessed the significance and strength of the association between medical student perception of their public health and community medicine instruction and practice location using data from the Medical School Graduation Questionnaire 1997-2004, 2013 American Medical Association Physician Masterfile, and 2013 Health Professional Shortage Areas. A higher proportion of medical students with an intent to practice in underserved areas reported inadequate instruction in public health and community medicine than those without such intentions. Students reporting adequate public health and community medicine instruction are slightly more likely to practice in a Health Professional Shortage Area, controlling for their intent to practice in underserved areas. Findings suggest an association between perceptions of public health and community medicine instruction and practice location. Improved public health and community medicine instruction may support medical students' preparation and ability to integrate public health skills into practices in underserved settings. More research is needed to ascertain factors enabling better incorporation of public health and community medicine in medical education. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Assessing Community Leadership: Understanding Community Capacity for Health Improvement.

    PubMed

    Castle, Billie; Wendel, Monica; Kelly Pryor, Brandy N; Ingram, Monique

    The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to

  4. [Health vulnerability mapping in the Community of Madrid (Spain)].

    PubMed

    Ramasco-Gutiérrez, Milagros; Heras-Mosteiro, Julio; Garabato-González, Sonsoles; Aránguez-Ruiz, Emiliano; Aguirre Martín-Gil, Ramón

    2016-10-20

    The Public Health General Directorate of Madrid has developed a health vulnerability mapping methodology to assist regional social health teams in health planning, prioritisation and intervention based on a model of social determinants of health and an equity approach. This process began with the selection of areas with the worst social indicators in health vulnerability. Then, key stakeholders of the region jointly identified priority areas of intervention and developed a consensual plan of action. We present the outcomes of this experience and its connection with theoretical models of asset-based community development, health-integrated georeferencing systems and community health interventions.

  5. [Community health in primary health care teams: a management objective].

    PubMed

    Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

    2016-12-01

    To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  6. Evaluation of community health assessment in Kansas.

    PubMed

    Curtis, Denice C

    2002-07-01

    This article evaluates the status of community health assessment in Kansas. It describes community characteristics associated with community health assessment completion, factors contributing to success, as well as barriers and limitations that prevented Kansas communities from initiating a community health assessment or completing the process. Survey findings show that certain community characteristics such as interagency cooperation, history of success at problem solving, and shared decision-making power are strongly associated with completion of a community health assessment. Results also indicate that factors such as lack of leadership, money, and time as well as poor functioning coalitions may hinder the completion of community health assessment.

  7. 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…

  8. Lymphatic filariasis patient identification in a large urban area of Tanzania: An application of a community-led mHealth system.

    PubMed

    Mwingira, Upendo; Chikawe, Maria; Mandara, Wilfred Lazarus; Mableson, Hayley E; Uisso, Cecilia; Mremi, Irene; Malishee, Alpha; Malecela, Mwele; Mackenzie, Charles D; Kelly-Hope, Louise A; Stanton, Michelle C

    2017-07-01

    Lymphatic filariasis (LF) is best known for the disabling and disfiguring clinical conditions that infected patients can develop; providing care for these individuals is a major goal of the Global Programme to Eliminate LF. Methods of locating these patients, knowing their true number and thus providing care for them, remains a challenge for national medical systems, particularly when the endemic zone is a large urban area. A health community-led door-to-door survey approach using the SMS reporting tool MeasureSMS-Morbidity was used to rapidly collate and monitor data on LF patients in real-time (location, sex, age, clinical condition) in Dar es Salaam, Tanzania. Each stage of the phased study carried out in the three urban districts of city consisted of a training period, a patient identification and reporting period, and a data verification period, with refinements to the system being made after each phase. A total of 6889 patients were reported (133.6 per 100,000 population), of which 4169 were reported to have hydrocoele (80.9 per 100,000), 2251 lymphoedema-elephantiasis (LE) (43.7 per 100,000) and 469 with both conditions (9.1 per 100,000). Kinondoni had the highest number of reported patients in absolute terms (2846, 138.9 per 100,000), followed by Temeke (2550, 157.3 per 100,000) and Ilala (1493, 100.5 per 100,000). The number of hydrocoele patients was almost twice that of LE in all three districts. Severe LE patients accounted for approximately a quarter (26.9%) of those reported, with the number of acute attacks increasing with reported LE severity (1.34 in mild cases, 1.78 in moderate cases, 2.52 in severe). Verification checks supported these findings. This system of identifying, recording and mapping patients affected by LF greatly assists in planning, locating and prioritising, as well as initiating, appropriate morbidity management and disability prevention (MMDP) activities. The approach is a feasible framework that could be used in other large

  9. Health Education through Analogies: Preparation of a Community for Clinical Trials of a Vaccine against Hookworm in an Endemic Area of Brazil

    PubMed Central

    Gazzinelli, Maria Flavia; Lobato, Lucas; Matoso, Leonardo; Avila, Renato; de Cassia Marques, Rita; Shah Brown, Ami; Correa-Oliveira, Rodrigo; Bethony, Jeffrey M.; Diemert, David J.

    2010-01-01

    Background Obtaining informed consent for clinical trials is especially challenging when working in rural, resource-limited areas, where there are often high levels of illiteracy and lack of experience with clinical research. Such an area, a remote field site in the northeastern part of the state of Minas Gerais, Brazil, is currently being prepared for clinical trials of experimental hookworm vaccines. This study was conducted to assess whether special educational tools can be developed to increase the knowledge and comprehension of potential clinical trial participants and thereby enable them to make truly informed decisions to participate in such research. Methodology/Principal Findings An informational video was produced to explain the work of the research team and the first planned hookworm vaccine trial, using a pedagogical method based on analogies. Seventy-two adults living in a rural community of Minas Gerais were administered a structured questionnaire that assessed their knowledge of hookworm, of research and of the planned hookworm vaccine trial, as well as their attitudes and perceptions about the researchers and participation in future vaccine trials. The questionnaire was administered before being shown the educational video and two months after and the results compared. After viewing the video, significant improvements in knowledge related to hookworm infection and its health impact were observed: using a composite score combining related questions for which correct answers were assigned a value of 1 and incorrect answers a value of 0, participants had a mean score of 0.76 post-video compared to 0.68 pre-video (p = 0.0001). Similar improvements were seen in understanding the purpose of vaccination and the possible adverse effects of an experimental vaccine. Although 100% of participants expressed a positive opinion of the researchers even before viewing the film and over 90% said that they would participate in a hookworm vaccine trial, an

  10. Community Public Health Fact Sheet

    EPA Pesticide Factsheets

    EPA’s Community Public Health (CPH) project in the Office of Research and Development (ORD) produces high quality science and tools to understand and assess environmental risks and ecosystem goods and services (EGS) to decision-makers at all levels.

  11. Health workforce equity in urban community health service of China.

    PubMed

    Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin

    2014-01-01

    To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (P<0.001). Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.

  12. Bridging the gap between community health and K-12 schools.

    PubMed

    Ahmed, Christine

    The topic of this article is program planning for K-12 school health programs collaborating with community agencies, businesses, colleges, and organizations. Community involvement was listed as one of the weakest areas of school health efforts in a national coordinated school health study [1]. This article presents the 5-year results demonstrating the outcomes of K-12 schools program planning aimed at community involvement in the coordinated school health model. Directors of the Departments of Education and Health in South Dakota initiated training for school personnel in the coordinated school health model through development of councils in the schools starting in 2000. The expectations of the councils were to design a program plan to support the health of students and staff in their school. The short-term results of a 5-year evaluation indicated the greatest area of gain was in community health involvement to improve student and staff health.

  13. Keys to Successful Community Health Worker Supervision

    ERIC Educational Resources Information Center

    Duthie, Patricia; Hahn, Janet S.; Philippi, Evelyn; Sanchez, Celeste

    2012-01-01

    For many years community health workers (CHW) have been important to the implementation of many of our health system's community health interventions. Through this experience, we have recognized some unique challenges in community health worker supervision and have highlighted what we have learned in order to help other organizations effectively…

  14. Keys to Successful Community Health Worker Supervision

    ERIC Educational Resources Information Center

    Duthie, Patricia; Hahn, Janet S.; Philippi, Evelyn; Sanchez, Celeste

    2012-01-01

    For many years community health workers (CHW) have been important to the implementation of many of our health system's community health interventions. Through this experience, we have recognized some unique challenges in community health worker supervision and have highlighted what we have learned in order to help other organizations effectively…

  15. Patient Moderator Interaction in Online Health Communities

    PubMed Central

    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. PMID:24551364

  16. 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.

  17. 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. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  18. Community Health Workers as Support for Sickle Cell Care

    PubMed Central

    Hsu, Lewis L.; Green, Nancy S.; Ivy, E. Donnell; Neunert, Cindy; 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

    2016-01-01

    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 report 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

  19. 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…

  20. Financing geriatric programs in community health centers.

    PubMed Central

    Yeatts, D E; Ray, S; List, N; Duggar, B

    1991-01-01

    There are approximately 600 Community and Migrant Health Centers (C/MHCs) providing preventive and primary health care services principally to medically underserved rural and urban areas across the United States. The need to develop geriatric programs within C/MHCs is clear. Less clear is how and under what circumstances a comprehensive geriatric program can be adequately financed. The Health Resources and Services Administration of the Public Health Service contracted with La Jolla Management Corporation and Duke University Center on Aging to identify successful techniques for obtaining funding by examining 10 "good practice" C/MHC geriatric programs. The results from this study indicated that effective techniques included using a variety of funding sources, maintaining accurate cost-per-user information, developing a marketing strategy and user incentives, collaborating with the area agency on aging and other community organizations, and developing special services for the elderly. Developing cost-per-user information allowed for identifying appropriate "drawing card" services, negotiating sound reimbursement rates and contracts with other providers, and assessing the financial impact of changing service mixes. A marketing strategy was used to enhance the ability of the centers to provide a comprehensive package of services. Collaboration with the area agency on aging and other community organizations and volunteers in the aging network was found to help establish referral networks and subsequently increase the number of elderly patients served. Finally, development of special services for the elderly, such as adult day care, case management, and health education, was found to increase program visibility, opportunities to work with the network of services for the aging, and clinical utilization. PMID:1908588

  1. Community health psychology: promoting analysis and action for social change.

    PubMed

    Campbell, Catherine; Murray, Michael

    2004-03-01

    Community health psychology is concerned with the theory and method of working with communities to combat disease and to promote health. This introductory article outlines key assumptions and debates underlying this area of research and practice-in the interests of framing the papers in this special edition of the Journal of Health Psychology. Attention is given to the value of emphasizing the community level of analysis and action; the role of collective action in improving health; psycho-social mediatiors between community participation and health; and the potential role of partnerships in creating 'healthy communities'. A distinction is made between 'accommodationist' and 'critical' perspectives, and the authors consider whether or not significant social change can come from community-level action.

  2. Prevalence and Overlap of Childhood and Adult Physical, Sexual, and Emotional Abuse: A Descriptive Analysis of Results from the Boston Area Community Health (BACH) Survey

    PubMed Central

    Chiu, Gretchen R.; Lutfey, Karen E.; Litman, Heather J.; Link, Carol L.; Hall, Susan A.; McKinlay, John B.

    2012-01-01

    Abuse is associated with a wide variety of health problems, yet comprehensive population-based data are scant. Existing literature focuses on a single type of abuse, population, or lifestage. Using a racially/ethnically diverse community-based sample, we document the prevalence of physical, emotional, and sexual abuse by lifestage and gender; assess variation in abuse by socio-demographics; establish overlap of abuses; and examine childhood abuse relationships with abuse in adulthood. Prevalence of abuse ranges from 15% to 27%; women report more adulthood emotional abuse and lifetime sexual abuse than men; reports of abuse can vary by race/ethnicity and poverty status, particularly in women; there is overlap between types of abuse; and a history of childhood abuse is associated with a greater risk of abuse as an adult. PMID:23862305

  3. Health Care Marketing: Role Evolution of the Community Health Educator.

    ERIC Educational Resources Information Center

    Syre, Thomas R.; Wilson, Richard W.

    1990-01-01

    This article discusses role delineation in the health education profession, defines and presents principles of health care marketing, describes marketing plan development, and examines major ethical issues associated with health care marketing when utilized by community health educators. A marketing plan format for community health education is…

  4. Referral Patterns of Community Health Workers Diagnosing and Treating Malaria: Cluster-Randomized Trials in Two Areas of High- and Low-Malaria Transmission in Southwestern Uganda

    PubMed Central

    Lal, Sham; Ndyomugenyi, Richard; Magnussen, Pascal; Hansen, Kristian S.; Alexander, Neal D.; Paintain, Lucy; Chandramohan, Daniel; Clarke, Siân E.

    2016-01-01

    Malaria-endemic countries have implemented community health worker (CHW) programs to provide malaria diagnosis and treatment to populations living beyond the reach of health systems. However, there is limited evidence describing the referral practices of CHWs. We examined the impact of malaria rapid diagnostic tests (mRDTs) on CHW referral in two cluster-randomized trials, one conducted in a moderate-to-high malaria transmission setting and one in a low-transmission setting in Uganda, between January 2010 and July 2012. All CHWs were trained to prescribe artemisinin-based combination therapy (ACT) for malaria and recognize signs and symptoms for referral to health centers. CHWs in the control arm used a presumptive diagnosis for malaria based on clinical symptoms, whereas intervention arm CHWs used mRDTs. CHWs recorded ACT prescriptions, mRDT results, and referral in patient registers. An intention-to-treat analysis was undertaken using multivariable logistic regression. Referral was more frequent in the intervention arm versus the control arm (moderate-to-high transmission, P < 0.001; low transmission, P < 0.001). Despite this increase, referral advice was not always given when ACTs or prereferral rectal artesunate were prescribed: 14% prescribed rectal artesunate in the moderate-to-high setting were not referred. In addition, CHWs considered factors alongside mRDTs when referring. Child visits during the weekends or the rainy season were less likely to be referred, whereas visits to CHWs more distant from health centers were more likely to be referred (low transmission only). CHWs using mRDTs and ACTs increased referral compared with CHWs using a presumptive diagnosis. To address these concerns, referral training should be emphasized in CHW programs as they are scaled-up. PMID:27799650

  5. Deaf community analysis for health education priorities.

    PubMed

    Jones, Elaine G; Renger, Ralph; Firestone, Rob

    2005-01-01

    Deaf persons' access to health-related information is limited by barriers to spoken or written language: they cannot overhear information; they have limited access to television, radio, and other channels for public information; and the average reading level of Deaf adults is at a 3rd to 4th grade level. However, literature searches revealed no published reports of community analysis focusing specifically on health education priorities for Deaf communities. A seven-step community analysis was conducted to learn the health education priorities in Arizona Deaf communities and to inform development of culturally relevant health education interventions in Deaf communities. The word "Deaf" is capitalized to reflect the cultural perspective of the Deaf community. A 14-member Deaf Health Committee collected data using multimethods that included review of state census data, review of national health priorities, key informant interviews, discussions with key community groups, a mail survey (n = 20), and semistructured interviews conducted in sign language with 111 Deaf adults. The community diagnosis with highest priority for health education was vulnerability to cardiovascular disease (CVD). Following completion of the community analysis, a heart-health education intervention (The Deaf Heart Health Intervention) was developed using a train-the-trainer, community health worker model. If this model proves to be effective in addressing vulnerability to CVD, then a similar protocol could be employed to address other health concerns identified in the Deaf community analysis.

  6. 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

  7. 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…

  8. 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…

  9. Health Workforce Equity in Urban Community Health Service of China

    PubMed Central

    Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin

    2014-01-01

    Objectives To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. Methods A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. Results On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (P<0.001). Conclusions Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers. PMID:25551449

  10. The Community Leaders Institute: An Innovative Program to Train Community Leaders in Health Research

    PubMed Central

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

    2013-01-01

    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 results 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 paper 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. Based on 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 utilized 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. PMID:23348087

  11. Social History, Mental Health, and Community Control

    ERIC Educational Resources Information Center

    Hersch, Charles

    1972-01-01

    The professional mental health community, which had romanticized the concept of community control, is presently becoming disenchanted with it due to the lack of facility and skills for working with it. The task is to understand and evaluate community control and to alter only those aspects found destructive to community well-being. (DM)

  12. Community Conceptualizations of Health: Implications for Transdisciplinary Team Science

    PubMed Central

    Martinez, Linda Sprague; Rubin, Carolyn Leung; Russell, Beverley; Leslie, Laurel K.; Brugge, Doug

    2011-01-01

    Objective This exploratory study set out to identify how communities in the Tufts University Clinical Translational Science Institute (CTSI) catchment area define health-related research priority areas. Methods Three focus groups comprised of community stakeholders were conducted in three communities. Participants were representatives from community-based organizations and health centers. A systematic content analysis was performed that involved the identification, labeling and categorization of data followed by thematic analysis. Results Participant conceptualizations of health and health priorities were not formulated in the context of specific disease conditions, such as diabetes, obesity, cardiovascular disease or asthma. Instead, participants described contextual factors including social, environmental, economic and political conditions that influence health and health behavior. Conclusions Respondents in the Tufts University CTSI catchment area, like many diverse urban communities, described multiple interconnected social determinants of health and wellbeing. As such, they were interested in research that focuses on “upstream” areas of intervention as opposed to disease prevention at the individual level. In addition, respondents were interested in research that would catalyze community change. PMID:21707945

  13. 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.

  14. Rural Community as Context and Teacher for Health Professions Education

    PubMed Central

    Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana

    2016-01-01

    Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed “community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation. PMID:27980887

  15. Rural Community as Context and Teacher for Health Professions Education.

    PubMed

    Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana; Renouf, Tia

    2016-11-07

    Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed "community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.

  16. 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

  17. Facilitating Community Health Improvement Capacity Through Nongovernmental Public Health Partners.

    PubMed

    Carman, Angela L; McGladrey, Margaret L

    The purpose of this study was to evaluate the effectiveness of the Facilitating the Community Health Improvement Process training in increasing the capacity of nongovernmental public health partners to serve as facilitators and supporters of community health improvement coalitions. Ten members of WellCare Advocacy and Community-Based Program teams (CommUnity Advocates) serving communities across the country were identified to participate in the pilot training group. They completed pre- and posttraining surveys to evaluate knowledge of community health improvement process models and facilitation techniques, as well as qualitative interviews to assess use of training material 6 months after the training. Results of the project revealed successful use of content from the training, which enhanced the impact of nongovernmental public health partners as facilitators of community health improvement planning and implementation.

  18. Evaluating community-based public health leadership training.

    PubMed

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  19. Developing Health Education Programs in Rural Areas.

    ERIC Educational Resources Information Center

    Colle, Royal D.

    If primary medical care is to be provided to remote rural populations in developing countries, alternative and innovative delivery systems emphasizing community participation, use of paraprofessionals, and health education programs must be considered. A recent American Public Health Association study of 180 health projects in developing countries…

  20. Community health workers and primary health care in Honduras.

    PubMed

    Quillian, J P

    1993-01-01

    Community participation and utilization of community health workers (CHWs) are essential components of the primary health care model. The success of CHWs is dependent on their training and subsequent community support. Community-prepared nurses are ideal CHW educators. A training program for CHWs was implemented in Honduras emphasizing the principles of adult learning and problem-based learning. Following a 4-month program of training a primary health care clinic was opened and managed by CHWs for a population over 10,000. Approximately 80% of local health problems were managed by the CHWs proving that well-trained CHWs can have a significant impact on the delivery of health care.

  1. 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

  2. Considering place in community health nursing.

    PubMed

    Bender, Amy; Clune, Laurie; Guruge, Sepali

    2007-09-01

    When a geographic location is assigned meaning, it becomes a place. The authors argue that place matters as both geographical location and lived experience. They extend the current conceptualization of nursing geography to encompass community health nursing and address intricacies of community nursing practice and research that often go unnoticed. They do so by exploring the notion of place in home and community, including the structural/spatial dimensions of the nurse-client relationship. The authors review the health geography literatures, then discuss the implications for practice and research in community health. They invite community health nurses to critically examine their practice and research with reference to such issues as the power of the nurse, marginalized places as determinants of health, and how best to care for clients living in diverse community settings.

  3. Personas in online health communities.

    PubMed

    Huh, Jina; Kwon, Bum Chul; Kim, Sung-Hee; Lee, Sukwon; Choo, Jaegul; Kim, Jihoon; Choi, Min-Je; Yi, Ji Soo

    2016-10-01

    Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users' needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged-Caretakers, Opportunists, Scientists, and Adventurers. The results inform users' interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support.

  4. Promoting Community Health Resources: Preferred Communication Strategies

    USDA-ARS?s Scientific Manuscript database

    Background: Community health promotion efforts involve communicating resource information to priority populations. Which communication strategies are most effective is largely unknown for specific populations. Objective: A random-dialed telephone survey was conducted to assess health resource comm...

  5. Environmental and community health: a reciprocal relationship

    Treesearch

    Jeffery Sugarman

    2009-01-01

    One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

  6. Art and community health: lessons from an urban health center.

    PubMed

    Siegel, Wilma Bulkin; Bartley, Mary Anne

    2004-01-01

    Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

  7. The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan - study protocol for a randomized controlled trial.

    PubMed

    Zafar, Shamsa; Sikander, Siham; Hamdani, Syed Usman; Atif, Najia; Akhtar, Parveen; Nazir, Huma; Maselko, Joanna; Rahman, Atif

    2016-04-06

    Rates of perinatal depression in low and middle income countries are reported to be very high. Perinatal depression not only has profound impact on women's health, disability and functioning, it is associated with poor child health outcomes such as pre-term birth, under-nutrition and stunting, which ultimately have an adverse trans-generational impact. There is strong evidence in the medical literature that perinatal depression can be effectively managed with psychological treatments delivered by non-specialists. Our previous research in Pakistan led to the development of a successful perinatal depression intervention, the Thinking Healthy Program (THP). The THP is a psychological treatment delivered by community health workers. The burden of perinatal depression can be reduced through scale-up of this proven intervention; however, training of health workers at scale is a major barrier. To enhance access to such interventions there is a need to look at technological solutions to training and supervision. This is a non-inferiority, single-blinded randomized controlled trial. Eighty community health workers called Lady Health Workers (LHWs) working in a post-conflict rural area in Pakistan (Swat) will be recruited through the LHW program. LHWs will be randomly allocated to Technology-assisted Cascade Training and Supervision (TACTS) or to specialist-delivered training (40 in each group). The TACTS group will receive training in THP through LHW supervisors using a tablet-based training package, whereas the comparison group will receive training directly from mental health specialists. Our hypothesis is that both groups will achieve equal competence. Primary outcome measure will be competence of health workers at delivering THP using a modified ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale immediately post training and after 3 months of supervision. Independent assessors will be blinded to the LHW allocation status. Women living in post

  8. Access to health care and community social capital.

    PubMed

    Hendryx, Michael S; Ahern, Melissa M; Lovrich, Nicholas P; McCurdy, Arthur H

    2002-02-01

    To test the hypothesis that variation in reported access to health care is positively related to the level of social capital present in a community. The 1996 Household Survey of the Community Tracking Study, drawn from 22 metropolitan statistical areas across the United States (n = 19,672). Additional data for the 22 communities are from a 1996 multicity broadcast media marketing database, including key social capital indicators, the 1997 National Profile of Local Health Departments survey, and Interstudy, American Hospital Association, and American Medical Association sources. The design is cross-sectional. Self-reported access to care problems is the dependent variable. Independent variables include individual sociodemographic variables, community-level health sector variables, and social capital variables. Data are merged from the various sources and weighted to be population representative and are analyzed using hierarchical categorical modeling. Persons who live in metropolitan statistical areas featuring higher levels of social capital report fewer problems accessing health care. A higher HMO penetration rate in a metropolitan statistical area was also associated with fewer access problems. Other health sector variables were not related to health care access. The results observed for 22 major U.S. cities are consistent with the hypothesis that community social capital enables better access to care, perhaps through improving community accountability mechanisms.

  9. Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service.

    PubMed

    McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne

    2017-02-03

    Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.

  10. Community Environmental Health Assessment in Peru's Desert Hills and Rainforest

    PubMed Central

    Baffigo, Virginia; Albinagorta, Jorge; Nauca, Luis; Rojas, Percy; Alegre, Rossana; Hubbard, Brian; Sarisky, John

    2001-01-01

    Peru's expanding population and rapid urbanization—a result of migration to its largest cities—have stressed the country's public services infrastructure and the provision of public health and environmental health services. In response, the Ministry of Health established the General Directorate of Environmental Health (DIGESA), the branch charged with assuring adequate environmental health services to populations in rural and urban areas. The magnitude of the environmental health problems in peri-urban settlements, however, has exceeded the capacity of DIGESA to respond. The Urban Environmental Health Project is an effort to develop the ability of local communities to address these problems PMID:11574311

  11. Modeling the principles of community-based participatory research in a community health assessment conducted by a health foundation.

    PubMed

    Williams, Karen Jaynes; Gail Bray, Patricia; Shapiro-Mendoza, Carrie K; Reisz, Ilana; Peranteau, Jane

    2009-01-01

    The authors discuss strategies used and lessons learned by a health foundation during development of a community health assessment model incorporating community-based participatory research (CBPR) approaches. The assessment model comprises three models incorporating increasing amounts of CPBR principles. Model A combines local-area analysis of quantitative data, qualitative information (key informants, focus groups), and asset mapping. Model B, a community-based participatory model, emphasizes participatory rural appraisal approaches and quantitative assessment using rapid epidemiological assessment. Model C, a modified version of Model B, is financially more sustainable for our needs than Model B. The authors (a) describe origins of these models and illustrate practical applications and (b) explore the lessons learned in their transition from a traditional, nonparticipatory, quantitative approach to participatory approaches to community-health assessment. It is hoped that this article will contribute to the growing body of knowledge of practical aspects of incorporating CBPR approaches into community health assessments.

  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. 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…

  14. The Challenge of Ghetto Community Mental Health.

    ERIC Educational Resources Information Center

    Mullan, Hugh

    The purpose and approach of community mental health in the urban ghetto is discussed. Mental health service is viewed as an alien institution by the deprived citizen and institutions of the Kennedy era were naive the approaches from 1963 on were only new in ideals but not practice. Each center is meant to offer its community consultation and…

  15. Community mental health care: documenting the role of the nurse.

    PubMed

    Zeeman, Zenith; Chapman, Rose; Wynaden, Dianne; McGowan, Sunita; Lewis, Mark; Austin, John; Finn, Michael

    2002-04-01

    In Australia, the process of deinstitutionalisation has resulted in the closure or downsizing of many large stand-alone psychiatric hospitals. The aim of modern community mental health care is to provide treatment and rehabilitation for people, who have a mental illness, in their local community. This aim is supported by the Australian National Mental Health Strategy that outlines the importance of health professionals, carers, and consumers working together to obtain the best therapeutic outcomes. This study was undertaken to obtain information regarding the current role of the community mental health nurse (CMHN). All community mental health nurses working in the Adult Program at the Directorate of Mental Health Services, Fremantle Hospital and Health Service in Western Australia participated in the study. The study was completed in November 2000. The results showed that the CMHNs' role focused on six main areas. These areas included the day-to-day management of clients, working with carers and their families; crisis work for both existing andfirst time contacts; as well as liaison and advocacy work. Thefinding of this study demonstrate CMHN's work most often with acutely ill and psychotic patients and theirfamilies. Therefore, CMHN's play a pivotal role in promoting and sustaining the philosophy of community mental health care. In addition, the liaison work within the community completed by CMHN's is vital to address the mental health needs of the community and to reduce the stigma associated with mental illness. The documentedfindings of this study provide challengesfor thefurther expansion of the CMHN's role and the development of best practice initiatives in community mental health care.

  16. 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.…

  17. 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.…

  18. 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. © 2011 Mount Sinai School of Medicine.

  19. 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. © The Author(s) 2015.

  20. Clinical profile and outcomes in octogenarians with atrial fibrillation: A community-based study in a specific European health care area.

    PubMed

    Rodríguez-Mañero, Moisés; López-Pardo, Estrella; Cordero, Alberto; Kredieh, Omar; Pereira-Vazquez, María; Martínez-Sande, Jose-Luis; Martínez-Gomez, Alvaro; Peña-Gil, Carlos; Novo-Platas, José; García-Seara, Javier; Mazón, Pilar; Laje, Ricardo; Moscoso, Isabel; Varela-Román, Alfonso; García-Acuña, Jose María; González-Juanatey, José Ramón

    2017-09-15

    Age increases risk of stroke and bleeding. Clinical trial data have had relatively low proportions of elderly subjects. We sought to study a Spanish population of octogenarians with atrial fibrillation (AF) by combining different sources of electronic clinical records from an area where all medical centres utilized electronic health record systems. Data was derived from the Galician Healthcare Service information system. From 383,000 subjects, AF was coded in 7990 (2.08%), 3640 (45.6%) of whom were ≥80 and 4350 (54.4%)<80. All CHA2DS2-VASc's components were more prevalent in the elderly except for diabetes. Of those ≥80, 2178 (59.8%) were women. Mean CHA2DS2-VASc was 4.2±1.1. Distribution of CHA2DS2-VASc components varied between genders. 2600 (71.4%) were on oral anticoagulant (OA). During a median follow up of 696days (124.23), all-cause mortality was higher in ≥80 (1011/3640 (27.8%) vs 350/4350 (8.05%) (p<0.001). There were differences in rate of thromboembolic (TE) and haemorrhagic events (2.3% vs 0.9%, p<0.01 and 2.5% vs 1.7%, p=0.01 respectively). In octogenarian, differences between genders were observed with regard to TE, but not in haemorrhagic or all-cause mortality rates. Age, heart failure, non-valvular AF, dementia, and OA were independent predictors of all-cause mortality. In regard to TE, female gender, hypertension, previous TE and OA were independent predictive factors. Octogenarians with AF had very different characteristics and outcomes from their younger counterparts. These results also provide reassurance about the effectiveness of OA in preventing TE events and maintaining a reasonable haemorrhagic event rate in the extremely elderly. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 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.

  2. Health Information Technology Adoption in California Community Health Centers

    PubMed Central

    Kim, Katherine K.; Rudin, Robert S.; Wilson, Machelle D.

    2016-01-01

    Objectives National and state initiatives to spur adoption of electronic health record (EHR) use and health information exchange (HIE) among providers in rural and underserved communities have been in place for 15 years. Our goal was to systematically assess the impact of these initiatives by quantifying the level of adoption and key factors associated with adoption among community health centers (CHCs) in California. Study Design Cross-sectional statewide survey. Methods We conducted a telephone survey of all California primary care CHCs from August to September 2013. Multiple logistic regressions were fit to test for associations between various practice characteristics and adoption of EHRs, Meaningful Use (MU)–certified EHRs, and HIE. For the multivariable model, we included those variables which were significant at the P = .10 level in the univariate tests. Results We received responses from 194 CHCs (73.5% response rate). Adoption of any EHRs (80.3%) and MU–certified EHRs (94.6% of those with an EHR) was very high. Adoption of HIE is substantial (48.7%) and took place within a few years (mean = 2.61 years; SD = 2.01). More than half (54.7%) of CHCs are able to receive data into the EHR, indicating some level of interoperability. Patient engagement capacity is moderate, with 21.6% offering a personal health record, and 55.2% electronic visit summaries. Rural location and belonging to a multi-site clinic organization both increase the odds of adoption of EHRs, HIE, and electronic visit summary, with odds ratios ranging from 0.63 to 3.28 (all P values <.05). Conclusions Greater adoption of health information technology (IT) in rural areas may be the result of both federal and state investments. As CHCs lack access to capital for investments, continued support of technology infrastructure may be needed for them to further leverage health IT to improve healthcare. PMID:26760431

  3. Community participation in health and development.

    PubMed

    Sule, S S

    2004-01-01

    This paper critically appraises the importance of community participation in health and development and the methods of involving them. It also emphasizes the role of every stakeholder in health and development. These involved the review of some literature on this subject and examination of issues arising from the review. Community participation in health offers various advantages in health care and development among which are helping communities to develop problem solving skills, making them to take responsibility for their health and welfare, ensuring that the need and problems of the community are adequately addressed, ensuring that the strategies and methods used are culturally and socially appropriate or acceptable and finally it enhances sustainability. It is the responsibility of the government at various level, non-governmental organizations, international health agencies and health care programme planners and providers to help the community to organize themselves and be involved in their health care and development. Them should be well established or institutionalized framework of making sure that people are consulted, persuaded, and given responsibility in decision making under technical and professional guidance of health care professionals. Plans must not be imposed or policies formulated without involving the community in all matters concerning health and development.

  4. 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.

  5. Weaving Clinical Expertise in Online Health Communities.

    PubMed

    Huh, Jina; Pratt, Wanda

    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.

  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. Pediatricians' involvement in community child health from 1989 to 2004.

    PubMed

    Minkovitz, Cynthia S; O'Connor, Karen G; Grason, Holly; Chandra, Anita; Aligne, C Andrew; Kogan, Michael D; Tayloe, David

    2008-07-01

    To explore pediatricians' current involvement in community child health activities, to examine trends in community involvement from 1989 to 2004, and to compare perspectives and skills related to community involvement among those participating and not participating in community activities. Cross-sectional analysis of 3 American Academy of Pediatrics Periodic Surveys of Fellows. In the 1989, 1993, and 2004 surveys, 1024, 1627, and 1829 pediatricians participated, respectively (response rates: 70.3%, 65.2%, and 57.6%). Involvement, skills, and perspectives related to community child health activities. The percentage of pediatricians involved in community child health activities in the preceding year rose from 56.6% in 1989 to 59.4% in 1993 but declined to 45.1% in 2004. Pediatricians increasingly reported that these activities were volunteer rather than paid (48.6% in 1989, 57.8% in 1993, and 79.6% in 2004). More participants in community child health activities vs nonparticipants viewed their current level of involvement as "just right" (52.5% vs 24.9%), reported themselves to be very responsible for children's health (42.2% vs 24.9%), expected their community work to increase during the next 5 years (63.5% vs 54.1%), and reported higher skills in 6 areas (all P < .001). Although there has been decreased participation in community child health, most pediatricians expect their community efforts to increase. Because most community activities are volunteer, challenges to address include incorporating community involvement into employment and identifying strategies to facilitate voluntary civic engagement.

  8. Infant health in an outpost area.

    PubMed

    Goldthorpe, W G

    1975-05-01

    Infant mortality continues high in the isolated Indian communities of Sioux Lookout Zone, northwestern Ontario, in spite of a well financed and organized comprehensive health service provided through cooperation of Health and Welfare Canada and the University of Toronto. A high proportion of infant deaths occur in their own communities, before trained help can be reached. Changes in lifestyle and economy hold more hope for improvement than does any further improvement of health care. The services and finances needed are roughly triple what could be provided by private practitioners on a fee for service income.

  9. 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.

  10. Health Educators and Community Health Workers

    MedlinePlus

    ... contact your state’s board of health, nursing, or human services. Important Qualities Analytical skills. Health educators collect ... patterns and causes of disease and injury in humans. They seek to reduce the risk and occurrence ...

  11. Aggregate/community-centered undergraduate community health nursing clinical experience.

    PubMed

    Flick, L H; Reese, C; Harris, A

    1996-02-01

    Debate continues about the appropriateness of clinical experiences targeting aggregates in undergraduate community health nursing education. This paper describes a practical model to teach, through experience, the concepts of aggregate/community-centered practice at the baccalaureate level. As a voluntary alternative to the usual community assessment paper, groups of students worked in partnership with community groups to define health needs and to address one need. Sequential student groups focused the assessment and implemented a plan. The required time for each project varied. One project is described to illustrate the model. While independent community-centered practice is not expected of the B.S.N. graduate, the model described here develops comprehension of the concepts and process of such practice.

  12. 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…

  13. [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.

  14. Promoting community health resources: preferred communication strategies.

    PubMed

    Colby, Sarah E; Johnson, Amy L; Eickhoff, Amanda; Johnson, Luann

    2011-03-01

    Community health promotion efforts involve communicating resource information to priority populations. Which communication strategies are most effective is largely unknown for specific populations. A random dialed representative phone survey was conducted assessing current health resource community awareness, health resource utilization, and communication strategy preferences. The survey revealed that community members preferred to receive information on health resources from the Internet (28.3%), newspaper (26.4%), or mail (22.3%). Different priority populations had varying health communication strategy preferences (e.g., young adults prefer Internet, older adults prefer newspaper, and obese adults prefer mail). Ideally, if health resources are intended for adult audiences, a campaign that would include communication through newspaper (targeting older adults), mailing (targeting obese adults), and Web sites (targeting younger adults) would be the most effective approach. This research suggests that an assessment of communication strategy preferences of the priority population might be a crucial first step when developing health promotion programs.

  15. Using community health workers for malaria control: experience in Zaire.

    PubMed Central

    Delacollette, C.; Van der Stuyft, P.; Molima, K.

    1996-01-01

    The potential for using community health workers (CHW) for administering timely and effective treatment for presumptive malaria attacks was evaluated in the Katana health zone in Zaire. In each of the 12 villages of an intervention area (area A) with 13000 inhabitants, a CHW was trained in the use of a simple fever management algorithm. The CHWs performed their services under the supervision of the nurse in charge of the area's health centre (HC). Malaria morbidity and mortality trends were monitored during 2 years in area A and in an ecologically comparable control area (area B), where malaria treatment continued to be available at the HC only. Health care behaviour changed dramatically in the intervention area, and by the end of the observation period 65% of malaria episodes were treated at the community level. Malaria morbidity declined 50% in area A but remained stable in the control area. Parasitological indices showed similar trends. Malaria-specific mortality rates remained, however, at essentially the same levels in both areas. The non-comprehensiveness of the CHWs' care and their ambiguous position in the health care system created problems that compromise the sustainability of the intervention. PMID:8823965

  16. 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

  17. 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.

  18. Community health centers and community development financial institutions: joining forces to address determinants of health.

    PubMed

    Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N

    2011-11-01

    Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

  19. Rural community leaders' perceptions of environmental health risks: improving community health.

    PubMed

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

    2006-03-01

    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.

  20. Community socioeconomic status and children's dental health.

    PubMed

    Gillcrist, J A; Brumley, D E; Blackford, J U

    2001-02-01

    Although a substantial decline in dental caries has occurred among U.S. children, not everyone has benefited equally. The first-ever surgeon general's report on oral health in America indicates that the burden of oral diseases is found in poor Americans. This study investigates the relationship between community socioeconomic status, or SES, and dental health of children. An oral health survey of 17,256 children, representing 93 percent of children residing in 62 Tennessee communities, was conducted in public elementary schools during the 1996-1997 school year. Portable dental equipment was used for examinations, and data from each examination were entered directly into a laptop computer. The authors performed analyses of covariance to examine the relationship between community SES (low/medium/high) and dental health, controlling for community fluoridation. Community SES was significantly related to caries experience in the primary teeth, the proportion of untreated caries in the primary and permanent teeth, dental treatment needs, dental sealants and incisor trauma. Overall, dental health was significantly worse for low-SES communities than for medium- and high-SES communities. The authors conclude that all specific dental indexes used to measure children's dental health in this study, with the exceptions of caries experience in the permanent teeth and sealant presence, were inversely related to the communities' SES. The percentage of children with dental sealants was directly related to the community's SES. Further improvements in oral health will necessitate that community-based preventive programs and access to quality dental care be made available to children who are identified as being at highest risk of experiencing oral disease.

  1. 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)

  2. 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)

  3. Canadian community pharmacists' use of digital health technologies in practice.

    PubMed

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

    2016-01-01

    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. 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. 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. 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. 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.

  4. 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.

  5. Listening to Community Health Workers: How Ethnographic Research Can Inform Positive Relationships Among Community Health Workers, Health Institutions, and Communities

    PubMed Central

    Closser, Svea; Kalofonos, Ippolytos

    2014-01-01

    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. PMID:24625167

  6. Building community participatory research coalitions from the ground up: the Philadelphia area research community coalition.

    PubMed

    Johnson, Jerry C; Hayden, U Tara; Thomas, Nicole; Groce-Martin, Jennine; Henry, Thomas; Guerra, Terry; Walker, Alia; West, William; Barnett, Marina; Kumanyika, Shiriki

    2009-01-01

    A coalition of formal, large organizations and informal, grassroots organizations, recruited through an open process, contrasts with the usual practice of developing a community-based participatory research (CBPR) coalition with a small number of well-developed organizations. This paper describes the process, developmental challenges, and accomplishments of the Philadelphia Area Research Community Coalition (PARCC). The University of Pennsylvania-Cheyney University of Pennsylvania EXPORT Center established the PARCC, an academic-community research partnership of twenty-two diverse organizations of variable size and with variable experience in health research. The EXPORT Center provided the infrastructure and staff support needed to engage in sustained, face-to-face community outreach and to nurture, coordinate, and facilitate the 2.5-year developmental process. The start-up process, governing principles, activities, challenges, and lessons learned are described. Since its inception, PARCC established core work groups, a governance structure, operating principles, research training activities, community health education projects, and several PARCC-affiliated research projects. Organizations across the spectrum of developmental capacity were major contributors to PARCC. The success of PARCC was based on committed and trusted leadership, preexisting relationships, trust among members from the community and academia, research training, extensive time commitment of members to the coalition's work, and rapid development of work group activities. Building a CBPR coalition from the ground up involving organizations of diverse size and at various stages of development presents unique challenges that can be overcome with committed leadership, clear governance principles, and appropriate infrastructure. Engagement in community-based research during the early stages, while still developing trust, structure, and governance procedures can be accomplished as long as training of

  7. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests: findings from randomized trials in two contrasting areas of high and low malaria transmission in south-western Uganda.

    PubMed

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Hansen, Kristian; Clarke, Siân E

    2016-09-01

    To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children <5 years of age receiving appropriately targeted treatment with artemisinin-based combination therapy (ACT), vs. presumptive treatment. Cluster-randomized trials were conducted in two contrasting areas of moderate-to-high and low malaria transmission in rural Uganda. Each trial examined the effectiveness of mRDTs in the management of malaria and targeting of ACTs by CHWs comparing two diagnostic approaches: (i) presumptive clinical diagnosis of malaria [control arm] and (ii) confirmatory diagnosis with mRDTs followed by ACT treatment for positive patients [intervention arm], with village as the unit of randomisation. Treatment decisions by CHWs were validated by microscopy on a reference blood slide collected at the time of consultation, to compare the proportion of children <5 years receiving appropriately targeted ACT treatment, defined as patients with microscopically-confirmed presence of parasites in a peripheral blood smear receiving artemether-lumefantrine or rectal artesunate, and patients with no malaria parasites not given ACT. In the moderate-to-high transmission area, ACT treatment was appropriately targeted in 79.3% (520/656) of children seen by CHWs using mRDTs to diagnose malaria, vs. 30.8% (215/699) of children seen by CHWs using presumptive diagnosis (P < 0.001). In the low transmission area, 90.1% (363/403) children seen by CHWs using mRDTs received appropriately targeted ACT treatment vs. 7.8% (64/817) seen by CHWs using presumptive diagnosis (P < 0.001). Low mRDT sensitivity in children with low-density parasitaemia (<200 parasites/μl) was identified as a potential concern. When equipped with mRDTs, ACT treatments delivered by CHWs are more accurately targeted to children with malaria parasites. mRDT use could play an important role in reducing overdiagnosis of malaria and improving fever case management within

  8. 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

    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's 1 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

  9. 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

  10. Computer Simulation of Community Mental Health Centers.

    ERIC Educational Resources Information Center

    Cox, Gary B.; And Others

    1985-01-01

    Describes an ongoing research project designed to develop a computer model capable of simulating the service delivery activities of community mental health care centers and human service agencies. The goal and methodology of the project are described. (NB)

  11. Asthma - Improving Health in Communities and Schools

    EPA Pesticide Factsheets

    To improve asthma health, it takes a variety of people working together to reduce triggers and provide safe and healthy environments for people with asthma. This includes parents and caregivers, community organizations, healthcare providers and schools.

  12. Promotion of oral health by community nurses.

    PubMed

    Garry, Brendan; Boran, Sue

    2017-10-02

    To explore the enablers and barriers perceived by community nurses in the promotion of oral health in an adult community trust directorate. Oral health care promotion in community care settings is being neglected. England and Wales have witnessed marked improvements in periodontal disease; however, no improvements have been seen in older people. A qualitative methodology was employed, where eight nurses from Band 5 to 7 were interviewed using a semi-structured approach. The data was analysed thematically. Data analysis was organised into four themes: professional self-concept and the development of knowledge, skills and attitudes necessary in the promotion of oral health; the impact an organisation has on the promotion of oral health and an exploration of the enablers and barriers identified by the community nurses while delivering care; the relationships between the nurse and patient and the potential impact on oral health promotion; the concept of self-regard in relation to the promotion of oral health and its overall impact. A commitment to improving oral health and requests for additional educational input were apparent. Organisational enablers and barriers were identified, alongside the crucial role a positive self-regard for oral health care may play in the promotion of oral health. Nurses need relevant education, organisational support, adequate resources and support from a multidisciplinary team to deliver optimal oral health promotion.

  13. 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…

  14. 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…

  15. 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…

  16. Issues faced by community health centers.

    PubMed

    Grover, Jane

    2009-05-01

    Federally qualified health centers face numerous issues with regard to marketplace competition, staffing, and reimbursement streams that assure financial viability. Positioning the dental department of a health center to a high community profile strengthens the health center in professional educational development leading to a pipeline of workforce members, effective dental directors, and innovative fund-raising. A new dental team member developed by the American Dental Association can be utilized in health centers to make all traditional auxiliaries more productive.

  17. [Quality control in the management of complaints from clients of Specialized Health Care Area 10 in the Madrid community (2000-2005)].

    PubMed

    Alonso, Raquel; Llanes, Luis

    2009-04-01

    To analyse the complaints made by users of the National Health System in the University Hospital of Getafe (Madrid, Spain), to characterise trends in complaint rates over time and to appraise the quality control in the management of complaints. All complaints made between January 2000 and December 2005 were recorded and the incidence rate and annual percent change were calculated. The relationships between complaints and time were analysed. Finally, the percentage of complaints correctly dealt with in less than 30 days was calculated. The number of complaints increased from 132.93 to 482.28 per 100,000 inhabitants. The annual percent increase was +15.21. There was a relationship between several types of complaints and time (disagreement with health care, the organisation, with loss of documents, with clinical information, with delays in surgical and non-surgical treatment and cancellations. In 2004, only 24.8% of complaints were answered in time, but increased to 44% in 2005. There was an increase in the incidence of the complaints in the University Hospital of Getafe (Madrid) during the period studied. The users give greater importance to the technical and human aspects of health care compared to organisational and planning aspects. The quality control in the management of the complaints is poor.

  18. A health education program for underserved community youth led by health professions students.

    PubMed

    Begley, Kimberley; Haddad, Ann Ryan; Christensen, Carla; Lust, Elaine

    2009-10-01

    To develop and implement a health fair and educational sessions for elementary school children led by health professions students. The structure and process were developed with elementary school administration to determine the health topics to be covered. Students and faculty members created a "hands-on," youth-oriented health fair and interactive health educational sessions. Quantitative and qualitative data were collected on learning outcomes from the underserved child population and health professions students. The health fair and educational sessions increased awareness of underserved youth in the areas of critical health behaviors, purposeful education on health issues facing their community, and exposure to careers in various health professions. The activities provided meaningful learning experiences for the health professions students. The health education program model is an excellent way to teach health education, communication and critical thinking skills, and service learning to health professions students.

  19. The role of the community health nurse in environmental health.

    PubMed

    Neufer, L

    1994-06-01

    Chemical contamination in the environment is affecting public health in increasing numbers of communities across the country. Although historically and theoretically well within the realm of nursing, methods for assessing and diagnosing threats to community environmental health are not being included in community health nurses' training. A community's environmental health is assessed by retrieving information from federal, state, and local sources. Developing the diagnosis involves four steps: identifying a community aggregate at highest risk of exposure, determining the potential or actual health response, citing related host and environmental factors, and correlating any existing epidemiologic data that may substantiate the nursing diagnosis. To illustrate these concepts, a systematic environmental health assessment was conducted for Douglas, Arizona. The results indicated elevated lead levels in residential soils and led to the community diagnosis, potential for injury: children in Douglas are at risk of developing adverse neurobehavioral health effects, and pregnant women in Douglas are at risk of developing adverse reproductive health effects related to several environmental and host factors, as evidenced by average blood lead level, in children exceeding the Centers for Disease Control recommended level of 10 micrograms/dl.

  20. An experiment with community health funds in Afghanistan.

    PubMed

    Rao, Krishna D; Waters, Hugh; Steinhardt, Laura; Alam, Sahibullah; Hansen, Peter; Naeem, Ahmad Jan

    2009-07-01

    As Afghanistan rebuilds its health system, it faces key challenges in financing health services. To reduce dependence on donor funds, it is important to develop sustainable local financing mechanisms. A second challenge is to reduce high levels of out-of-pocket payments. Community-based health insurance (CBHI) schemes offer the possibility of raising revenues from communities and at the same time providing financial protection. This paper describes the performance of one type of CBHI scheme, the Community Health Fund (CHF), which was piloted for the first time in five provinces of Afghanistan between June 2005 and October 2006. The performance of the CHF programme demonstrates that complex community-based health financing schemes can be implemented in post-conflict settings like Afghanistan, except in areas of high insecurity. The funds raised from the community, via premiums and user fees, enabled the pilot facilities to overcome temporary shortages of drugs and supplies, and to conduct outreach services via mobile clinics. However, enrolment and cost-recovery were modest. The median enrolment rate for premium-paying households was 6% of eligible households in the catchment areas of the clinics. Cost recovery rates ranged up to 16% of total operating costs and 32% of non-salary operating costs. No evidence of reduced out-of-pocket health expenditures was observed at the community level, though CHF members had markedly higher utilization of health services. The main reasons among non-members for not enrolling were being unaware of the programme; high premiums; and perceived low quality of services at the CHF clinics. The performance of Afghanistan's CHF was similar to other CHF-type programmes operating at the primary care level internationally. The solution to building local capacity to finance health services lies in a combination of financing sources rather than any single mechanism. In this context, it is critical that international assistance for Afghanistan

  1. [Community Health Agent: status adapted with Family Health Program reality?].

    PubMed

    dos Santos, Karina Tonini; Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba; Arcieri, Renato Moreira; Carvalho, Maria de Lourdes

    2011-01-01

    This study analyses the status and work reality of Community Health Agents, with the purpose of contributing to the improvement of the Brazilian Health System (SUS) in small cities. It was discussed aspects related to their participation in the team of the Family Health Program (PSF) and their interaction with the community. It was observed a lack of motivation and experience, which compromises the quality of Agents performance in the community. It is known that these findings are reflex and consequence of an established context. It is necessary the team rethink their practice, specially the managers, having always as a fundament the principles that guide the SUS and PSF.

  2. Community Organizing Network for Environmental Health: Using a Community Health Development Approach to Increase Community Capacity around Reduction of Environmental Triggers

    PubMed Central

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

    2010-01-01

    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. PMID:20306137

  3. 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.

  4. New York Community Health Centers' Population Health Activities: Findings from a Statewide Assessment.

    PubMed

    Haley, Sean J; Barnes, Jeff

    2017-01-01

    The U.S. spends just 5% of its health care budget to prevent morbidity and mortality. This study surveyed N.Y. State community health centers' (CHCs) population health activities aligned with the N.Y. Prevention Agenda (response rate of 72%). More than half of CHCs considered population health a high priority. Chronic disease and reducing preventable infections were the leading activity areas. One third of activities were dedicated to patient treatment follow-up. Community health centers reported that more than two-thirds of all activities received no funding. Despite a commitment to population health among CHCs, widespread improvements in population health may remain limited without an increase in dedicated funding to support community-based prevention strategies.

  5. Community health workers: social justice and policy advocates for community health and well-being.

    PubMed

    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.

  6. Report of a Resident Health-Medical Care Survey. Southwest New Mexico Community Health Education Systems.

    ERIC Educational Resources Information Center

    Poulsen, Roger L.

    This survey was conducted to provide informational inputs for planning and establishing a community health education system in southwest New Mexico. Information was gathered concerning the opinions of typical area residents regarding needed health-medical care facilities, personnel training needs, services, personnel requisite to their well-being,…

  7. Partnership of the community in support of health for all.

    PubMed

    Abdullatif, A

    2000-07-01

    Health for all is a people-based approach to health which considers the community as its focus. Community partnership is an important principle of health for all. This paper describes the many aspects of community partnership and gives examples of community partnerships initiatives in the World Health Organization Eastern Mediterranean Region, such as the basic development needs approach. The main agenda of community partnership for health for all is discussed and some opportunities conducive to community partnership in the Region are outlined.

  8. Community-Driven Research Agenda to Reduce Health Disparities.

    PubMed

    McElfish, Pearl A; Kohler, Peter; Smith, Chris; Warmack, Scott; Buron, Bill; Hudson, Jonell; Bridges, Melissa; Purvis, Rachel; Rubon-Chutaro, Jellesen

    2015-12-01

    This paper describes how a new regional campus of an academic health center engaged in a community-based participatory research (CBPR) process to set a community-driven research agenda to address health disparities. The campus is situated among growing Marshallese and Hispanic populations that face significant health disparities. In 2013, with support from the Translational Research Institute, the University of Arkansas for Medical Sciences Northwest began building its research capacity in the region with the goal of developing a community-driven research agenda for the campus. While many researchers engage in some form of community-engaged research, using a CBPR process to set the research agenda for an entire campus is unique. Utilizing multiple levels of engagement, three research areas were chosen by the community: (1) chronic disease management and prevention; (2) obesity and physical activity; and (3) access to culturally appropriate healthcare. In only 18 months, the CBPR collaboration had dramatic results. Ten grants and five scholarly articles were collaboratively written and 25 community publications and presentations were disseminated. Nine research projects and health programs were initiated. In addition, many interprofessional educational and service learning objectives were aligned with the community-driven agenda resulting in practical action to address the needs identified. © 2015 Wiley Periodicals, Inc.

  9. 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…

  10. Group Psychotherapy and Group Methods in Community Mental Health Programs.

    ERIC Educational Resources Information Center

    Pattison, E. Mansell

    An ad hoc committee of the American Group Psychotherapy Association (AGPA) was charged to investigate the use of group methods in Community mental health centers (CMHC), to assess the conceptual basis for the use of various group methods, to relate the use of group methods to group psychotherapy, and to evaluate trends in this area of mental…

  11. 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…

  12. 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,…

  13. Childhood Sexual Abuse: Impact on a Community's Mental Health Status.

    ERIC Educational Resources Information Center

    Scott, Kathryn D.

    1992-01-01

    This study examined the impact of childhood sexual abuse (CSA) on the mental health status of the Los Angeles Epidemiologic Catchment Area. A history of CSA was found to significantly increase an individual's odds of developing eight psychiatric disorders in adulthood. CSA's effect on the community level was also found to be substantial.…

  14. 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,…

  15. Community Arts for Health: An Evaluation of a District Programme

    ERIC Educational Resources Information Center

    South, Jane

    2006-01-01

    Purpose: The purpose of this paper is to present an evaluation of a community arts for health programme in the UK involving the delivery of three separate projects targeted at disadvantaged areas. Design/methodology/approach: Evaluation plans were drawn up for each project, which linked long-term goals, objectives, indicators of success and data…

  16. How do health workers see community participation?

    PubMed

    Freyens, P; Mbakuliyemo, N; Martin, M

    1993-01-01

    A survey of health workers in Rwanda suggested that they were somewhat reluctant to accept the involvement of lay people in the promotion and implementation of primary care programmes. Various obstacles to community participation were identified by the health workers, who, however, suggested general rather than specific remedies for the situation as they saw it.

  17. California Community Colleges Health Services Survey.

    ERIC Educational Resources Information Center

    McIntyre, Chuck

    In 1990, a telephone survey was conducted of health services offered by California's community colleges. Statewide, 42 of the 71 districts in California levied a health service fee, 18 districts offered services without charge, and 11 offered no service. Districts operating programs collected an average of $15.81 in student fees per credit average…

  18. Second Thoughts on Community Mental Health

    ERIC Educational Resources Information Center

    Buxbaum, Carl B.

    1973-01-01

    This critical review of the 1961 report of the Joint Commission on Mental Illness and Health concludes that the report and its adherents promised more than could be delivered and its claims regarding community mental health could not be supported by the available data. (Author)

  19. Rural Oregon community perspectives: introducing community-based participatory research into a community health coalition.

    PubMed

    Young-Lorion, Julia; Davis, Melinda M; Kirks, Nancy; Hsu, Anna; Slater, Jana Kay; Rollins, Nancy; Aromaa, Susan; McGinnis, Paul

    2013-01-01

    The Community Health Improvement Partnership (CHIP) model has supported community health development in more than 100 communities nationally. In 2011, four rural Oregon CHIPs collaborated with investigators from the Oregon Rural Practice-based Research Network (ORPRN), a component of the Oregon Clinical and Translational Research Institute (OCTRI), to obtain training on research methods, develop and implement pilot research studies on childhood obesity, and explore matches with academic partners. This article summarizes the experiences of the Lincoln County CHIP, established in 2003, as it transitioned from CHIP to Community Health Improvement and Research Partnership (CHIRP). Our story and lessons learned may inform rural community-based health coalitions and academicians who are engaged in or considering Community-based participatory research (CBPR) partnerships. Utilizing existing infrastructure and relationships in community and academic settings provides an ideal starting point for rural, bidirectional research partnerships.

  20. 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.

  1. 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.

  2. Community Health Workers Support Community-based Participatory Research Ethics:

    PubMed Central

    Smith, Selina A.; Blumenthal, Daniel S.

    2013-01-01

    Ethical principles of community-based participatory research (CBPR)— specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability—stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR. PMID:23124502

  3. Understanding Determinants of Cardiovascular Health in a Mexican American Community.

    PubMed

    Larimer, Karen A; Gulanick, Meg; Penckofer, Sue

    2017-07-01

    Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed. Fifteen community leaders were interviewed using guided interviews. Database searches and direct observations were conducted. Using these methods provided comprehensive assessment of social and physical determinants of health, and access issues that were unique to the community studied. Findings demonstrated greater awareness of diabetes than CVD as a health problem, with little knowledge of CVD risk factors. Lack of access to health services (lack of insurance, lack of a medical home) and presence of cultural and socioeconomic barriers such as language, unemployment, low income, and lack of insurance were identified. The physical determinants such as environment presented fewer barriers, with adequate access to fruits and vegetables, transportation, and parks. Results revealed target areas for intervention.

  4. Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

    PubMed

    Al-Delaimy, W K; Webb, M

    2017-06-01

    The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

  5. Bellevue Community College Service Area Census 2000 Data Book.

    ERIC Educational Resources Information Center

    Nixon, Cora

    The Bellevue Community College (BCC) Service Area 2000 Data Book includes the following demographic information on the BCC Service Area: total population; race and ethnicity descriptive statistics; Hispanic and Latino population demographics; age and gender distributions; household data; and the service area zip codes, areas, and school districts.…

  6. Beacon communities' public health initiatives: a case study analysis.

    PubMed

    Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

    2014-01-01

    The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach

  7. 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.

  8. Community Health Asset Mapping Partnership Engages Hispanic/Latino Health Seekers and Providers.

    PubMed

    Cutts, Teresa; Langdon, Sarah; Meza, Francis Rivers; Hochwalt, Bridget; Pichardo-Geisinger, Rita; Sowell, Brandon; Chapman, Jessica; Dorton, Linda Batiz; Kennett, Beth; Jones, Maria Teresa

    2016-01-01

    The Hispanic/Latino population in Forsyth County, North Carolina, is growing quickly and experiencing significant disparities in access to care and health outcomes. Assessing community perceptions and utilization of health care resources in order to improve health equity among Hispanics/Latinos at both the county and state levels is critical. Our community engagement process was guided by the Community Health Assets Mapping Partnerships (CHAMP) approach, which helps identify gaps in health care availability and areas for immediate action to improve access to and quality of health care. Specifically, we invited and encouraged the Hispanic/Latino population to participate in 4 different workshops conducted in Spanish or English. Participants were identified as either health care providers, defined as anyone who provides health care or a related service, or health care seekers, defined as anyone who utilizes such services. The most commonly cited challenges to access to care were cost of health care, documentation status, lack of public transportation, racism, lack of care, lack of respect, and education/language. These data were utilized to drive continued engagement with the Hispanic community, and action steps were outlined. While participation in the workshops was acceptable, greater representation of health care seekers and community providers is needed. This process is fundamental to multilevel initiatives under way to develop trust and improve relationships between the Hispanic/Latino community and local health care entities in Forsyth County. Follow-through on recommended action steps will continue to further identify disparities, close gaps in care, and potentially impact local and state policies with regard to improving the health status of the Hispanic/Latino community. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  9. Ethnographic Approach to Community Organization and Health Empowerment.

    ERIC Educational Resources Information Center

    Braithwaite, Ronald L.; And Others

    1994-01-01

    A case study of the use of ethnographic approaches in community organization and development demonstrates their utility in achieving health empowerment among communities of color. The importance of citizen participation in community-based health initiatives is stressed. (SK)

  10. GUIDELINES FOR THE DEVELOPMENT OF MERGED AREA VOCATIONAL SCHOOLS AND AREA COMMUNITY COLLEGES BY THE MERGED AREA BOARDS.

    ERIC Educational Resources Information Center

    Iowa State Dept. of Public Instruction, Des Moines.

    THE STAFF OF THE STATE DEPARTMENT OF PUBLIC INSTRUCTION, ADVISORY COMMITTEES, ADMINISTRATORS OF JUNIOR AND COMMUNITY COLLEGES, AND DIRECTORS AND ADMINISTRATORS OF AREA VOCATIONAL SCHOOLS WERE INVOLVED IN CREATING THESE GUIDELINES DESIGNED TO HELP NEW BOARDS OF DIRECTORS OF AREA VOCATIONAL SCHOOLS AND AREA COMMUNITY COLLEGES. CONTENTS INCLUDE (1)…

  11. 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.

  12. 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.

  13. Transboundary effects on health care services in the European Community.

    PubMed

    du Pré, F M

    1993-01-01

    This article deals with the rights that community law gives to the medical and allied professions to exercise their professional activities in a member state other than their state of origin. Firstly, the scope of the general economic provisions of the European Community (EC) Treaty is broadly described. Secondly, the specific rules of the EC secondary legislation concerning the harmonization of the national legislations on professional qualifications in the health care sector are reviewed. Lastly, an example is given of the application of these rules in the health care sector by the Court of Justice of the European Community. It is submitted that the exercise of these rights can contribute to transboundary cooperation within the EC in the rendering of health care services to patients in the member states. This is specially relevant in frontier areas.

  14. Communities of solution: partnerships for population health.

    PubMed

    Griswold, Kim S; Lesko, Sarah E; Westfall, John M

    2013-01-01

    Communities of solution (COSs) are the key principle for improving population health. The 1967 Folsom Report explains that the COS concept arose from the recognition that complex political and administrative structures often hinder problem solving by creating barriers to communication and compromise. A 2012 reexamination of the Folsom Report resurrects the idea of the COS and presents 13 grand challenges that define the critical links among community, public health, and primary care and call for ongoing demonstrations of COSs grounded in patient-centered care. In this issue, examples of COSs from around the country demonstrate core principles and propose visions of the future. Essential themes of each COS are the crossing of "jurisdictional boundaries," community-led or -oriented initiatives, measurement of outcomes, and creating durable connections with public health.

  15. A community health report card: comprehensive assessment for tracking community health (CATCH).

    PubMed

    Studnicki, J; Steverson, B; Myers, B; Hevner, A R; Berndt, D J

    1997-01-01

    A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

  16. 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

  17. Community vulnerability to health impacts of wildland fire ...

    EPA Pesticide Factsheets

    Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on factors known to increase the risks of health effects from air pollution and wildfire smoke exposures. These factors included county prevalence rates for asthma in children and adults, chronic obstructive pulmonary disease, hypertension, diabetes, obesity, percent of population 65 years of age and older, and indicators of socioeconomic status including poverty, education, income and unemployment. Using air quality simulated for the period between 2008 and 2012 over the continental U.S. we also characterized the population size at risk with respect to the level and duration of exposure to fire-originated fine particulate matter (fire-PM2.5) and CHVI. We estimate that 10% of the population (30.5 million) lived in the areas where the contribution of fire-PM2.5 to annual average ambient PM2.5 was high (>1.5 µg m3) and that 10.3 million individuals experienced unhealthy air quality levels for more than 10 days due to smoke. Using CHVI we identified the most vulnerable counties and determined that these communities experience more smoke exposures in comparison to less vulnerable communities. We describe the development of an index of community vulnerability for the health effects of smoke based o

  18. 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

  19. 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.

  20. Public Health and Hospitals: a Common Area for Clinical and Public Health Medicine.

    PubMed

    Muzzi, A; Panà, A

    2017-01-01

    Contrary to what has happened so far, hospitals should become a setting which jointly exercise Clinical and Public Health Medicine. The areas of activity that require the presence of multidisciplinary teams and can bring benefits both to the patients and to the community is briefly described.

  1. Personal health practices of urban adults in Alabama: Davis Avenue Community Study.

    PubMed Central

    Morris, J; Windsor, R A

    1985-01-01

    The need to establish baseline data on and monitor the personal health practices and beliefs of adults in a community served by health care facilities is well documented. The purpose of the survey was to determine health care practices, personal health behaviors, and health services use of the adults living in the Davis Avenue Community (DAC), a six-census tract area located in Mobile, AL. The DAC's population is approximately 95 percent black. Using methods developed by the National Center for Health Statistics, 402 adults between the ages of 20 and 69 years were interviewed by telephone by trained personnel to ascertain the health-related characteristics of residents in this health services area. Information collected in this survey provided the staff of the Franklin Memorial Primary Health Center, who provide primary health care in the area, with an empirical base on which to plan and market health promotion and education programs for the health services area. PMID:3931168

  2. 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

  3. Community factors supporting child mental Health.

    PubMed

    Earls, F

    2001-10-01

    A principal purpose of this article has been to examine the gap between research and practice in relation to community factors in child mental health. Two caveats were introduced in preparation for this assessment. First, it was pointed out that the definition of communities has been expanded by considering the organizing properties of social aggregates that are not simply a function of the race, ethnicity, or social class of individuals who compose them. Having these definitions grounded in theory substantially advances the needs of research and the design and goals of community-level interventions. The second caveat relates to the boundaries of the disciplines that cater to the needs of children. During the same era when child psychiatry is largely occupied with placing psychotropic medications at the center of clinical approaches, there is an important effort in child psychology and sociology to cut across their disciplinary confines to form more comprehensive designs that are sensitive to experiences and circumstances that emerge from specific aspects of community context. Research from the PHDCN was used as an example of this new interdisciplinary approach. Several community-based research projects were selected for review based on their clear implications to improve context-sensitive assessment of child mental health and design effective community-based interventions to improve child mental health. The Healthy Start and CATCH programs indicate that involving child professionals at the grassroots of community life requires skill and patience but that the effort is satisfying and potentially effective. Other examples, exemplified by North Carolina's Smart Start initiative and the program of developmental assets from the Search Institute, demonstrate coherent approaches that provide a foundation for long-term capacity building in assessment, local decision making, and the design and evaluation of interventions. Three conclusions are warranted from this

  4. Community support as a moderator of postdisaster mental health symptoms in urban and nonurban communities.

    PubMed

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

    2013-10-01

    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. 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.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. 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.

  5. 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

  6. 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…

  7. Use of the community assessment for public health emergency response to conduct community health assessments for public health accreditation.

    PubMed

    Conley, Ashley M; Vagi, Sara; Horney, Jennifer A

    2014-01-01

    A community health assessment (CHA) is a collaborative process of collecting and analyzing data to learn about the health status of a community. Community health assessments are also a requirement of public health accreditation for state and local health departments and of the Affordable Care Act for nonprofit hospitals. One element of a CHA is primary data collection. This article describes the use of the Community Assessment for Public Health Emergency Response (CASPER) method for primary data collection to meet public health accreditation requirements in 2 case study communities--Nashua, New Hampshire, and Davidson County, North Carolina; CASPER is a flexible and efficient method for the collection of population-based primary data in an urban or rural setting.

  8. Oral health promotion in the community pharmacy: an evaluation of a pilot oral health promotion intervention.

    PubMed

    Sturrock, A; Cussons, H; Jones, C; Woodcock, C; Bird, L

    2017-09-15

    Introduction Poor oral health is a significant public health concern, costing the NHS in England £3.4 billion annually. Community pharmacies are easily accessible, frequently visited by patients and the community pharmacy contractual framework requires pharmacies to provide healthy living advice to patients - therefore offering a little explored avenue for the delivery of oral health interventions.Methodology A pilot oral health promotion intervention was introduced in five pharmacies in deprived areas of County Durham between September and December 2016. A mixed methods approach to the evaluation was performed, utilising a patient evaluation questionnaire and semi-structured qualitative interviews with pharmacy staff.Results One thousand and eighty-nine participants received the intervention. Following the intervention 72% of participants perceived their knowledge of oral health as much better, 66% definitely intended to change their oral health habits and 64% definitely thought a pharmacy was the right place to receive advice about oral health. Three themes emerged from the qualitative data: (1) intervention feedback, (2) knowledge gap and (3) service development.Discussion The data demonstrated the acceptability of patients to a community pharmacy based oral health intervention, with most patients reporting intentions to change their oral healthcare habits after receiving the intervention. Previous literature has identified a willingness of pharmacy staff to become involved with oral health; this study provides evidence that patients are also receptive to such services being delivered in the community pharmacy setting. Further work is required to assess the benefits of a community pharmacy based oral health intervention and the potential for further growth of this role.Conclusion A community pharmacy is perceived by patients as an acceptable provider of oral health interventions and has the potential to provide positive changes to the oral health of the

  9. Women's impetus in community and health development.

    PubMed

    Roestam, K S

    1994-01-01

    Women in Indonesia are playing an increasingly large part in economic activity and community development. Moreover, they are making a significant beneficial impact on the nation's health, most notably, perhaps, by helping to secure financial resources. The present article describes some of the ways in which women are working to improve the well-being of the Indonesian people.

  10. Cash planning in community mental health agencies.

    PubMed

    Williams, E

    1976-01-01

    Community mental health agencies often receive funds from a number of different sources with varying restrictions. Cash planning can help them manage these funds properly and avoid serious problems. The use of a projected cash flow statement may even help produce additional income for them.

  11. Community mental health agency views of research.

    PubMed

    Gonzalez, Jodi M; Cortés, Dharma E; Reeves, Tamara; Whitley, Rob; Lopez, Linda; Bond, Gary R; Velligan, Dawn I; Miller, Alexander L

    2012-04-01

    We examined community mental health center staff perceptions of ongoing research within their agency. We interviewed upper management and conducted focus groups with medical staff, non-medical clinicians, and administrative staff. Participants were asked about (1) their attitudes towards research in general, agency research and towards the principal academic institution doing research with clients, (2) their perceptions of the value of research and (3) ideas for improving the collaboration. We identified 5 overarching themes: inter-agency communication, shared goals and equality in research, researchers adding knowledge to the agency, improving attitudes toward research, and agency involvement in research. Under these domains, specific suggestions are made for how to improve the collaboration across all stakeholder groups. Lack of shared values and inadequate communication processes can negatively impact community-based research collaborations. However, clear strategies, and adequate resources have great potential to improve community mental health collaborations.

  12. 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

  13. Integrating mental health into public health: The community mental health development project in India

    PubMed Central

    Ng, Chee; Chauhan, Ajay P.; Chavan, Bir Singh; Ramasubramanian, Chellamuthu; Singh, Amool R.; Sagar, Rajesh; Fraser, Julia; Ryan, Brigid; Prasad, Jagdish; Singh, Sujeet; Das, Jayanta; Isaac, Mohan

    2014-01-01

    The Ministry of Health and Family Welfare and its public health institutes are collaborating with Asia Australia Mental Health on an innovative community mental health development project designed to enhance initiatives under the District Mental Health Program and increase accessibility of essential community mental health services. The project is an exciting opportunity to create positive change in meeting the challenges of community mental health care in India. It recognizes that no one single model of care can be applied to all the community in the country and that locally appropriate models working in close partnership with local communities is required. Targeted and skill-based training programs are useful to build local leadership capacity in implementing quality and culturally appropriate community mental health services. PMID:25316931

  14. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    PubMed Central

    Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

    2016-01-01

    Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality

  15. New Mexico Community Health Councils: Documenting Contributions to Systems Changes.

    PubMed

    Sánchez, Victoria; Andrews, Mark L; Carrillo, Christina; Hale, Ron

    2015-01-01

    Coalition research has shifted from delineating structures and processes to identifying intermediate, systems changes (e.g., changes in policies) that contribute to longterm community health improvement. The University of New Mexico, the New Mexico Department of Health, and community health councils entered a multiyear participatory evaluation process to answer: What actions did health councils take that led to improving health through intermediate, systems changes? The evaluation system was created over several phases through an iterative, participatory process. Data were collected for councils' health priority areas (e.g., substance abuse) from 2009 to 2011. Twenty-three community health councils participated. Intermediate systems changes were measured: 1) networking and partnering, 2) joint planning of strategies, programs, and services, 3) leveraging resources, and 4) policy initiatives. Health councils reported data for each intermediate outcome by health priority area. Data showed councils identified local public health priorities and addressed those priorities through strengthening networks and partnerships, which lead to the creation and enhancement of strategies, services, and programs. Data also showed councils influenced policies in several ways (e.g., developing policy, identifying new policy, or sponsoring informational forums). Additionally, data showed councils leveraged $1.10 for every dollar invested by the state. When funding was suspended in July 2010, data showed dramatic decreases in activity levels from 2010 to 2011. The data demonstrate the feasibility and utility of an Internet-based system designed to gather intermediate systems changes evaluation data. This process is a model for similar efforts to capture common outcomes across diverse coalitions and partnerships.

  16. Managing Newborn Health in the Global Community

    PubMed Central

    Foege, William

    2001-01-01

    The largest health disparities in the world are found in maternal and neonatal mortality figures between the industrialized countries and the poorest sections of the poorest countries. Young lives would be saved if the skills and knowledge that have been accumulated by health workers aroundthe world could be readily applied. The problems reside with lack of management resources rather than lack of scientific knowledge. The Healthy Newborn: A Reference Manual for Program Managersis a graduate course in management aimed at providing health to newborns and healthy newborns to communities. PMID:11574306

  17. 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…

  18. 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…

  19. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    PubMed

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

  20. Community health education: reaching ethnically diverse elders.

    PubMed

    States, Rebecca A; Susman, William M; Riquelme, Luis F; Godwin, Ellen M; Greer, Ellen

    2006-01-01

    To address disparities in access to health care information, we developed a model program of community-based, health education workshops to be delivered in English and Spanish to older urban adults from diverse ethnic, cultural, and language backgrounds. The workshops were created through an interdisciplinary collaboration among faculty from seven health care professions and focused on three healthcare topics identified in Healthy People 2010: dementia and depression, stress reduction, and physical activity. The development of workshop content and structure, including didactic and interactive components, an approach to interdisciplinary student involvement, and program evaluation by clients and community center staff, are presented as a model for other educators. The workshops presented at five senior centers were attended by 1110 mostly female clients with an average age of 74 yrs and with a large proportion self-identified as of minority background. One hundred seven students from seven healthcare programs helped deliver the workshops. Interviews and surveys of the clients demonstrated that most had a positive learning experience, whereas the evidence of intent to take action on health care issues was less definitive. Analysis of student essays demonstrated increased student understanding of older adults and of community services. A website, Geriatric Educational Resources for Instructors and Elders (www.GERIE.org), was created to provide access to the instructional and resource materials used for the workshops, including presentation materials in Spanish. This model program may help address the substantial health education needs of a growing population of older adults from diverse ethnic, cultural, and language minorities.

  1. Recreational activities in community health care.

    PubMed

    Shaw, I

    1980-08-01

    Recreation is a significant element of preventive health care, used by community health centres as an aid to rehabilitation, moderation of stress and maintenance of health. Although the amount of leisure available to the people is increasing, many are unable to take full advantage of it due to inadequate recreational education or other causes. Community health centres have an educative responsibility in this regard especially towards the unemployed. These centres organize therapeutic and socializing groups for patients in need. Examples are given. Recreational activities are also useful in the relief of stress, during breaks in production in work-places. The principles of safety need to be taught as an essential part of recreational education and the fitness of participants needs to be ensured by screening school children. The planning and erection of playground equipment needs supervision by competent professionals who exist in the community health centres. The conclusion recommends that safety check lists be available for all normal recreations and that everyone should receive adequate education to enable successful participation in recreational activities. Copyright © 1980 Australian Physiotherapy Association. Published by . All rights reserved.

  2. 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.

  3. Community health worker insights on their training and certification.

    PubMed

    Catalani, Caricia E; Findley, Sally E; Matos, Sergio; Rodriguez, Romelia

    2009-01-01

    In recent years, the community health worker (CHW) field has grown significantly in the United States, with increasing numbers, roles, and visibility of CHWs. State health department regulators, health program administrators, and community health advocates have observed this growth with uncertainty about the definition of a CHW, how CHW roles differ from those of other health professionals, CHW training needs, and the potential impact of the growing certification and accreditation regulations. Despite the proliferation of regulatory policies, few studies have examined how regulation can most effectively support CHWs in the field. Our objective is to define CHW, identify training needs, and examine possibilities for credentialing from the perspective of CHWs in New York City. Community-based participatory research (CBPR) was used to engage CHW leadership and gather input from CHWs in the design and conduct of the study. The academic-community-state partnership designed focus group topic guides, and conducted fifteen focus groups with CHWs in New York City. The focus group responses were analyzed using HyperResearch and formed the basis for policy recommendations to the participating partners. We developed a consensus definition of CHW and its fundamental qualities. We identified unmet training needs in the area of core competencies. We outlined the characteristics of a credentialing process that would support and advance the work of CHWs. CBPR enabled CHWs to have a direct voice in defining their description, roles, training, and certification preferences. This informed policy recommendations to the state, university, and CHWs through a collaborative process.

  4. Exploring the role of the mental health nurse in community mental health care for the aged.

    PubMed

    Ryan, Rob; Garlick, Robyn; Happell, Brenda

    2006-01-01

    There is currently considerable discussion about the impact of the aging population on the demand for health care services, however there is considerably less attention paid to the impact of mental health issues on the needs of the aged population. Nurses comprise the largest professional group within the mental health workforce in Australia. The availability of a high quality mental health nursing workforce will therefore be crucial to meeting the health needs of aging clients in the future, accompanied by an increased pressure to increase the proportion of care delivered in the community. There is however, a paucity of literature on the role and contribution of community mental health nurses specialising in the aged care field. The aim of this paper is to present the findings of a project designed to examine the role of mental health nursing within aged persons' community mental health teams in Victoria, Australia, with particular emphasis on the biopsychosocial interventions used. Fifteen participants from three community mental health services in Victoria participated in a focus group interview to share their insights and experiences. Data analysis revealed two main themes, the role of the nurse, and the specific functions of the nurse. This data is presented as a beginning contribution to the paucity of literature currently available in this important area.

  5. Enhancing Themes and Strengths Assessment: Leveraging Academic-Led Qualitative Inquiry in Community Health Assessment to Uncover Roots of Community Health Inequities.

    PubMed

    Hebert-Beirne, Jennifer; Felner, Jennifer K; Castañeda, Yvette; Cohen, Sheri

    Rigorous qualitative research can enhance local health departments' efforts to gain a deeper insight into residents' perceived community health inequities necessary for productive community health assessments (CHAs) and community health improvement plans (CHIPs). The Chicago Department of Public Health and the Partnership for Healthy Chicago used the National Association of County & City Health Officials' Mobilizing for Action through Planning and Partnerships (MAPP) model to conduct its CHA/CHIP, Healthy Chicago 2.0 (HC 2.0). Public health graduate students conducted qualitative research for part of the Community Themes and Strengths Assessment (CTSA), one of the 4 MAPP assessments. Using a health equity lens, this qualitative component included focus groups and oral histories with residents in Chicago Community Areas with the highest social and economic hardship to better understand how residents perceive health inequities in their respective neighborhoods. Community-based organizations in 6 Chicago neighborhoods with the highest quartile of social and economic hardship. Forty-eight Chicago residents from 5 community areas participated in focus groups, and 6 residents of a Mexican ethnic enclave shared oral histories. Residents' perceptions of community needs and assets. Needs identified include inaccessible resources and opportunities, economic instability, and safety. Assets include the efficacy and agency of resilient residents, as well as faith and spirituality. Systemic and institutional discrimination was identified at the roots of community health inequities. Through qualitative inquiry, the more nuanced understanding of how residents perceive health inequities better positioned HC 2.0 to develop upstream strategies in line with advanced health equity practice. Engaging qualitative academic researchers in CTSA brings academic expertise to enrich the CHA while providing real-time learning experiences to prepare future public health practitioners to work on

  6. Community Health Crisis: Solving the Nurse Shortage.

    ERIC Educational Resources Information Center

    Vitiello, Erie

    2003-01-01

    Describes how Los Rios Community College District (LRCCD), California, the major provider of nursing graduates to the Sacramento area, addressed the issue of the nursing shortage crisis. LRCCD faced the dual issues of student/faculty ratio restrictions of 10/1 and funding that accommodated a 40/1 ratio. Describes LRCCD's new off-campus,…

  7. Sleep health in a black community sample.

    PubMed

    Cukor, Daniel; Ver Halen, Nisha; Pencille, Melissa; Fraser White, Marilyn; Primus, Nicole; Kaur, Kulpreet; Furer, Tzvi; Salifu, Moro

    2016-06-01

    Poor sleep health is a major health disparity and public health concern. The primary goal of this study was to accurately obtain the rates of self-reported sleep disorders, sleep dysfunction, and daytime sleepiness in a true community sample of black adults. We used a community-based participatory research design to identify a health priority to design a study that could (a) provide an accurate assessment of the problem, (b) help to better understand the barriers to treatment, and (c) provide the community with access to care. Subsequently, 470 black adults, approached at salons, barber shops, and churches throughout Brooklyn participated. They underwent anthropometric measurement and completed a self-reported sleep assessment. Sleep disorders (insomnia, obstructive sleep apnea) were found in 34% of the sample, and 75% of the population that had a sleep disorder was unaware of it. Fourteen percent of the sample self-identified as having obstructive sleep apnea, 38.0% reported having Insomnia, and 38% reported having excessive daytime somnolence. People with a sleep disorder described less satisfaction with their sleep quality and poorer health than did those without a sleep disorder. The variability in the reported rates of sleep disorders in black samples suggests that the true rates of these conditions are not well-known. However, the large number of black individuals who have sleep disturbances warrants increased scientific and public health attention. In addition, with increased community involvement in research, there can be increased buy-in and greater accuracy in the assessments and reduced barriers to treatment. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  8. Bridging community intervention and mental health services research.

    PubMed

    Wells, Kenneth; Miranda, Jeanne; Bruce, Martha L; Alegria, Margarita; Wallerstein, Nina

    2004-06-01

    This article explores the potential of community intervention perspectives for increasing the relevance, reach, and public health impact of mental health services research. The authors reviewed community intervention strategies, including public health and community development and empowerment interventions, and contrast community intervention with practice-based quality improvement and policy research. A model was proposed to integrate health services and community intervention research, building on the evidence-based strength of quality improvement and participatory methods of community intervention to produce complementary functions, such as linking community-based case finding and referral with practice-based quality improvement, enhanced by community-based social support for treatment adherence. The community intervention approach is a major paradigm for affecting public health or addressing health disparities. Despite challenges in implementation and evaluation, it represents a promising approach for extending the reach of mental health services interventions into diverse communities.

  9. Health Promotion, Community Development, and Participation: An Approach to Native Health Education

    PubMed Central

    Phillips, Susan

    1988-01-01

    Health-care parameters for Natives living in isolated northern areas of Canada show rates of life expectancy, morbidity, and infant mortality far worse than the Canadian average. Improving access to medical facilities has not affected these statistics. Socioeconomic factors such as inadequate housing and lack of sewage systems are likely contributors to poor health, as is an attitude of hopelessness and impotence on the part of Native people. Health-care providers have recognized the need for health promotion as well as treatment, but have often instituted programs that blame the victim. An approach to health education that embodies community development, participation, and the fostering of a positive self-image is discussed. The implication of this approach is that when Native Canadian groups can identify their own health problems, have access to the information needed for their solution, and develop the confidence and assertiveness to act, change may occur at a community, as well as an individual, level. PMID:21253037

  10. 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... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....

  11. Health Impact Assessment: Linking Public Health to Community Decisions (Cumulative Impacts Community Vulnerability Symposium)

    EPA Science Inventory

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substanc...

  12. 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.

  13. Social network fragmentation and community health.

    PubMed

    Chami, Goylette F; Ahnert, Sebastian E; Kabatereine, Narcis B; Tukahebwa, Edridah M

    2017-09-05

    Community health interventions often seek to intentionally destroy paths between individuals to prevent the spread of infectious diseases. Immunizing individuals through direct vaccination or the provision of health education prevents pathogen transmission and the propagation of misinformation concerning medical treatments. However, it remains an open question whether network-based strategies should be used in place of conventional field approaches to target individuals for medical treatment in low-income countries. We collected complete friendship and health advice networks in 17 rural villages of Mayuge District, Uganda. Here we show that acquaintance algorithms, i.e., selecting neighbors of randomly selected nodes, were systematically more efficient in fragmenting all networks than targeting well-established community roles, i.e., health workers, village government members, and schoolteachers. Additionally, community roles were not good proxy indicators of physical proximity to other households or connections to many sick people. We also show that acquaintance algorithms were effective in offsetting potential noncompliance with deworming treatments for 16,357 individuals during mass drug administration (MDA). Health advice networks were destroyed more easily than friendship networks. Only an average of 32% of nodes were removed from health advice networks to reduce the percentage of nodes at risk for refusing treatment in MDA to below 25%. Treatment compliance of at least 75% is needed in MDA to control human morbidity attributable to parasitic worms and progress toward elimination. Our findings point toward the potential use of network-based approaches as an alternative to role-based strategies for targeting individuals in rural health interventions.

  14. Climate change and health research: has it served rural communities?

    PubMed

    Bell, Erica J

    2013-01-01

    the health sciences. 'Rural' and 'Aboriginal' concepts have increased by 1% across both discipline areas, since 2011 for the 'rural' concept and since 2004 for the 'Aboriginal' concept. 'Health' concepts in the health sciences and 'economic' concepts in the social sciences, as well as 'urban' concepts, are referred to more positively than either the 'rural' or 'Aboriginal' concepts. While care needs to be taken in interpreting the results of this study too negatively for rural and Aboriginal communities, they suggest that a disease focus dominates climate and health research typically unconnected to wider socio-economic and human system factors. This finding needs to be considered in light of the accumulating evidence of the importance of such contextual systemic factors in understanding climate and health effects and responses. The study adds some support to the view that a key priority is bringing the learnings of applied community-based researchers, from those in rural health to those in the social sciences, to climate research. There is a need to build confidence, including in the rural health sector which has arguably been slow to participate in programs of climate change research, that community-based research could make a difference to rural health in a climate-changing world.

  15. [Community nutrition strategy project: an innovation in community health].

    PubMed

    Diallo, I; Ndiaye, B; Pouye, A; Gaye, I A; Sy, A; Sarr, R; Tall-Dia, A

    1998-01-01

    The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months.

  16. Community Mental Health Services and Daily Living Skills: The Relevance of a Home Economics Curriculum.

    ERIC Educational Resources Information Center

    Cunningham, Flora E.; Weis, David L.

    1986-01-01

    Community treatment settings offer home economists an opportunity to participate actively in the deinstitutionalization of mental health clients. Behavioral objectives for these clients are examined in the following areas: personal health and safety, community awareness, housing, nutrition, clothing and personal appearance, and financial…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

    PubMed

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

  4. Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya.

    PubMed

    Mutiso, Victoria N; Musyimi, Christine W; Nayak, Sameera S; Musau, Abednego M; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K; Pike, Kathleen; Ndetei, David M

    2017-09-01

    The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Participants ( n = 44 HWs and n = 60 CHVs) completed the self-report Mental Health Knowledge Schedule and the Reported and Intended Behavior Scale, along with sociodemographic questions. Multiple regression models were used to assess predictors of mental health knowledge and stigmatizing behaviors. HWs had significantly higher mean mental health knowledge scores than CHVs, p < .001, and significantly higher mean positive attitudes scores than CHVs, p = .042. When controlling for relevant covariates, higher positive attitudes was the only significant predictor of higher mental health knowledge, and self-rating of sense of belonging to the community and mental health knowledge remained the main predictors of positive attitudes. Results suggest that stigma-related mental health knowledge and attitudes are associated, and interventions should target these areas with health workers. There is scope for intervention to increase knowledge and positive attitudes for individuals who feel a strong sense of community belonging. Future studies should test feasible ways to reduce stigma in this population.

  5. Community Vulnerability to Health Impacts of Wildland Fire Smoke Exposure.

    PubMed

    Rappold, Ana G; Reyes, Jeanette; Pouliot, George; Cascio, Wayne E; Diaz-Sanchez, David

    2017-06-20

    Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on factors known to increase the risks of health effects from air pollution and wildfire smoke exposures. These factors included county prevalence rates for asthma in children and adults, chronic obstructive pulmonary disease, hypertension, diabetes, obesity, percent of population 65 years of age and older, and indicators of socioeconomic status including poverty, education, income and unemployment. Using air quality simulated for the period between 2008 and 2012 over the continental U.S. we also characterized the population size at risk with respect to the level and duration of exposure to fire-originated fine particulate matter (fire-PM2.5) and CHVI. We estimate that 10% of the population (30.5 million) lived in the areas where the contribution of fire-PM2.5 to annual average ambient PM2.5 was high (>1.5 μg/m(3)) and that 10.3 million individuals experienced unhealthy air quality levels for more than 10 days due to smoke. Using CHVI we identified the most vulnerable counties and determined that these communities experience more smoke exposures in comparison to less vulnerable communities.

  6. Building Research Infrastructure in Community Health Centers: A Community Health Applied Research Network (CHARN) Report

    PubMed Central

    Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E.

    2015-01-01

    This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and “matchmaking” between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings. PMID:24004710

  7. 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.

  8. Symbolism of community II: the boundary between community mental health professional and community.

    PubMed

    Parker, Damon B; Barrett, Robert J

    2006-04-01

    To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. The paper draws on anthropological theories of symbolism, boundary work and social networks. Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.

  9. Health posts: providers of basic health care and family planning in the rural areas.

    PubMed

    Yang, J M

    1985-10-01

    The integrated project was introduced in in Korea in 1977 to raise the family planning practice rate by integrating parasite control and nutrition programs with family planning and thereby help enhance the health and living standard of community residents. A new integrated approach was introduced in 1984 to provide health services including basic health care and preventive medication through primary health posts in remote rural areas. Several strategies were adopted including: strengthening the functions of the steering committees at various levels; consolidating cooperative relationships between the government and related organization; and conducting training and educational activities to generate positive participation of the community volunteers in the integrated program. Of 3483 eligible couples, 2446 (70.2%) practiced family planning in 1983. In May 1985, the rate increased to 75%. Of 10,381 persons examined, 813 persons (7.9%) suffered from parasite infection in 1983, but the rate decreased to 5.8% in May 1985. An effort to improve environmental sanitation resulted in housing improvement, latrine improvement, kitchen improvement, and piped water supply. Despite manpower shortage and financial difficulties, the 11 community health practitioners (CHPs) have been active in various project activities, including health education on nutrition improvement, maternal health service, child healt service, and medical treatment. To further expand and develop the project, more primary health posts now engage in activities such as providing IEC materials to publicize the function and role of the primary health posts, fully utilize village health workers to motivate community residents and secure basic facilities and medical supplies and provide necessary manpower.

  10. 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

  11. 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

  12. Reforming Victoria's primary health and community service sector: rural implications.

    PubMed

    Alford, K

    2000-01-01

    In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

  13. Linkages between community mental health centers and public mental hospitals.

    PubMed

    Worley, N K; Lowery, B J

    1991-01-01

    Directors of community mental health centers and superintendents of public mental health hospitals in one state were surveyed to gather data on interagency linkages. Implementation of affiliation agreements, exchange of staff training, and exchange of patient information were investigated. Affiliation agreements tended to be implemented with little difficulty and there was more interagency cooperation than that reported in earlier research. However, exchange of training and staff were still areas of minimal interaction. Geographic proximity was found to have a positive influence and competition a negative influence on cooperation. Further attempts at interagency linkages in the interest of continuity of patient care are recommended.

  14. Reorienting health services through community health promotion in Kwaio, Solomon Islands.

    PubMed

    MacLaren, David; Kekeubata, Esau

    2007-01-01

    When ethnic minorities adhere to cultural practices which mark them as unique, structural impediments within health services can deny access and significantly add to the burden of disease. This is particularly pertinent if the development of health services is not done in partnership with all population groups in the area. This is the case at Atoifi Hospital, which structure prevents certain Kwaio people (Solomon Islands) from receiving benefits of hospital services and maintaining cultural beliefs at the same time. A Participatory Action Research process was used to collaboratively work with health service providers and community groups to review the situation, design and build a health facility with both medically and culturally appropriate policies and procedures. The Participatory Action Research process of collectively looking, thinking, planning and acting towards reorienting health services to become more culturally appropriate at Atoifi was the first time leaders, from both the community and hospital, had collectively sat together in a mutually respectful way to discuss community health promotion initiatives. The project was complete in 2006 with collaboration and dialogue between both groups proving vital to its success. Numerous indicators are present that the culturally appropriate health facility is making a difference, not only in terms of the hospital usage by all, but also for the feeling of "community ownership."

  15. The contribution of school health education to community health promotion: what can we reasonably expect?

    PubMed Central

    Bartlett, E E

    1981-01-01

    Evaluative studies of outcomes of traditional school health education programs have shown that they are very effective in increasing knowledge, somewhat effective in improving attitudes, and, with few notable exceptions, generally ineffective in changing health practices. This paper discusses the previous reviews of the literature of outcomes of school health education programs, and discusses the constraints inherent in school-based activities; an emphasis on cognitive learning, lecture-oriented teaching methods, inadequate pupil assessment procedures, a captive audience, competing subject areas, competing behavioral influences, behavior change attempts directed at ingrained health habits, inadequate coordination with community resources, and lack of consensus regarding educational goals. The paper then examines several recent successful school health education programs emphasizing non-traditional approaches in self-initiated care, pregnancy prevention, smoking prevention, and nutrition. It is concluded that school-based health education programs have three important roles in community health promotion: 1. the provision of a fundamental understanding of health and disease concepts to large segments of the population; 2. the reinforcement of positive health attitudes; and 3. the alteration of concurrent health behaviors for significant health problems. Although school health education may be helpful in enhancing decision-making and social interaction skills, little empirical evidence exists at this time to support this conclusion. PMID:7032324

  16. 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…

  17. Meeting the Health Promotion Needs of Hispanic Communities.

    ERIC Educational Resources Information Center

    American Journal of Health Promotion, 1995

    1995-01-01

    The paper reviews demographic and health status data for Hispanic communities and relates them to the role of culture in health care, recommending that health promotion programs focus on specific community data, understand the impact of culture and language, develop powerful outreach, and team up with community-based organizations. (SM)

  18. Meeting the Health Promotion Needs of Hispanic Communities.

    ERIC Educational Resources Information Center

    American Journal of Health Promotion, 1995

    1995-01-01

    The paper reviews demographic and health status data for Hispanic communities and relates them to the role of culture in health care, recommending that health promotion programs focus on specific community data, understand the impact of culture and language, develop powerful outreach, and team up with community-based organizations. (SM)

  19. 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…

  20. Exploring health literacy competencies in community pharmacy.

    PubMed

    Emmerton, Lynne M; Mampallil, Liz; Kairuz, Therese; McKauge, Leigh M; Bush, Robert A

    2012-03-01

    Health literacy is the ability to obtain, interpret and use health information. Low rates of health literacy in Australia have been suggested, but no validated measure exists. To explore health literacy competencies in a sample of community pharmacy consumers. Structured interviews were undertaken by a team of researchers during August, 2009. The instrument was derived from available literature, measuring aspects of functional, interactive and critical health literacy regarding use of medicines. Twelve community pharmacies in the Brisbane region, Australia. Six hundred and forty-seven consumers participated; 64% were women. A wide distribution of ages was evident. English was the first language of 89% of respondents. More than half of the sample (55%), predominantly aged 26-45 years, was tertiary educated. While 87% of respondents recognized a sample prescription, 20% could not readily match the prescription to a labelled medicine box. Eighty-two percentage of respondents interpreted 'three times a day' appropriately, but interpretation of a standard ancillary label was highly variable. Advanced age, less formal education, non-English-speaking background and male gender were independently related to lower performance in some variables. This health literacy measure applied comprehension and numeracy skills required of adults receiving prescription medications. While the majority of consumers adequately performed these tasks, some behaviours and responses were of sufficient concern to propose additional verbal and written information interventions by pharmacy staff. This research provides insight into issues that may affect consumers' appropriate use of medicines and self-efficacy. Initiatives to improve public health literacy are warranted. © 2010 Blackwell Publishing Ltd.

  1. Drought, drying and climate change: emerging health issues for ageing Australians in rural areas.

    PubMed

    Horton, Graeme; Hanna, Liz; Kelly, Brian

    2010-03-01

    Older Australians living in rural areas have long faced significant challenges in maintaining health. Their circumstances are shaped by the occupations, lifestyles, environments and remoteness which characterise the diversity of rural communities. Many rural regions face threats to future sustainability and greater proportions of the aged reside in these areas. The emerging changes in Australia's climate over the past decade may be considered indicative of future trends, and herald amplification of these familiar challenges for rural communities. Such climate changes are likely to exacerbate existing health risks and compromise community infrastructure in some instances. This paper discusses climate change-related health risks facing older people in rural areas, with an emphasis on the impact of heat, drought and drying on rural and remote regions. Adaptive health sector responses are identified to promote mitigation of this substantial emerging need as individuals and their communities experience the projected impact of climate change.

  2. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    PubMed

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-04-08

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  3. 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..., Table 21 Table 21 to Part 679—Eligible GOA Communities, Halibut IFQ Regulatory Use Areas and Community.... Whale Pass Whale Pass Community Association. Akhiok City of Akhiok. Chenega Bay Chenega IRA...

  4. Managerial support of community mental health nurses.

    PubMed

    Funakoshi, Akiko; Miyamoto, Yuki; Kayama, Mami

    2007-05-01

    This paper is a report of a study to describe the support behaviours practised by managers of community mental health nurses (CMHNs) who provide homecare for people with mental illness, and to identify factors related to those behaviours. Homecare of mentally ill clients can prevent hospital readmission, provide rehabilitation, and include support for medication adherence, personal relationships, mental health, activities of daily living, as well as supporting informal caregivers. However, this work is stressful for CMHNs, who can themselves develop mental health problems and suffer burnout. Therefore support for these nurses is essential. Semi-structured interviews were conducted with 10 nurse managers in 2004. A constant comparative data collection and analysis process was used, and a core category identified. Four categories of managerial support behaviour were identified: (1) 'modifying client-nurse relationships'; (2) 'ensuring community mental health nurse safety'; (3) 'providing emotional support'; (4) 'providing opportunities for skill development'. 'To continue homecare for clients in need' emerged as a core category, representing the ultimate purpose of managerial support behaviours. Moreover, the timing of managerial support behaviours was influenced by the quality and length of the client-nurse relationship. The managerial support behaviours reported in the present study may be useful in other cultural contexts. Further research is needed to evaluate their effectiveness for CMHNs in other settings in Japan and other countries.

  5. Distribution of Subsidized Insecticide-treated Bed Nets through a Community Health Committee in Boboye Health District, Niger

    PubMed Central

    Nonaka, Daisuke; Maazou, Abani; Yamagata, Shigeo; Oumarou, Issofou; Uchida, Takako; Yacouba, Honoré JG; Kobayashi, Jun; Takeuchi, Tsutomu; Mizoue, Tetsuya

    2012-01-01

    In Niger, insecticide-treated bed nets (ITNs) have been distributed to the target group of households with young children and/or pregnant women at healthcare facilities in the course of antenatal/immunization clinics. With the aim of universal coverage, ITNs were additionally distributed to households through strengthened community health committees in 2009. This study assessed the impact of the community-based net distribution strategy involving community health committees in the ITN coverage in Boboye Health District, Niger. A cross-sectional survey was carried out on 1,034 households drawn from the intervention area (the co-existence of the community-based system together with the facility-based system) and the control area (the facility-based system alone). In the intervention area, 55.8% of households owned ITNs delivered through the community-based system, and 29.6% of households exclusively owned ITNs obtained through the community-based system. The community-based system not only reached households within the target group (54.6% ownership) but also those without (59.1% ownership). Overall, household ITN ownership was significantly higher in the intervention area than in the control area (82.5% vs. 60.7%). In combination, the community-based system and the facility-based system achieved a high ITN coverage. The community-based system contributed to reducing leakage in the facility-based system. PMID:23532450

  6. 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 To...

  7. 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 To...

  8. 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...

  9. 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...

  10. Health promotion by communities and in communities: current issues for research and practice.

    PubMed

    South, Jane

    2014-11-01

    This paper explores contemporary issues around community-based health promotion in the light of international health policies reaffirming the central role of community action within broader efforts to achieve health equity. Adopting a system-level approach poses challenges for current health promotion practice and evaluation, particularly where there is a shift in emphasis from small-scale community health projects towards mainstream community programmes, capable of engaging widely across diverse populations. Drawing on research with community members carried out by the Centre for Health Promotion Research, Leeds Metropolitan University, UK, the paper re-examines assumptions about the nature of interventions within community settings, and what participation means from a lay perspective. Key research issues for community-based health promotion are highlighted. The paper concludes by proposing that community-based interventions need to be reframed, if the dual challenges of citizen involvement and evidence based practice are to be met. © 2014 the Nordic Societies of Public Health.

  11. 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.

  12. Clinic closure brings power to a community. Lessons learned to inform health policy.

    PubMed

    Clarke, Pamela N

    2002-01-01

    Development of a community clinic as a campus/community partnership served as a model for community empowerment in a unique demonstration project in a rural state. The purpose was to provide primary health care and illustrate the impact of expert faculty practice with extremely vulnerable populations. Advanced practice students in a variety of disciplines participated with faculty in health care delivery in an underserved area.

  13. Climate change, health, and vulnerability in Canadian northern Aboriginal communities.

    PubMed

    Furgal, Christopher; Seguin, Jacinthe

    2006-12-01

    Canada has recognized that Aboriginal and northern communities in the country face unique challenges and that there is a need to expand the assessment of vulnerabilities to climate change to include these communities. Evidence suggests that Canada's North is already experiencing significant changes in its climate--changes that are having negative impacts on the lives of Aboriginal people living in these regions. Research on climate change and health impacts in northern Canada thus far has brought together Aboriginal community members, government representatives, and researchers and is charting new territory. In this article we review experiences from two projects that have taken a community-based dialogue approach to identifying and assessing the effects of and vulnerability to climate change and the impact on the health in two Inuit regions of the Canadian Arctic. The results of the two case projects that we present argue for a multi-stakeholder, participatory framework for assessment that supports the necessary analysis, understanding, and enhancement of capabilities of local areas to respond and adapt to the health impacts at the local level.

  14. Climate Change, Health, and Vulnerability in Canadian Northern Aboriginal Communities

    PubMed Central

    Furgal, Christopher; Seguin, Jacinthe

    2006-01-01

    Background Canada has recognized that Aboriginal and northern communities in the country face unique challenges and that there is a need to expand the assessment of vulnerabilities to climate change to include these communities. Evidence suggests that Canada’s North is already experiencing significant changes in its climate—changes that are having negative impacts on the lives of Aboriginal people living in these regions. Research on climate change and health impacts in northern Canada thus far has brought together Aboriginal community members, government representatives, and researchers and is charting new territory. Methods and Results In this article we review experiences from two projects that have taken a community-based dialogue approach to identifying and assessing the effects of and vulnerability to climate change and the impact on the health in two Inuit regions of the Canadian Arctic. Conclusions The results of the two case projects that we present argue for a multi-stakeholder, participatory framework for assessment that supports the necessary analysis, understanding, and enhancement of capabilities of local areas to respond and adapt to the health impacts at the local level. PMID:17185292

  15. Evaluating community-based participatory research to improve community-partnered science and community health.

    PubMed

    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

    2012-01-01

    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. 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. 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. 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. Study methodologies and lessons learned can help community-academic research partnerships translate research in communities.

  16. California: Environmental Health Coalition Clean Ports, Healthy Communities in San Diego (A Former EPA CARE Project)

    EPA Pesticide Factsheets

    The Environmental Health Coalition (EHC) is a recipient of a CARE Level II cooperative agreement grant. The Clean Ports, Healthy Communities in San Diego targets the Barrio Logan and Old Town National City areas located along San Diego Bay.

  17. 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.

  18. Long-term employment and health inequalities in Canadian communities.

    PubMed

    Safaei, Jalil

    2008-01-01

    This study examines the long-term unemployment rate and various health outcomes across Canadian communities to estimate employment-related health inequalities in these communities. The study uses cross-sectional community-level health data along with data on the long-term employment rate for various communities across Canada to quantify health inequalities among these communities. The health outcomes that are considered in this study include total and disease specific mortality rates; health conditions such as high blood pressure, diabetes, injuries, and self rated health; and life expectancies at birth and at age 65. Health inequalities are estimated using the concentration index, which is used to measure health inequalities along socioeconomic dimensions. The concentration index is estimated by a regression of weighted relative health (ill health) over weighted cumulative relative rank of the populations. All the estimates are provided separately for males and females. The findings of the study support the existence of inequalities in community health outcomes as related to the long-term employment rates in those communities. Communities with lower long term employment rates (higher unemployment rates) have poorer health outcomes in terms of higher mortality rates, worse health conditions, and shorter life expectancies. Health inequalities related to long-term employment have important policy implications. They call for policies that would increase and maintain long term employment rates as part of a broader socioeconomic approach to health. Long term employment ensures income security and prevents the psychosocial experiences leading to mental and physical ill health.

  19. 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

  20. The development of a town of safety, security and health project in an area with a very high population aging rate: -the activities of a community salon on a shopping street and their assessment-.

    PubMed

    Hoshino, Akiko; Usui, Kanae; Katsura, Toshiki

    2011-01-01

    The aim of this study was to assess the "Health Care Town in Kyoto" project designed to promote health and safety for health conscious people in a small community. We conducted a survey involving the users of the salon and local residents to examine the effects of the activities in the salon. We recorded the activities of salon and conducted semi-structured interviews with ten local residents to ask their opinions about the salon. The data from the interviews were analyzed using the Grounded Theory Approach. We distributed a questionnaire and collected 215 valid responses (valid response rate: 67.8%). 1) Purpose of using the salon was categorized into health consultation, conversation with others, rest and other purpose. 2) The significance of the salon for users was categorized into usability, acquisition of useful information, changes in daily habits and their maintenance, diversion, interaction with other people and acceptance by the shopping center. 3) The results of the questionnaire survey showed marked relations between Well-Being Index (WHO-5), age, employment and family budget, self-rated health and ability to perform daily activities (TMIG), whereas use of the salon was not associated with Well-Being Index (WHO-5). On the other hand, there were marked relations between loneliness (LSO), educational background and use of the salon, demonstrating that the facility helped its users reduce loneliness (LSO). In this town, the salon has served as a place providing effective preventive support for the health of individual users.

  1. 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.

  2. 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.

  3. Voices across Kansas: community health assessment and improvement efforts among local health departments.

    PubMed

    Wetta, Ruth E; Pezzino, Gianfranco; LaClair, Barbara; Orr, Shirley; Brown, Molly B

    2014-01-01

    Community health assessment (CHA) and community health improvement planning (CHIP) is central to public health accreditation and essential functions and therefore important to local health departments (LHDs). However, rural states face significant challenges to pursue public health accreditation. The purpose of this statewide study was to identify factors that impede or promote the timeliness of CHA and CHIP completion. Fifteen focus groups, representing 11 of 15 public health regions, were conducted via telephone, using a structured interview script between April and September 2012. The sampling frame for the project was represented by counties in Kansas that planned to conduct a CHA-CHIP activity during 2012. Participants (N = 76) were LHD administrators, hospital representatives, and key community stakeholders from frontier, rural, and urban settings who were involved in CHA-CHIP activities. They were predominantly female (86.0%) and 51 years or older (66.7%). The study assessed perceptions and opinions about the inputs, process, outputs, and outcomes of CHA-CHIP activities within the community. Overall, CHA-CHIP implementation in Kansas was in its early stages. Rural counties reported a lack of capacity and confidence to perform many CHA-CHIP activities. Early CHA-CHIP adopters were located in more populous, metropolitan areas and had progressed further into the CHA-CHIP process. Regardless of rural/urban status, a history of collaborative activity among community stakeholder groups appeared to promote progress in CHA-CHIP completion. Participants reported that additional funding, time, trained staff, technical assistance, and community leadership were needed to conduct CHA-CHIP activities. Barriers included maintaining required LHD services while conducting assessment and planning activities and differences in public health and federal cycles for performing CHA. Study findings have implications for strengthening rural workforce development and technical

  4. 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.

  5. 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.…

  6. 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)

  7. 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)

  8. Establishing Community Health Centers in Rural Appalachia Utilizing Lay Volunteers

    ERIC Educational Resources Information Center

    Morris, Frances

    1978-01-01

    Appalachian Leadership Outreach Health Program established community health centers in the homes of volunteers in 10 Kentucky communities. The cost has been nominal, and the advantages in transportion time and improved health awareness and care promise to help meet basic health needs of the rurally isolated. (JC)

  9. Characteristics and functions of community health workers in Saradidi, Kenya.

    PubMed

    Kaseje, D C; Spencer, H C; Sempebwa, E K

    1987-04-01

    A community-based health development programme in Saradidi, Kenya had 126 village health helpers (VHH's) for the 56 villages. These volunteer health workers lived in the community and served a total population of about 43,000 in an area of 225 km2. Each VHH served a maximum of 100 households averaging 4.0 persons. Conditions imposed by the community were that the VHH be perceived to be a mature person, to be compassionate and to have a desire to help people and to live in the village. Literacy or formal education were not requirements. VHH's were chosen and supported by the people who lived in their village. Characteristics of the 126 VHH's were that 96.8% were women, 99.2% were married, 75.4% were between 25 and 39 years of age, and 80.2% had at least five years of formal education (only 7.1% had none). The VHH's spent an average five to ten days each month on programme activities in addition to their other responsibilities which included preparing meals, cleaning their homes, carrying water and firewood from long distances, caring for their children and cultivating food for their family. Each VHH visited about 15 households per month, spending one to two hours on a visit. Problems experienced by a random sample of 36 VHH's included difficulties due to lack of transport, lack of medicines, slowness of the community to accept new ideas, distance from project clinic, lack of food in the village, weak village health committees, and no payment for services. The main support for the VHH's came from village women individually, women's groups, and the central programme committee. Village Health Committees did not provide effective support. Nevertheless, in four years only four of the 126 VHH's dropped out of the programme. The main reasons that 36 VHH's reported for continuing to volunteer were as follows: the continuous training they were given was beneficial (mentioned by all); they agreed to serve the villages and did not want to go back on their word (36.1%); they

  10. 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

  11. 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.

  12. 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.

  13. Community matters - why outbreak responses need to integrate health promotion.

    PubMed

    Kickbusch, Ilona; Reddy, K Srikanth

    2016-03-01

    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

  14. Community health and reform in Hong Kong.

    PubMed

    McDermott, K

    1986-01-01

    In this paper I argue that the health crisis in the underdeveloped world today is not primarily one of shortages of services, but is a result of lack of power and control over economic, political and social institutions by the majority of the population. Hong Kong is presented as a case study in which a plural medical system is dominated by a political economy that shapes patterns of both sickness and health care. As an advanced capitalist colony, a financial center for the Pacific Basin, and a neutral area for China's foreign negotiations, social policies in Hong Kong aim at promoting business growth, often at the expense of the health of the population. Further, government and voluntary agencies attempts at reforming the health system have done little more than further solidify biomedicine and its social relations. Finally an attempt is made to define potential vehicles for change.

  15. Community health centers at the crossroads

    PubMed Central

    Proser, Michelle; Bysshe, Tyler; Weaver, Donald; Yee, Ronald

    2015-01-01

    ABSTRACT In response to increased demand for primary care services under the Affordable Care Act, the national network of community health centers (CHCs) will play an increasingly prominent role. CHCs have a broad staffing model that includes extensive use of physician assistants (PAs), nurse practitioners (NPs), and certified nurse midwives (CNMs). Between 2007 and 2012, the number of PAs, NPs, and CNMs at CHCs increased by 61%, compared with 31% for physicians. However, several policy and payment issues jeopardize CHCs' ability to expand their workforce and meet the current and rising demand for care. PMID:25802941

  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. Community based needs assessment in an urban area: a participatory action research project.

    PubMed

    Ahari, Saeid Sadeghieh; Habibzadeh, Shahram; Yousefi, Moharram; Amani, Firouz; Abdi, Reza

    2012-03-07

    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. 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. 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. Participatory action research is an effective method for

  18. 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

  19. Perspectives on utilization of community based health information systems in Western Kenya.

    PubMed

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

  20. Perspectives on utilization of community based health information systems in Western Kenya

    PubMed Central

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Introduction Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Methods Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Results Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. Conclusion The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers. PMID:28904707

  1. Implementation of a Coordinated School Health Program in a Rural, Low-Income Community

    ERIC Educational Resources Information Center

    Cornwell, Lisa; Hawley, Suzanne R.; St. Romain, Theresa

    2007-01-01

    Background: Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and…

  2. Implementation of a Coordinated School Health Program in a Rural, Low-Income Community

    ERIC Educational Resources Information Center

    Cornwell, Lisa; Hawley, Suzanne R.; St. Romain, Theresa

    2007-01-01

    Background: Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and…

  3. Exercises in emergency preparedness for health professionals in community clinics.

    PubMed

    Fowkes, Virginia; Blossom, H John; Sandrock, Christian; Mitchell, Brenda; Brandstein, Kendra

    2010-10-01

    Health professionals in community settings are generally unprepared for disasters. From 2006 to 2008 the California Statewide Area Health Education Center (AHEC) program conducted 90 table top exercises in community practice sites in 18 counties. The exercises arranged and facilitated by AHEC trained local coordinators and trainers were designed to assist health professionals in developing and applying their practice site emergency plans using simulated events about pandemic influenza or other emergencies. Of the 1,496 multidisciplinary health professionals and staff participating in the exercises, 1,176 (79%) completed learner evaluation forms with 92-98% of participants rating the training experiences as good to excellent. A few reported helpful effects when applying their training to a real time local disaster. Assessments of the status of clinic emergency plans using 15 criteria were conducted at three intervals: when the exercises were scheduled, immediately before the exercises, and for one-third of sites, three months after the exercise. All sites made improvements in their emergency plans with some or all of the plan criteria. Of the sites having follow up, most (N = 23) were community health centers that made statistically significant changes in two-thirds of the plan criteria (P = .001-.046). Following the exercises, after action reports were completed for 88 sites and noted strengths, weaknesses, and plans for improvements in their emergency plans Most sites (72-90%) showed improvements in how to activate their plans, the roles of their staff, and how to participate in a coordinated response. Challenges in scheduling exercises included time constraints and lack of resources among busy health professionals. Technical assistance and considerations of clinic schedules mitigated these issues. The multidisciplinary table top exercises proved to be an effective means to develop or improve clinic emergency plans and enhance the dialogue and coordination among

  4. Exercises in Emergency Preparedness for Health Professionals in Community Clinics

    PubMed Central

    Blossom, H. John; Sandrock, Christian; Mitchell, Brenda; Brandstein, Kendra

    2010-01-01

    Health professionals in community settings are generally unprepared for disasters. From 2006 to 2008 the California Statewide Area Health Education Center (AHEC) program conducted 90 table top exercises in community practice sites in 18 counties. The exercises arranged and facilitated by AHEC trained local coordinators and trainers were designed to assist health professionals in developing and applying their practice site emergency plans using simulated events about pandemic influenza or other emergencies. Of the 1,496 multidisciplinary health professionals and staff participating in the exercises, 1,176 (79%) completed learner evaluation forms with 92–98% of participants rating the training experiences as good to excellent. A few reported helpful effects when applying their training to a real time local disaster. Assessments of the status of clinic emergency plans using 15 criteria were conducted at three intervals: when the exercises were scheduled, immediately before the exercises, and for one-third of sites, three months after the exercise. All sites made improvements in their emergency plans with some or all of the plan criteria. Of the sites having follow up, most (N = 23) were community health centers that made statistically significant changes in two-thirds of the plan criteria (P = .001–.046). Following the exercises, after action reports were completed for 88 sites and noted strengths, weaknesses, and plans for improvements in their emergency plans Most sites (72–90%) showed improvements in how to activate their plans, the roles of their staff, and how to participate in a coordinated response. Challenges in scheduling exercises included time constraints and lack of resources among busy health professionals. Technical assistance and considerations of clinic schedules mitigated these issues. The multidisciplinary table top exercises proved to be an effective means to develop or improve clinic emergency plans and enhance the dialogue and

  5. Trust the process: community health psychology after Occupy.

    PubMed

    Cornish, Flora; Montenegro, Cristian; van Reisen, Kirsten; Zaka, Flavia; Sevitt, James

    2014-01-01

    This article argues that community health psychology's core strategy of 'community mobilisation' is in need of renewal and proposes a new way of conceptualising community health action. Taking the Occupy movement as an example, we critique modernist understandings of community mobilisation, which are based on instrumental action in the service of a predetermined goal. Aiming to re-invigorate the 'process' tradition of community health psychology, we explore possibilities of an open-ended, anti-hierarchical and inclusive mode of community action, which we label 'trusting the process'. The gains to be made are unpredictable, but we suggest that the risk is worth taking.

  6. Improving maternal and newborn health: effectiveness of a community health worker program in rural Kenya.

    PubMed

    Adam, Mary B; Dillmann, Maria; Chen, Mei-kuang; Mbugua, Simon; Ndung'u, Joram; Mumbi, Priscilla; Waweru, Eunice; Meissner, Peter

    2014-01-01

    Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance. The study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women's children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas. Mean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%. The delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance.

  7. 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.

  8. Community assessment in a vertically integrated health care system.

    PubMed Central

    Plescia, M; Koontz, S; Laurent, S

    2001-01-01

    OBJECTIVES: In this report, the authors present a representative case of the implementation of community assessment and the subsequent application of findings by a large, vertically integrated health care system. METHODS: Geographic information systems technology was used to access and analyze secondary data for a geographically defined community. Primary data included a community survey and asset maps. RESULTS: In this case presentation, information has been collected on demographics, prevalent health problems, access to health care, citizens' perceptions, and community assets. The assessment has been used to plan services for a new health center and to engage community members in health promotion interventions. CONCLUSIONS: Geographically focused assessments help target specific community needs and promote community participation. This project provides a practical application for integrating aspects of medicine and public health. PMID:11344895

  9. Localized Health News Releases and Community Newspapers: A Method for Rural Health Promotion.

    PubMed

    Young, Rachel; Willis, Erin; Stemmle, John; Rodgers, Shelly

    2015-07-01

    Newspaper health stories often originate with news releases from health organizations. Tailoring news releases to a particular mass media outlet increases the possibility that the release will result in a published story. This study describes a 2-year effort to promote coverage of health through dissemination of localized health news releases to newspapers. Each newspaper received stories tailored to that community. Localized elements of stories included local headlines and local data. Nearly half of newspapers in our study (48.2%) published at least one of our health news stories, and 541 health news stories were published as a result of the project. We also examined which types of newspapers were most likely to publish health news stories. Newspapers in rural versus suburban and urban areas were more likely to publish health news stories, as were midsized newspapers. In addition, rural newspapers were more likely than urban newspapers to publish stories about aging, specifically arthritis and heart disease. Our findings indicate that tailoring health news releases with local information and targeting releases to align with newspaper audience demographics could increase the quantity and quality of health-promoting information available to rural residents, who experience disparities in health care access and health outcomes. © 2015 Society for Public Health Education.

  10. Health Manpower: Action to Meet Community Needs. Report of the Task Force on Health Manpower.

    ERIC Educational Resources Information Center

    National Commission on Community Health Services, Washington, DC.

    In 1963, the National Commission on Community Health Services appointed the Task Force on Health Manpower to assess community health needs, to evaluate methods of recruiting, educating, developing, motivating and utilizing manpower, and to recommend ways to assure availability and optimal utilization of manpower based upon community health needs.…

  11. 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)

  12. 78 FR 20523 - Community Health Needs Assessments for Charitable Hospitals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... Internal Revenue Service 26 CFR Parts 1 and 53 RIN 1545-BL30 Community Health Needs Assessments for... organizations on the community health needs assessment (CHNA) requirements, and related excise tax and reporting... requiring a transparent assessment process with ample opportunity for community input. 1. Hospital...

  13. [Community participation. Some perspectives on professional involvement in health programs].

    PubMed

    Pérez Mendoza, S; Ascanio, S V

    1990-01-01

    Action Community regarding health is but part of a long-term project started out back in the 1960. As far as Latin America was concerned the so-called experience did not work out; notwithstanding, it has become an Attention-Getter among the countries of the area once again. How so? Because of the Primary-Approach. Understood as an approach based on the global development of society, self-involvement lies at the cornerstone of the whole process. The health section gives full measure of the primary-approach theoretical framework and propose alternatives to get it of the ground. Professionals from the health section aim at "self-involvement" as activity performed willingly. Besides as it were, it should be supervised by experts. Nowadays the venezuelan government promotes action community claiming it will endorse the Primary-Approach on health granted the national health system bill is approved. Amid such context dentistry most meet the challenge of upcoming changes, so must fellow-dentists who, in the end, will dominate center stage. The process must narrow down to actions with will stem from its own dynamics along the way. Needless to say, these actions can not be easily foreseen, let alone do they guarantee success.

  14. Conducting community audits to evaluate community resources for healthful lifestyle behaviors: an illustration from rural eastern North Carolina.

    PubMed

    McGuirt, Jared T; Jilcott, Stephanie B; Vu, Maihan B; Keyserling, Thomas C

    2011-11-01

    A community audit is a qualitative and quantitative research technique in which researchers drive through a community to observe its physical and social attributes, primarily through windshield tours and "ground truthing." Ground truthing is a verification process that uses data gathered by direct observation to corroborate data gathered from secondary sources. Community audits have been used for epidemiologic studies and in program planning for health-promotion interventions. Few studies have detailed the methodology for conducting community audits in rural areas or the extent to which community audits can contribute to an accurate assessment of community characteristics (eg, presence of sidewalks) and nutrition and physical activity resources (eg, produce stands, parks) that may promote healthful lifestyle behaviors. The objective of this article is to describe our approach to conducting a community audit (consisting of windshield tours and ground truthing) to enumerate resources, to assess community characteristics, and to inform revisions to a community guide on nutrition and physical activity resources. We conducted an audit in 10 communities in a rural eastern North Carolina county in 2010. We also collected data from secondary sources to make comparisons with community audit data. The initial resource guide included 42 resources; the community audits identified 38 additional resources. There was moderate to high agreement between windshield tour observations and secondary data sources for several community characteristics, such as number of fast-food restaurants (67% agreement) and existence of sidewalks (100% agreement). Community audits improved the description of health-promoting community resources and the context in which people make lifestyle choices.

  15. Community health agency administrators' access to public health data for program planning, evaluation, and grant preparation.

    PubMed

    Lane, Sandra D; Cashman, Donna M; Keefe, Robert H; Narine, Lutchmie; Ducre, Bradford; Chesna, Sharon; Hall, Meghan; Oliver, David

    2017-02-01

    The Affordable Care Act mandates that public health data be made available for community agency use. Having access to such data allows community agencies to tailor interventions, evaluations, and funding requests more effectively. This study, jointly undertaken by Syracuse University faculty and students with the New York State Perinatal Association, sought to understand community agencies' access to requests for governmental data, as well as to identify areas for improving data access. Results from this survey of administrators from 43 agencies in New York State found that only one-half of their requests for data were successful. Difficulties in obtaining access to needed data included fiscal and staffing constraints of the state-level agencies that house the data, as well as possible overinterpretation of confidentiality policies. In addition, some of community agency respondents reported that their staff lacked skills in data analysis and would benefit from training in epidemiology and quantitative evaluation.

  16. Australian rural, remote and urban community nurses' health promotion role and function.

    PubMed

    Roden, Janet; Jarvis, Lynda; Campbell-Crofts, Sandra; Whitehead, Dean

    2016-09-01

    Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

  17. Effects of a global health and risk assessment tool for prevention of ischemic heart disease in an individual health dialogue compared with a community health strategy only results from the Live for Life health promotion programme.

    PubMed

    Lingfors, Hans; Persson, Lars-Göran; Lindström, Kjell; Bengtsson, Calle; Lissner, Lauren

    2009-01-01

    To evaluate the effect of an individual health dialogue on health and risk factors for ischemic heart disease in addition to that of a community based strategy. Inhabitants in four communities in the area of Skaraborg, Sweden were invited to a health examination including a health dialogue both at the age of 30 and 35 (target communities). In another four communities inhabitants were invited only at the age of 35 (reference communities). Health and risk factors in 35-year old inhabitants in the target communities who participated in the health dialogue in 1989-1991 and 1994-1996 were analysed and compared with 35-year olds in the reference communities participating during the same periods of time. Inhabitants in communities where there had been a previous individualised health intervention programme had, on the community level, a more favourable development concerning dietary habits, mental stress, body mass index, waist circumference, cholesterol, blood pressure and metabolic risk profile compared to inhabitants in communities with only a community based health intervention programme. An individual lifestyle oriented health dialogue supported by a global health and risk assessment pedagogic tool seems to be more effective than a community health strategy only.

  18. Mental Health Perceptions and Practices of a Cree Community in Northern Ontario: A Qualitative Study.

    PubMed

    Danto, David; Walsh, Russ

    2017-01-01

    This project is a qualitative study of the mental health perceptions and practices of one Aboriginal community in the northern Ontario James and Hudson Bay region. Despite a shared history of trauma and oppression with the other five Cree communities in this area, as well as an added trauma of natural disaster and subsequent relocation, this community has been reported to have markedly lower rates of mental health services utilization and suicide. Interviews with eight community leaders and mental health services providers were conducted and analyzed in order to identify the features that distinguish this community. In line with recent recommendations for culturally sensitive and community-compatible research methods, participants' narratives were organized in terms of the "medicine wheel" of traditional healing. Results showed strong connection to the land and traditions, openness to both traditional and Christian spirituality, community engagement, and shared parenting as strengths valued by a majority of participants.

  19. Meeting local needs while developing public health practice skills: a model community-academic partnership.

    PubMed

    Rutkow, Lainie; Levin, Mindi B; Burke, Thomas A

    2009-01-01

    Public health graduate education helps future practitioners to develop relevant skills, yet students have few opportunities to gain experience with community-level public health practice beyond work with health departments. Although the importance of academic-community partnerships is mentioned in the classroom, many students believe that they lack the time to pursue hands-on public health work in their local communities. Despite this, community-based organizations recognize the potential benefits of collaborating with public health students. This article describes the inception and implementation of the Connection Community Consultant Group, a program designed to increase interactions between students of public health and community-based organizations as well as to provide a forum for the application of students' developing public health knowledge and skills. Students who participate in the Connection gain public health practice experience in areas such as environmental health, healthcare access, health education, and violence prevention. The Connection serves as a model program for a mutually beneficial exchange: Graduate students can develop public health practice skills, and community-based organizations can capitalize on these skills to meet short-term needs.

  20. "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…

  1. 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…

  2. Motivation of community care givers in a peri-urban area of Blantyre, Malawi.

    PubMed

    Mkandawire, Wanangwa C; Muula, Adamson S

    2005-01-01

    The main objective was to determine motivating factors for community care givers (CCGs), the services they provided to the community, and to identify sources of CCGs' material supplies. A cross sectional qualitative study was done using in-depth key informant interviews with community cares givers and traditional leaders. Analysis was based on themes utilizing content analysis. Most of the CCGs were housewives. Intrinsic motivating factors included feelings of empathy, altruism and religious convictions. Extrinsic motivators were rarely mentioned and these included expected opportunities for loans to start businesses, recognition by the community and eventual employment. The services that CCGs provided in their communities included; offering psycho-spiritual support, providing clothes, food and money to the under-privileged and paying school fees for orphans. In many instances the community care givers were spending from their own personal resources to help the under-privileged, while support from non-governmental organizations could only be sourced erratically. Mobilising resources from the local community through contributions was not seen a viable option. Intrinsic factors are an important motivator for community health volunteers CCGs in the peri-urban area of Blantyre. There is need for community groups to explore the feasibility of tapping from local material and financial resources.

  3. Oral Histories as Critical Qualitative Inquiry in Community Health Assessment.

    PubMed

    Hernandez, Sarah Gabriella; Genkova, Ana; Castañeda, Yvette; Alexander, Simone; Hebert-Beirne, Jennifer

    2017-10-01

    Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories center residents' lived experiences, which often reveal more complex social and health phenomena than conventional qualitative inquiry. This article examines an oral history research component of the Little Village Community Health Assessment, a collaborative research effort to promote health equity in an urban, Mexican ethnic enclave. We collected of 32 oral histories from residents to provide deeper, more grounded insight on community needs and assets. We initially used thematic data analysis. After analytic peer debriefings with the analysis team, we found the process inadvertently reductionist and instead opted for community listening events for participatory data analysis, knowledge translation, and dissemination of findings. Oral histories were most meaningful in their original audio form, adding to a holistic understanding of health by giving voice to complex problems while also naming and describing concepts that were culturally unique. Moreover, the oral histories collectively articulated a counternarrative that celebrated community cultural wealth and opposed the mainstream narrative of the community as deprived. We argue for the recognition and practice of oral histories as a more routine form of qualitative inquiry in community health assessment. In the pursuit of health equity and collaboratively working toward social justice, oral histories can push the boundaries of community health assessment research and practice.

  4. 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

  5. The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

    PubMed

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

    2014-08-19

    Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest-posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  6. Community Characteristics and Qualified Health Plan Selection during the First Open Enrollment Period.

    PubMed

    Boudreaux, Michel; Blewett, Lynn A; Fried, Brett; Hempstead, Katherine; Karaca-Mandic, Pinar

    2017-06-01

    To examine state and community factors that contributed to geographic variation in qualified health plan selection during the first open enrollment period. Administrative data on qualified health plan selections at the ZIP code area merged with survey estimates from the American Community Survey. Descriptive and regression analyses. Data were generated by healthcare.gov and from a household survey. Thirty-one percent of the variation in qualified health plan selection ratios resulted from between-state differences, and the rest was driven by local area differences. Education, language, age, gender, and the ethnic composition of communities contributed to disparate levels of plan selection. Medicaid expansion states had a qualified health plan selection ratio that was 4.4 points lower than non-Medicaid expansion states, controlling for covariates. Our results suggest community-level differences in the intensity or receptiveness to outreach and enrollment activities during the first open enrollment period. © Health Research and Educational Trust.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. Some experience in an area health authority child health clinic.

    PubMed Central

    Illingworth, R S

    1979-01-01

    Three years' experience as a doctor taking two clinics a week in an area health authority child health clinic was reviewed. A wide range of clinical conditions was seen, including: problems associated with feeding in breast- and bottle-fed infants; minor developmental abnormalities (mental, behavioural, and physical); surgical and orthopaedic conditions requiring treatment; medical conditions, mainly respiratory and alimentary infections, skin conditions, and problems of over-treatment for minor ailments; and minor genetic abnormalities. Mothers asked for advice on a wide range of topics, risks and benefits of immunisation being the most common. The clinic doctor needs a wide experience in paediatrics to deal with such problems. It is suggested that all lecturers in child health and paediatric and senior registrars should take one clinic a week for six months, and all medical students should attend some clinics as part of their paediatric training. Health visitors have an important role in helping the clinic doctor, but their training should be more realistic and appropriate facilities should be provided to keep them up to date in their work. PMID:86374

  12. Compositional, Contextual, and Collective Community Factors in Mental Health and Well-Being in Australian Rural Communities.

    PubMed

    Collins, Jessica; Ward, Bernadette M; Snow, Pamela; Kippen, Sandra; Judd, Fiona

    2017-04-01

    There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of "place" contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities.

  13. Compositional, Contextual, and Collective Community Factors in Mental Health and Well-Being in Australian Rural Communities

    PubMed Central

    Collins, Jessica; Ward, Bernadette M.; Snow, Pamela; Kippen, Sandra; Judd, Fiona

    2016-01-01

    There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of “place” contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities. PMID:26848083

  14. Factors influencing motivation and job satisfaction among supervisors of community health workers in marginalized communities in South Africa.

    PubMed

    Akintola, Olagoke; Chikoko, Gamuchirai

    2016-09-06

    Management and supervision of community health workers are factors that are critical to the success of community health worker programmes. Yet few studies have explored the perspectives of supervisors in these programmes. This study explored factors influencing motivations of supervisors in community health worker programmes. We conducted qualitative interviews with 26 programme staff providing supervision to community health workers in eight community-based organizations in marginalized communities in the greater Durban area of South Africa from July 2010 to September 2011. Findings show that all the supervisors had previous experience working in the health or social services sectors and most started out as unpaid community health workers. Most of the participants were poor women from marginalized communities. Supervisors' activities include the management and supply of material resources, mentoring and training of community health workers, record keeping and report writing. Supervisors were motivated by intrinsic factors like making a difference and community appreciation and non-monetary incentives such as promotion to supervisory positions; acquisition of management skills; participation in capacity building and the development of programmes; and support for educational advancement like salary, bonuses and medical benefits. Hygiene factors that serve to prevent dissatisfaction are salaries and financial, medical and educational benefits attached to the supervisory position. Demotivating factors identified are patients' non-adherence to health advice and alienation from decision-making. Dissatisfiers include working in crime-prevalent communities, remuneration for community health workers (CHWs), problems with material and logistical resources, job insecurity, work-related stressors and navigating the interface between CHWs and management. While participants were dissatisfied with their low remuneration, they were not demotivated but continued to be motivated

  15. [The ''neighbourhood health'' strategy: actions focused on areas with special social and health needs].

    PubMed

    Sierra, Isabel; Cabezas, Carmen; Brugulat, Pilar; Mompart, Anna

    2008-12-01

    Through the Law 2/2004 on improving neighbourhoods, urban areas and towns requiring special attention, the Government of Catalonia set up a fund for financing projects prepared by town/city councils for the integral improvement of neighbourhoods. The Ministry of Health signed on to the strategy with The Neighbourhood Health Programme, which was a healthcare policy priority. Healthcare and municipal structures cooperate at neighbourhood level in all of the phases of the community intervention project (analysis and detection of needs, prioritisation of the problems detected, definition and distribution of actions). Techniques such as the nominal group are used. Four vulnerable groups have been identified with higher levels of illness, co-morbidity, situations of risk, etc. (the young, the elderly, women and recent immigrants). The actions of all the agents involved, among them those from the Ministry of Health itself, are then intensified and prioritised and a specific portfolio of public health services is prepared.

  16. Community-based participatory research within the Latino health for all coalition.

    PubMed

    Fawcett, Stephen B; Collie-Akers, Vicki; Schultz, Jerry A; Cupertino, Paula

    2013-01-01

    Despite widespread recognition that Latinos and other minorities are at higher risk for diabetes and cardiovascular diseases, much less is known about how to create conditions for health and health equity. This report presents information about implementation of the Health for All Model in accordance with principles of community-based participatory research (CBPR). Using an empirical case study design, we reported on community changes (i.e., new or modified programs, policies, or practices) facilitated by the coalition and their distribution among primary goal areas (i.e., healthy nutrition, physical activity, and access to health services) and in different community sectors and ecological levels. Qualitative information suggested that the community and scientific partners shared decision making and control, as well as adherence to other principles of community-based participatory research. Such systematic efforts contribute to our understanding of how collaborative action can achieve the changes in conditions necessary to assure health for all.

  17. Air pollution and health in urban areas.

    PubMed

    Schwela, D

    2000-01-01

    In this paper, recent reviews of the World Health Organization, other review papers, and more recent literature on the human health effects of current air pollution trends in urban areas are reviewed and summarized as follows: Sulphur dioxide. Some studies, but not others, found associations between sulphur dioxide (SO2) exposure and daily mortality and morbidity. Single-pollutant correlations sometimes disappeared when other pollutants, especially suspended particulate matter (SPM), were included. Cross-sectional studies with asthmatics revealed significant, non-threshold relations between SO2 and decrements of the forced expiratory volume in 1 second (FEV1). Nitrogen dioxide. Weak associations between short-term nitrogen dioxide (NO2) exposure from gas cooking and respiratory symptoms and a decrement in lung function parameters were found in children, but not consistently in exposed women. With long-term exposure, children, but not adults, exhibit increased respiratory symptoms, decreased lung function, and increased incidences of chronic cough, bronchitis, and conjunctivitis. A causal relationship between NO2 exposure and adverse health effects has not yet been established. Carbon monoxide. Binding of CO in the lungs with hemoglobin in the blood forms carboxyhemoglobin (COHb), which impairs the transport of oxygen. The health effects of CO include hypoxia, neurological deficits and neurobehavioral changes, and increases in daily mortality and hospital admissions for cardiovascular diseases. The latter persists even at very low CO levels, indicating no threshold for the onset of these effects. Whether the relation between daily mortality and exposure to CO are causal or whether CO might act as a proxy for SPM is still an open question. Ambient CO may have even more serious health consequences than does COHb formation and at lower levels than that mediated through elevated COHb levels. Ozone. Short-term acute effects of O3 include pulmonary function decrements

  18. Mental Health Center Services for the Elderly: The Impact of Coordination with Area Agencies on Aging.

    ERIC Educational Resources Information Center

    Lebowitz, Barry D.; And Others

    1987-01-01

    Examined coordination between community mental health centers (CMHCs) and Area Agencies on Aging (AAAs) through survey of 281 CMHCs. Found affiliation with AAA associated with more indirect services of all types; more sites where mental health programs were offered to elderly; and more provision of direct services, such as Alzheimer's disease…

  19. The Art and Process of Negotiation: An Area Health Education Center Model.

    ERIC Educational Resources Information Center

    Hassan, Umar A.

    The negotiating relationship of a medical school and a community-based organization is examined, based on the point of view of a negotiator and the California Area Health Education Center (AHEC) System model. The Health Professions Educational Assistance Act (1974) funds medical schools to negotiate the use of a portion of their educational…

  20. Mental Health Center Services for the Elderly: The Impact of Coordination with Area Agencies on Aging.

    ERIC Educational Resources Information Center

    Lebowitz, Barry D.; And Others

    1987-01-01

    Examined coordination between community mental health centers (CMHCs) and Area Agencies on Aging (AAAs) through survey of 281 CMHCs. Found affiliation with AAA associated with more indirect services of all types; more sites where mental health programs were offered to elderly; and more provision of direct services, such as Alzheimer's disease…

  1. Use of Electronic Health Records in Residential Care Communities

    MedlinePlus

    ... and use varied by facility characteristics. Figure 1. Percentages of residential care communities using electronic health records, by selected community characteristics: United States, 2010 NOTES: For all characteristics, differences were significant at p < 0.05. Figure excludes ...

  2. Conducting a Hispanic Health Needs Assessment in rural Kansas: building the foundation for community action.

    PubMed

    Bopp, Melissa; Fallon, Elizabeth A; Bolton, Debra J; Kaczynski, Andrew T; Lukwago, Susan; Brooks, Alicia

    2012-11-01

    Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity. The assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment. This process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. 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…

  4. 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…

  5. Community vulnerability to health impacts of wildland fire smoke exposure

    EPA Science Inventory

    Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on fact...

  6. Making Things Happen: Community Health Nursing and the Policy Arena.

    ERIC Educational Resources Information Center

    Williams, Carolyn A.

    1983-01-01

    It is important that nurses, particularly those who consider themselves community health nursing specialists, assign a high priority to participation in the formation of health policy and broader public policy. To put subsequent remarks about policy into perspective, it is useful to consider the case for seeing community health nursing as…

  7. Community Health Aides in Grenada: A Proposed Experimental Training Model.

    ERIC Educational Resources Information Center

    Kaur, Manjit; Mayfield, James B.

    1994-01-01

    Key factors of a model for training community health aides are (1) extended time for updating and reinforcing skills; (2) relevance to local situations; (3) group process and interpersonal communication training; (4) practical materials; and (5) participation of physicians, local health workers, and community leaders in rural health policy…

  8. Teaching a Community Health Course. An Interdisciplinary Approach.

    ERIC Educational Resources Information Center

    Corbin, David E.; Leach, Marilyn M.

    1985-01-01

    Community Health 360, a required class for community health educators and exercise science majors at University of Nebraska at Omaha, was developed to teach students the interrelatedness of health, music, art, language, history, and environment. The course and its evaluation by students and by peer review is described. (MT)

  9. Training community health students to develop community-requested social marketing campaigns: an innovative partnership.

    PubMed

    Lindsey, Billie J; Hawk, Carol Wetherill

    2013-01-01

    This paper describes a sustained partnership between a university community health program and local and regional community health agencies. As a key component of the Health Communication and Social Marketing course, the partnership involves undergraduate community health students working for and with community agencies and community members to design social marketing campaigns based on community-identified health needs. The goals of the course are to (1) provide students with the opportunity to work within the community to apply their skills in program planning, evaluation, and communication and (2) provide community agencies with a tailored campaign that can be implemented in their communities. Throughout the 10-week quarter, teams of students follow the principles of community participation in planning a social marketing campaign. These include (1) audience segmentation and formative assessment with the intended audience to determine campaign content and strategies and (2) pretesting and revisions of campaign messages and materials based on community feedback. This partnership contributes to the promotion of health in the local community and it builds the skills and competencies of future health educators. It demonstrates a successful and sustainable combination of community-based participatory research and experiential learning. From 2005 to 2011, 35 campaigns have been developed, many which have been implemented.

  10. 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

  11. African refugee and immigrant health needs: report from a community-based house meeting project.

    PubMed

    Boise, Linda; Tuepker, Anais; Gipson, Teresa; Vigmenon, Yves; Soule, Isabelle; Onadeko, Sade

    2013-01-01

    As in other communities in the United States, information is lacking about the health needs of Africans refugees and immigrants living in Portland, Oregon. In 2008, the African Partnership for Health coalition (APH) was formed to carry out research, advocacy and education to improve the health and well-being of Africans in Oregon. This was APH's initial project. The purposes of this study were to gather data about the perceived health needs and barriers to health care Africans encounter, and lay the foundation for a program of action to guide APH's future work. Community-based participatory research (CBPR) methods were used to collect data on how to improve the health of the African community in the Portland area and define an agenda for future projects. Popular education principles guided the engagement and training of African community members, who conducted nine house meetings with 56 Africans from 14 countries. The results were analyzed by African community members and researchers and prioritized at a community meeting. Three themes emerged: The stressfulness of life in America, the challenges of gaining access to health care, and the pervasive feelings of disrespect and lack of understanding of Africans' health needs, culture, and life experiences by health providers and staff members. Using CBPR methods, we identified and prioritized the needs of the African community. This information provides a framework for future work of the African Partnership for Health and other service and advocacy groups.

  12. Community health screenings can complement public health outreach to minority immigrant communities.

    PubMed

    Siddaiah, Roopa; Roberts, Jon E; Graham, Leroy; Little, Anne; Feuerman, Marty; Cataletto, Mary B

    2014-01-01

    We sought to provide culturally competent, community-based respiratory health screening and education in minority communities with high concentrations of Latino immigrants on Long Island and to assess the impact of this intervention on their decision to seek medical care. Seven health care screenings were performed in communities with high concentrations of immigrants from Latin America. A subgroup of participants who identified themselves as Hispanic/Latino were analyzed. After completion of a respiratory health questionnaire and spirometry, screening scores were calculated, education provided, and recommendations were made for medical evaluation in those who screened positive. A positive screen was defined as abnormal respiratory symptoms, abnormal spirometry, or both. Follow-up contacts were made at 1, 6, and 12 months to assess compliance with the recommendation to seek care in those who screened positive. High positive screening rates for both men (64%) and women (61%) were found. Of the participants who screened positive and were advised to seek medical care, 52% did so. Compliance with the recommendation to seek care was associated with the presence of an identified medical provider at baseline. Of those who screened positive and who did not comply with team's recommendation, 75% were unable to identify a health care provider. A significant number of participants who screened positive could not identify a health care provider and did not follow-up with the recommendation to seek medical evaluation. Community-based screenings provide an opportunity to access at-risk immigrant populations for health screening and education, and to facilitate referral and access to medical services.

  13. [Historical changes in community concepts and the effect of such on community health nursing praxis].

    PubMed

    Yeh, Lily; Chen, Yi-Hsing

    2011-02-01

    In the 21st century, many healthcare programs are delivered in community settings. As such, successfully recruiting target members of the community to participate in programs represents a key challenge for the nursing profession. Although the "community" is not a new concept, its meaning has changed over the past century or more of public healthcare, which has had a profound effect on community health nursing praxis. This article describes changes in community concepts through history in order to define the significance of community participation in today's community health nursing practice.

  14. Community-Based Nursing versus Community Health Nursing: What Does It All Mean?

    ERIC Educational Resources Information Center

    Zotti, Marianne E.; And Others

    1996-01-01

    Offers practice models for community-based nursing and community health nursing that demonstrate the different roles, philosophies, and activities of the two approaches. Points to curriculum changes that are needed to prepare students to practice in an increasingly community-oriented health care industry. (Author)

  15. DEFINING THE "COMMUNITY" FOR A COMMUNITY-BASED PUBLIC HEALTH INTERVENTION ADDRESSING LATINO IMMIGRANT HEALTH DISPARITIES: AN APPLICATION OF ETHNOGRAPHIC METHODS.

    PubMed

    Edberg, Mark; Cleary, Sean; Simmons, Lauren B; Cubilla-Batista, Idalina; Andrade, Elizabeth L; Gudger, Glencora

    2015-01-01

    Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity.

  16. 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.…

  17. 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.…

  18. Community health needs assessment in Wake County, North Carolina: partnership of public health, hospitals, academia, and other stakeholders.

    PubMed

    Alfano-Sobsey, Edie; Ledford, Sue Lynn; Decosimo, Kasey; Horney, Jennifer A

    2014-01-01

    Hospitals and other health care agencies are required to conduct a community health needs assessment (CHNA) every 3 years to obtain information about the health needs and concerns of the population. In 2013, to avoid duplication of efforts and to achieve a more comprehensive CHNA, Wake County Human Services, WakeMed Health and Hospitals, Duke Raleigh Hospital, Rex Healthcare, Wake Health Services, United Way of the Greater Triangle, and the North Carolina Institute for Public Health partnered to conduct a joint assessment for Wake County. Information was collected from the community through opinion surveys and focus groups. To understand the social, economic, and health status of Wake County residents, statistics were also collected from state, county, and local sources. Analysis of all data sources allowed 9 areas of community concern to be identified. Five community forums were held simultaneously at locations in east, south, west, north, and central Wake County to inform residents about the main findings of the assessment and to prioritize the 9 areas of concern. The top 3 priority areas identified were poverty and unemployment, health care access and utilization, and mental health and substance use. Results may not be generalizable to counties in North Carolina that are more rural or to counties outside North Carolina. The success of this unique collaborative process provides further opportunity for the project partners and other organizations to coordinate action plans, pool resources, and jointly address the priorities of this assessment over the next 3 years.

  19. Electronic networks, community intermediaries, and the public's health.

    PubMed Central

    Milio, N

    1996-01-01

    Information technology (IT) has the potential to assist disadvantaged communities in gaining access to mainstream resources, and to a new kind of community health-supporting infrastructure. Federal and state information technology policy will affect how and how well community institutions can reach their goals, collaborate with service agencies, and effectively advocate investing essential, health-supporting resources in their communities. The current information technology focus of the health professions is institution and provider-oriented. It should have a wider scope to include community-based organizations. Laborious efforts undertaken by community-based organizations (CBOs) with only a patchwork of resources and without policy support suggest their value to the public's health. Increasingly burdened public health organizations should examine the public health interest in closing the gap between IT-poor and IT-rich organizations and develop a strategy for building inclusive electronic webs with CBOs. PMID:8826628

  20. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing.

    ERIC Educational Resources Information Center

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.

    1999-01-01

    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  1. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing.

    ERIC Educational Resources Information Center

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.

    1999-01-01

    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  2. Empowerment Praxis: Community Organizing to Redress Systemic Health Disparities.

    PubMed

    Douglas, Jason A; Grills, Cheryl T; Villanueva, Sandra; Subica, Andrew M

    2016-12-01

    Social and environmental determinants of childhood obesity present a public health dilemma, particularly in low-income communities of color. Case studies of two community-based organizations participating in the Robert Wood Johnson Foundation's Communities Creating Healthy Environments (CCHE) childhood obesity initiative demonstrate multilevel, culturally situated community organizing strategies to address the root causes of this public health disparity. Informed by a 3-lens prescription-Social Justice, Culture-Place, and Organizational Capacity-contained in the CCHE Change Model and Evaluation Frame, we present examples of individual, organizational, and community empowerment to redress systemic inequities that manifest in poor health outcomes for people of color. These case studies offer compelling evidence that public health disparities in these communities may effectively be abated through strategies that employ bottom-up, community-level approaches for (a) identifying proximal and distal determinants of public health disparities, and (b) empowering communities to directly redress these inequities. Guided by this ecological framework, application of the CCHE evaluation approach demonstrated the necessity to document the granularity of community organizing for community health, adding to the community psychology literature on empowering processes and outcomes. © Society for Community Research and Action 2016.

  3. 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.

  4. Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia.

    PubMed

    Cyril, Sheila; Polonsky, Michael; Green, Julie; Agho, Kingsley; Renzaho, Andre

    2016-07-15

    Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives.Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives.Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives.Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia.What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However

  5. 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…

  6. 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

  7. Community-based teaching about health disparities: combining education, scholarship, and community service.

    PubMed

    Cené, Crystal W; Peek, Monica E; Jacobs, Elizabeth; Horowitz, Carol R

    2010-05-01

    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.

  8. The future of community health trusts.

    PubMed

    Browning, R

    1996-02-01

    In summary therefore, I believe Community/Mental Health Trusts must: Work closely with purchasers/contracts in context. Focus local services in GP surgeries or own homes. Dispose of unnecessary estate. Concentrate on what they do best. Meet customer needs, improve customers' perceptions and market and publicise services. Cut out restrictive professional practices and increase staff flexibility, information systems etc. Develop customer relations, contracting, business planning. Identify ¿niche' (minority/specialist) markets (including social care). Develop active Quality Assurance, Clinical Audit, outcomes, research programmes. Create effective organisation and management style (Empowerment, delivery). Minimise costs (Value For Money, minimise internal expenditure, rationalise estate, streamline management). Maximise income. Build alliances. Develop user empowerment, advocacy etc. Finally, whatever the future holds we must keep our eye on the ball - the patient - and ensure their needs are paramount over professions and organisations.

  9. 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

  10. 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

  11. Building trusting relationships in online health communities.

    PubMed

    Zhao, Jing; Ha, Sejin; Widdows, Richard

    2013-09-01

    This study investigates consumers' use of online health communities (OHCs) for healthcare from a relationship building perspective based on the commitment-trust theory of relationships. The study proposes that perspective taking, empathic concern, self-efficacy, and network density affect the development of both cognitive and affective trust, which together determine OHC members' membership continuance intention (MCI) and knowledge contribution. Data collected from eight existing OHCs (N=255) were utilized to test the hypothesized model. Results show that perspective taking and self-efficacy can increase cognitive trust and affective trust, respectively. Network density contributes to cognitive and affective trust. Both cognitive trust and affective trust influence MCI, while only affective trust impacts members' knowledge contribution behaviors.

  12. The fear of crime and area differences in health.

    PubMed

    Chandola, T

    2001-06-01

    A number of studies have shown that major health inequalities exist between different areas within the UK. However, there has been some debate about the mechanisms underlying area differences in health. One of the mechanisms which could explain area differences in health is the fear of crime in the local area or neighbourhood. This study examines data from the 1996 British Crime Survey (N=16,090). The fear of crime was found to be associated with self-rated health even after adjusting for health behaviours and a number of individual and household level socio-economic factors. Area differences in self-rated health were reduced to non-significance after health behaviours, socio-economic factors and the fear of crime were adjusted for in the regression model. There is some evidence that fear of crime is associated with health and it may have an important role in explaining area differences in health.

  13. Process evaluation of community kitchens: Results from two Victorian local government areas.

    PubMed

    Lee, Jia Hwa; Palermo, Claire; Bryce, Andrea; McCarten, Julia

    2010-12-01

    this paper describes a process evaluation of the participants and organisations involved in Community Kitchens in the Local Government Areas of Frankston City and Mornington Peninsula Shire in Victoria, Australia. participants, facilitators and project partners from 17 Community Kitchens were invited to participate in the evaluation via a written survey and focus group discussion (participants) or structured telephone interview (facilitators and project partners). Qualitative data were analysed using a thematic analysis approach. ninety-three individuals (63 participants, 20 facilitators, and 10 project partners) participated in the evaluation. Data showed that Community Kitchens reached population sub-groups that face the greatest health inequalities. Project partners were generally satisfied with the project and were able to identify enablers (e.g. support from the project team and running of other concurrent programs) and barriers (e.g. size of the kitchen and transportation) to setting up and sustaining a Community Kitchen. The themes that emerged from participants' and facilitators' experience of participating in the project concerned food and cooking skills, social skills and community participation. the project enabled the development of food knowledge and cooking skills, as well as social skills and support networks among participants and facilitators. There is a need to determine what impact Community Kitchens may have on participants' nutritional status, as well as the effect of Community Kitchens on food security at an individual, household and community level. Further longitudinal studies are needed to affirm the findings of this study.

  14. 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.

  15. 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…

  16. Establishing common ground in community-based arts in health.

    PubMed

    White, Mike

    2006-05-01

    This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus

  17. 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.

  18. Polycythemia Vera Management and Challenges in the Community Health Setting

    PubMed Central

    Gerds, Aaron T.; Dao, Kim-Hien

    2017-01-01

    Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms. For many patients, PV is managed in a community health setting, and it is important that community hematologists, oncologists, and internists are familiar with the contemporary management of PV to improve patient outcomes, including management for patients who present with unique health-care needs. This review provides an overview of current treatment options for patients with PV and discusses challenging circumstances encountered by community providers in the management of PV, including symptom assessment, identification of hydroxyurea resistance/intolerance, pregnancy, elective surgeries, concomitant immunosuppressants, and managing patients in areas with limited access to specialized hematologic care. PMID:28095380

  19. 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.…

  20. [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.

  1. 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).

  2. The interrater reliability of the Community Health Environment Checklist.

    PubMed

    Stark, Susan L; Hollingsworth, Holly; Morgan, Kerri; Chang, Melissa; Gray, David B

    2008-11-01

    The purpose of this preliminary study was to examine the interrater reliability of the Community Health Environment Checklist. Thirty buildings were randomly selected. Three trained raters assessed each destination with the Community Health Environment Checklist. All buildings assessed during this study were located in an urban community in St. Louis, Missouri. Buildings represent 13 categories of building type from a defined geographic region. Not applicable. The outcome measure in this study was the Community Health Environment Checklist, which is used to quantify the receptivity of public buildings from the perspectives of people with mobility impairments. The findings suggest that the subscales of the Community Health Environment Checklist have excellent interrater reliability coefficients, (intraclass correlation coefficient, .76-.99). The findings of this study provide preliminary data to support the clinical utility of the Community Health Environment Checklist as a measure of the receptivity of the physical environment for persons with mobility impairments.

  3. Latino children's health and the family-community health promotion model.

    PubMed Central

    Mendoza, F S; Fuentes-Afflick, E

    1999-01-01

    A majority of Latino children in the US live in poverty. However, unlike other poor children, Latino children do not seem to have a consistent association between poverty and poor health. Instead, many poor Latino children have unexpectedly good health outcomes. This has been labeled an epidemiologic paradox. This paper proposes a new model of health, the family-community health promotion model, to account for this paradox. The family-community health promotion model emphasizes the family-community milieu of the child, in contrast to traditional models of health. In addition, the family-community model expands the outcome measures from physical health to functional health status, and underscores the contribution of cultural factors to functional health outcomes. In this paper, we applied the family-community health promotion model to four health outcomes: low birthweight, infant mortality, chronic and acute illness, and perceived health status. The implications of this model for research and policy are discussed. PMID:10063394

  4. 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.

  5. Exploration Into the Business Priorities Related to Corporate Engagement in Community Health Improvement Partnerships.

    PubMed

    Pronk, Nicolaas P; Baase, Catherine; May, Jeanette; Terry, Paul; Moseley, Karen

    2017-07-24

    To explore factors that matter to business in making decisions regarding engagement in community health improvement efforts. Using qualitative methods, domains of interest were identified through literature reviews and expert interviews. Relevance of the domains in terms of potential priorities for action was tested through employer and community stakeholder interviews. Factors that employers considered important to sustained community collaboration as a business priority included (1) credibility of the convener, (2) broad representation of the community, (3) strong mission and goals, (4) individual commitment to health, (5) organizational commitment to health, and (6) demonstrated commitment from leadership. Priorities have been identified for engaging business in community health efforts. Implications for research, practice, and policy include the need for measurement, transparency in reporting, and agreement on principles for public-private partnership in this area.

  6. The Chicago Health Corps: strengthening communities through structured volunteer service.

    PubMed

    McElmurry, B J; Wansley, R; Gugenheim, A M; Gombe, S; Dublin, P

    1997-01-01

    The Chicago Health Corps is an AmeriCorps*USA program, established in 1994 by the Corporation for National Service in partnership with the Health Resources and Services Administration (HRSA) of the U.S. Public Health Service. The Chicago Health Corps deploys 20 full-time equivalent corps members in selected community sites that offer primary health care services to Chicago's underserved families. Chicago Health Corps members provide a combination of outreach, home visit, and case management services to address unmet health needs identified by community members, including both laypersons and professionals. Providing meaningful opportunities for participants to assist their communities with health care helps corps members develop an awareness of their fellow community members and an ethic of service.

  7. Community mental health nursing: keeping pace with care delivery?

    PubMed

    Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa

    2008-06-01

    The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.

  8. Access to eye health services among indigenous Australians: an area level analysis

    PubMed Central

    2012-01-01

    Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %). The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA). Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO) guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help. PMID:22998612

  9. Community management that works: how to build and sustain a thriving online health community.

    PubMed

    Young, Colleen

    2013-06-11

    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.

  10. 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

  11. A community mental health service delivery model: integrating the evidence base within existing clinical models.

    PubMed

    Flannery, Frank; Adams, Danielle; O'Connor, Nick

    2011-02-01

    A model of care for community mental health services was developed by reviewing the available literature, surveying ?best practice? and evaluating the performance of existing services in a metropolitan area mental health service servicing a population of approximately 1.1 million people. A review of relevant academic literature and recognized ?good practice? service delivery models was undertaken in conjunction with a review of local activity data and consultation with key stakeholders (not addressed in this paper). A model was developed identifying the core functions of community mental health service delivery. The components of a comprehensive, integrated model of community mental health service (CMHS) are outlined. The essential components of a comprehensive, integrated model of CMHSs include: acute and emergency response, community continuing care services, assertive rehabilitation teams, partnerships with general practitioners and other human services agencies. We propose a comprehensive integrated model of community mental health service. Clarity of role, required outputs and expected outcomes will assist the development of effective and appropriate community mental health services. Outreach to the community is a key success factor for these services and their associated inpatient services. Gap analysis can assist in the planning and costing of community mental health services.

  12. Pasadena Area Community College District Community Needs Assessment Study: Final Report.

    ERIC Educational Resources Information Center

    Lau, Peter

    A needs assessment of local residents was conducted in the Pasadena Area Community College District to provide information for college planning. Telephone interviews solicited information on residents' characteristics, knowledge of Pasadena City College (PCC), attitudes toward the college, and past and anticipated participation in college…

  13. Electronic health record project initiation and early planning in a community health center.

    PubMed

    Cortelyou-Ward, Kendall; Noblin, Alice; Martin, Jeremy

    2011-01-01

    Community health centers exist to help their constituents become proactive in addressing their own health care needs and to improve the overall well-being of the community. However, they pose a different set of challenges when implementing an electronic health record system. This article applies 2 project management principles, initiation and early planning, to the electronic health record implementation in a community health center. Issues such as planning, financial considerations, and quality improvement are discussed.

  14. Online Health Communities and Chronic Disease Self-Management.

    PubMed

    Willis, Erin; Royne, Marla B

    2017-03-01

    This research uses content analysis (N = 1,960) to examine the computer-mediated communication within online health communities for evidence of chronic disease self-management behaviors, including the perceived benefits and perceived barriers to participating in such behaviors. Online health communities act as informal self-management programs led by peers with the same chronic disease through the exchange of health information. Online health communities provide opportunities for health behavior change messages to educate and persuade regarding chronic disease self-management behaviors.

  15. COMMUNITY ENGAGEMENT IN CHILDREN’S ENVIRONMENTAL HEALTH RESEARCH

    PubMed Central

    Brenner, Barbara L.; Manice, Melissa P.

    2010-01-01

    Community engagement strategies and skills can build trust and reduce historical mistrust between researchers, communities and populations being studied, as well as contribute to the quality of study designs, methods and dissemination of findings. This review paper discusses why community engagement is of increasing importance in children’s environmental health research, describes models and the continuum of methods that are used and discusses their challenges and benefits. Two case studies, representing different study designs and using different community engagement models and methods, and lessons learned from these cases are described. Community engagement methods are best understood on a continuum based on the degree to which community members or representatives of community populations are involved in research planning, decision making and dissemination. Methods along this continuum include community consultation, community based participatory research(CBPR) and community consent to research. Community engagement knowledge and skills are especially important in the conduct of children’s environmental health research with its emphasis on reducing environmental risks at the community level; the increasing focus on genetics and gene-environment interactions; and the importance placed on translation of scientific results into behaviors and policies that protect the community. Across study designs, whether qualitative survey research, an observational epidemiology study, or a randomized intervention trial, understanding community interests, norms and values is necessary to describe attitudes and behaviors of specific population groups, build evidence of cause and effect between environmental exposures and health and/or that demonstrate the effectiveness of interventions to reduce risks. PMID:21259265

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

    PubMed

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

    2016-02-01

    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. 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. 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. 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 areas for action if success of policy change through

  17. 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

  18. 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

  19. Men's health and communities of practice in Australia.

    PubMed

    Henwood, Maree; Shaw, Amie; Cavanagh, Jillian; Bartram, Timothy; Marjoribanks, Timothy; Kendrick, Madeleine

    2017-04-10

    Purpose The purpose of this paper is to examine the social opportunities for Aboriginal and Torres Strait Islander men created through Men's Groups/Sheds across urban, regional and remote areas of Australia. Men's Sheds are a safe space, resembling a work-shop setting or backyard shed, where men are encouraged to socialise and participate in health promotion, informal learning and engage in meaningful tasks both individually and at the community level. Design/methodology/approach Explore five case study sites through Wenger's (1998) active communities of practice (CoP). Qualitative methods are presented and analysed; methods comprise semi-structured interviews and yarning circles (focus groups). Five Indigenous leaders/coordinators participated in semi-structured interviews, as well as five yarning circles with a total of 61 Indigenous men. Findings In a societal context in which Indigenous men in Australia experience a number of social and health issues, impeding their quality of life and future opportunities, the central finding of the paper is that the effective development of social relations and socially designed programs through Men's Groups, operating as CoP, may contribute to overcoming many social and health well-being concerns. Originality/value Contributions will provide a better understanding of how Indigenous men are engaging with Men's Sheds, and through those interactions, are learning new skills and contributing to social change.

  20. 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.

  1. A survey of community gardens in upstate New York: implications for health promotion and community development.

    PubMed

    Armstrong, D

    2000-12-01

    Twenty community garden programs in upstate New York (representing 63 gardens) were surveyed to identify characteristics that may be useful to facilitate neighborhood development and health promotion. The most commonly expressed reasons for participating in gardens were access to fresh foods, to enjoy nature, and health benefits. Gardens in low-income neighborhoods (46%) were four times as likely as non low-income gardens to lead to other issues in the neighborhood being addressed; reportedly due to organizing facilitated through the community gardens. Additional research on community gardening can improve our understanding of the interaction of social and physical environments and community health, and effective strategies for empowerment, development, and health promotion.

  2. Ecology and community health in the north.

    PubMed

    Petrova, P G; Yakovleva, N P; Zakharova, F A

    2001-04-01

    Health of a nation is a sensitive barometer of the environmental situation, especially in the North, where vulnerable nature cannot resist intensive industrial development. The geographical location and severe climatic conditions of the Republic of Sakha (Yakutia) significantly sharpen any negative impact of industrial activity on the state of the environment. The impact of ecological factors on the health of population has been studied in the case of a diamond province (Vilyuy region), where a complex of chemical pollutants from diamond mining, products of wood decay in places of flooding of the water reservoir for the Vilyuisk power station, highly mineralised underground waters and consequences of underground explosions have caused a substantial negative effect on the environment and people. Studies on the health of the population in the Vilyuy region has shown that sickness and morbidity rates of viral hepatitis, tuberculosis, pathologies during pregnancy and other diseases are higher in comparison to rates in the Republic as a whole, a feature which has been attributed to environmental degradation in the area.

  3. Health Concerns in Communities and the Wider Benefits of Learning. Perspectives from Practice in Scotland.

    ERIC Educational Resources Information Center

    Tett, Lyn

    A study examined the ways a group of people experiencing poverty, poor housing, and stress assessed the impact of these factors on their health through participating in a course called "Health Issues in the Community." It involved people from a range of socioeconomically excluded areas and groups throughout Scotland in identifying and…

  4. Community Health Education Consortia (CHEC) Feasibility Study of Northeast Central Nebraska. Final Report.

    ERIC Educational Resources Information Center

    Hutkin, Ronald M.; Holmberg, Mary Lou

    This study sought to determine the extent of existing in-service education programs in health care available in northeast central Nebraska and to determine if there was a need for a Community Health Education Consortium (CHEC). Two questionnaires were developed for the study and were mailed to hospitals and nursing homes in a 22 county area; 86%…

  5. Lichen communities for forest health monitoring in Colorado, USA: A report to the USDA Forest Service

    Treesearch

    Bruce McCune; Paul Rogers; Andrea Ruchty; Bruce Ryan

    1998-01-01

    Lichen communities were included in the Forest Health Monitoring program because they help to answer several key assessment questions. These questions concern the contamination of natural resources, biodiversity, forest health, and sustainability of timber production. Field crews collected data on epiphytic macrolichens from throughout forested areas of Colorado from...

  6. 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…

  7. Health worker recruitment and deployment in remote areas of Indonesia.

    PubMed

    Efendi, Ferry

    2012-01-01

    Providing health care in remote and very remote areas has long been a major concern in Indonesia. In order to improve access to quality health care for residents in these areas, various policies on recruitment and deployment of health workers have been implemented, among them compulsory service, contracted staff and the Special Assignment of strategic health workers. Indonesia's difficult geography presents great challenges to health service delivery and most health workers prefer to serve in urban areas, resulting in an uneven distribution of health workers and shortages in remote areas. Great efforts have been made to mobilize health human resources more equitably, including placement schemes for strategic health workers and contracted staff, combined with an incentive scheme. While these have partially addressed the severe shortage of health workers in remote areas, current government policies were reviewed in order to clarify the current situation in Indonesia. The Contracted Staff and Special Assignment of Strategic Health Workers programs show have made a significant contribution to improving the availability of health workers in Indonesia's remote areas. As these two programs used financial incentives as the main intervention, other non-financial interventions should also be trialed. For example, incentives such as the promise of a civil servant appointment or the provision of continuing professional education, as well as the recruitment of rural-background health workers may increase the willingness of health staff to serve in the remote and very remote areas of Indonesia.

  8. China's community-based strategy of universal preconception care in rural areas at a population level using a novel risk classification system for stratifying couples´ preconception health status.

    PubMed

    Zhou, Qiongjie; Zhang, Shikun; Wang, Qiaomei; Shen, Haiping; Tian, Weidong; Chen, Jingqi; Acharya, Ganesh; Li, Xiaotian

    2016-12-28

    Preconception care (PCC) is recommended for optimizing a woman's health prior to pregnancy to minimize the risk of adverse pregnancy and birth outcomes. We aimed to evaluate the impact of strategy and a novel risk classification model of China´s "National Preconception Health Care Project" (NPHCP) in identifying risk factors and stratifying couples' preconception health status. We performed a secondary analysis of data collected by NPHCP during April 2010 to December 2012 in 220 selected counties in China. All couples enrolled in the project accepted free preconception health examination, risk evaluation, health education and medical advice. Risk factors were categorized into five preconception risk classes based on their amenability to prevention and treatment: A-avoidable risk factors, B- benefiting from targeted medical intervention, C-controllable but requiring close monitoring and treatment during pregnancy, D-diagnosable prenatally but not modifiable preconceptionally, X-pregnancy not advisable. Information on each couple´s socio-demographic and health status was recorded and further analyzed. Among the 2,142,849 couples who were enrolled to this study, the majority (92.36%) were from rural areas with low education levels (89.2% women and 88.3% men had education below university level). A total of 1463266 (68.29%) couples had one or more preconception risk factors mainly of category A, B and C, among which 46.25% were women and 51.92% were men. Category A risk factors were more common among men compared with women (38.13% versus 11.24%; P = 0.000). This project provided new insights into preconception health of Chinese couples of reproductive age. More than half of the male partners planning to father a child, were exposed to risk factors during the preconception period, suggesting that an integrated approach to PCC including both women and men is justified. Stratification based on the new risk classification model demonstrated that a majority of the

  9. 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,…

  10. Community Assessment Methods in Rural Mental Health Promotion.

    ERIC Educational Resources Information Center

    Nettekoven, Linda; Sundberg, Norman

    1985-01-01

    Describes community assessment component of four-part training model designed to prepare doctoral students to carry out mental health promotion projects in rural settings. Incorporates windshield survey, ratings of community impressions, archival data, community leadership analysis, key informant interviews, person along-the-street interviews,…

  11. [Social determinants of health: community features and nurse work in family health care].

    PubMed

    Sant'Anna, Cynthia Fontella; Cezar-Vaz, Marta Regina; Cardoso, Leticia Silveira; Erdmann, Alacoque Lorenzini; Soares, Jorgana Fernanda de Souza

    2010-03-01

    The purpose of this study is to identify the Social Determinants of Health Care which emerge in nurses' statements as they characterize the community, analyzing its relation to the work carried out by them. It is an exploratory and descriptive study containing a qualitative analysis in the theoretical categories of the determinants. We used a semi-structured interview, recorded with the permission of the 65 nurses of the Family Health Care, members of the 3rd Regional Health Care Coordination of Rio Grande do Sul, Brazil. It has been shown the inter- and intra-relation in the health determinant factors, obtaining 104 citations for the anatomo-physiological features of the corresponding individuals/community to the proximal correspondents and in association, mainly, to the work carried out by the nurses. For intermediate determinants there were 27 citations and, for distals, 166, with predominant reference to the territorial localization of communities in rural areas and peripheries. The nurses have stated a narrow relation between the proximal features and the work carried out by them, as well as the connection with other determinants in the relation with the process of getting sick.

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

    PubMed Central

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

    2016-01-01

    Summary 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. PMID:26917110

  13. A Community Mental Health Approach to Drug Addiction.

    ERIC Educational Resources Information Center

    Brotman, Richard; Freedman, Alfred

    The nature of the historical changes in the presumed stereo-types of drug users in the United States, and the associated policy changes, are described in this report which takes a community health viewpoint of drug use while concurrently dealing with the individual. Eight case histories illustrate the community mental health approach in action.…

  14. 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.

  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. 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…

  17. Spokane Community Mental Health Center--Elderly Services.

    ERIC Educational Resources Information Center

    Raschko, Raymond

    This document describes services for the elderly provided by the Spokane Community Mental Health Center (CMHC) in Spokane, Washington. It begins by stating several reasons that the elderly are often unserved or underserved by health and social service agencies and by noting the need for community efforts to identify and locate the subpopulation of…

  18. Conference report: community health centers and vulnerable workers.

    PubMed

    Robbins, Anthony

    2013-01-01

    A one-day conference in Washington brought together leaders of community health centers and worker advocates to discuss collaboration. They agreed that health centers could help protect vulnerable workers. They agreed on use of electronic medical records; access to workers compensation; Medical-Legal Partnerships; better understanding of work settings in their communities; and educating clinicians on work and jobs.

  19. Community Health Nursing Curriculum. Components in Baccalaureate Nursing Education.

    ERIC Educational Resources Information Center

    Catell, Grace Manion

    Community health nursing curriculum components in a sample of baccalaureate nursing programs were investigated. Questionnaires were sent to a sample of 12 National League of Nursing (NLN) accredited, generic, baccalaureate nursing programs representative of the four NLN regions in the United States. Community health nursing content in theory…

  20. 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)

  1. Promoting Good Health for Community College Students. ERIC Digest.

    ERIC Educational Resources Information Center

    McKinney, Kristen J.

    This digest discusses a variety of methods that community colleges have employed to integrate health care into the curriculum and campus services. Providing health care in community colleges is particularly challenging due to the lack of institutional resources, as compared with four-year colleges and universities where the residential living…

  2. 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.

  3. Rural Community Mental Health Centers' Responses to the Farm Crisis.

    ERIC Educational Resources Information Center

    Mermelstein, Joanne; Sundet, Paul A.

    1986-01-01

    Survey of 20 community mental health centers in 12 Midwest grain belt farm states found continuum of farm crisis problems requires professional responses consistent with philosophy and goals of community mental health. Results indicate responses vary, not in relationship to severity of problems, but because of center philosophy and resource…

  4. Community financed and operated health services: the case of the Ajo-Lukeville Health Service District.

    PubMed

    Lopes, P M; Nichols, A W

    1990-07-01

    The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.

  5. 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

  6. Community health workers and home-based care programs for HIV clients.

    PubMed Central

    Johnson, Becky A.; Khanna, Sunil K.

    2004-01-01

    In Nyanza Province, Kenya, estimated HIV prevalence is 22%. Given that more than 80% of the population resides in rural areas, the majority of individuals in Nyanza Province do not have access to medical facilities on a regular basis. In response to the growing demands the HIV epidemic has placed on the people and communities in this region, hundreds of lay individuals have been trained as community health workers to provide home-based care to sick or dying HIV/AIDS clients in rural areas. This paper discusses the role and impact of these community health workers in Nyanza Province, Kenya. It outlines the collaborative relationship between community health workers and the Ministry of Health, examining community health workers' use of extant biomedical structures at the district level to provide services that government-run health facilities lack the monetary resources or personnel to provide. Finally, it explores the role played by community health workers in providing HIV/AIDS education to individuals in an attempt to prevent further infections. PMID:15101670

  7. Building a Pediatric Oral Health Training Curriculum for Community Health Workers.

    PubMed

    Martin, Molly; Frese, William; Lumsden, Christie; Sandoval, Anna

    2017-06-16

    Community health workers (CHWs) are a promising approach to oral health promotion in high-risk populations. This article describes the process of creating a pediatric oral health CHW training curriculum. Existing curricula were identified through outreach efforts to experts in the oral health and CHW fields, as well as PubMed and Google searches. After coding basic information, curricula were mapped to define oral health domains. Then group discussion was employed to determine final curriculum contents. United States. Curricula were included if they addressed oral health, were in English or Spanish, involved US populations, did not target dental clinicians, and whether sufficient data could be obtained. Curricula were evaluated for delivery format, number of hours, target audience, inclusion of CHWs, completeness, and oral health content. Eighteen unique curricula were identified; 14 (78%) were CHW specific. Pathologic factors, caries formation, toothbrushing basics, flossing, nutrition, sugar-sweetened beverages, oral health recommendations, baby bottle tooth decay, fluoride treatments, and fluoride were covered to some extent in 75% of curricula. More than half did not mention types of teeth, oral health during pregnancy, antifluoride, cultural humility, and special needs populations. After comparing CHW curricula with non-CHW curricula, the original 26 oral health domains were condensed into 10 CHW training domains. Using existing evidence and expert insight, an oral health CHW training curriculum outline was created that emphasizes behaviors, social support, and navigation assistance to promote preventive oral health behaviors in families of young children. This has implications beyond oral health. CHW programs are expanding to address the social determinants of health. The process of creating this curriculum and its basic elements can be applied to other disease areas. Clearly defined trainings that are made publicly available, such as this one, support

  8. Participatory Democracy, Community Organizing and the Community Assessment of Freeway Exposure and Health (CAFEH) Partnership.

    PubMed

    Sprague Martinez, Linda; Reisner, Ellin; Campbell, Maria; Brugge, Doug

    2017-02-04

    Background: Conflicting interests, power imbalance and relationships characterized by distrust are just a few of the many challenges community-academic research partnerships face. In addition, the time it takes to build relationships is often overlooked, which further complicates matters and can leave well-intentioned individuals re-creating oppressive conditions through inauthentic partnerships. This paper presents a novel approach of using meeting minutes to explore partnership dynamics. The Community Assessment of Freeway Exposure and Health (CAFEH) partnership is used as an illustrative case study to identify how community academic partnerships overcome the challenges associated with community-based participatory research (CBPR). CAFEH is a study of ultrafine particle exposure (UFP) near highways in the Boston, MA area. Methods: Qualitative analysis was applied to meeting minutes and process evaluation reports from the first three years of the CAFEH study (n = 73 files). In addition, a group meeting was held with project partners in order to contextualize the findings from the document analysis. Results: The three most commonly referenced challenges included language barriers, the overall project structure and budgetary constraints. Meanwhile, a heavy emphasis on process and an approach steeped in participatory democracy facilitated CAFEH's ability to overcome these challenges, as well as sustain and augment strong partnership ties. Conclusions: This experience suggests that leadership that incorporates an organizing approach and a transformational style facilitates CBPR processes and helps teams surmount challenges.

  9. Project TEACH: A Capacity-Building Training Program for Community-Based Organizations and Public Health Agencies.

    PubMed

    Sauaia, Angela; Tuitt, Nicole R; Kaufman, Carol E; Hunt, Cerise; Ledezma-Amorosi, Mariana; Byers, Tim

    2016-01-01

    Project TEACH (Teaching Equity to Advance Community Health) is a capacity-building training program to empower community-based organizations and regional public health agencies to develop data-driven, evidence-based, outcomes-focused public health interventions. TEACH delivers training modules on topics such as logic models, health data, social determinants of health, evidence-based interventions, and program evaluation. Cohorts of 7 to 12 community-based organizations and regional public health agencies in each of the 6 Colorado Area Health Education Centers service areas participate in a 2-day training program tailored to their specific needs. From July 2008 to December 2011, TEACH trained 94 organizations and agencies across Colorado. Training modules were well received and resulted in significant improvement in knowledge in core content areas, as well as accomplishment of self-proposed organizational goals, grant applications/awards, and several community-academic partnerships.

  10. 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

  11. Conducting Community Health Needs Assessments in the Local Public Health Department: A Comparison of Random Digit Dialing and the Community Assessment for Public Health Emergency Response.

    PubMed

    Stone, Kahler; Sierocki, Allison; Shah, Vaidehi; Ylitalo, Kelly R; Horney, Jennifer A

    2017-01-30

    Community health needs assessments (CHNAs) are now required by the Affordable Care Act (ACA) for nonprofit hospitals and the Public Health Accreditation Board (PHAB) for local health departments that seek accreditation. Currently, various primary data collection methods exist that meet the ACA and PHAB requirements. To compare 2 CHNA data collection methods implemented in the same geographical area from a local health department perspective. Two community surveys, one door-to-door and one telephone, in the 76706 zip code area of McLennan County, Texas. Adult survey respondents (Community Assessment for Public Health Emergency Response [CASPER]: N = 184; random digit dialing [RDD]: N = 133) of the 76706 zip code in McLennan County, Texas. Survey response rates, sociodemographic characteristics of survey respondents, and self-reported health behaviors from both community survey types. The CASPER survey had a contact rate of 36.0% and a cooperation rate of 60.5%, compared with a 10.1% response rate for the RDD survey. CASPER respondents were younger (26.6% aged 18-24 years), had lower education attainment (17.4% less than high school), and had a higher proportion of Hispanics (24.5%) than RDD respondents (4.6%, 10.5%, and 17.3%, respectively). CASPER respondents were less likely to report being overweight or obese (56.5%), to report days where no fruit or vegetables were consumed (7.1%), and to report days where no walking activity was conducted (9.8%) than RDD respondents (70.2%, 27.8%, and 21.8%, respectively). The CASPER survey cost less to conduct ($13 500) than the RDD survey ($100 000) and was logistically easier for the local health department to conduct using internally available resources. Local health departments use various data collection methods to conduct CHNAs for their populations and require varying levels of commitment and resources. RDD and CASPER can be used to meet ACA and PHAB requirements, collecting valuable health needs estimates and offer

  12. 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…

  13. 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…

  14. Implementation research on community health workers’ provision of maternal and child health services in rural Liberia

    PubMed Central

    Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J

    2017-01-01

    Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511

  15. Implementation research on community health workers' provision of maternal and child health services in rural Liberia.

    PubMed

    Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J; Panjabi, Rajesh

    2017-02-01

    To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes.

  16. A spiritual health community seminar based on religious commitment research.

    PubMed

    Lottes, Christine R; Engstrom, Del; Engstrom, Lorri F

    2002-12-01

    There is a need for spiritual health seminars at the work site and through hospital and other community venues. This article describes how the authors prepared for and conducted seminars in their community. The research demonstrates that religious commitment may play a beneficial role in an individual's health. Once the authors were armed with this research and a fundamentally sound and practical program, they were able to assist individuals in their community in designing and initiating their own individual spiritual health workouts, which may then influence their physical and mental health. In this way, the authors were able to apply holistic principles of spirit, mind, and body.

  17. Exploring the expanded practice roles of community mental health nurses.

    PubMed

    Elsom, Stephen; Happell, Brenda; Manias, Elizabeth

    2007-04-01

    Significant changes to the delivery of mental health services have resulted in the expansion of the community mental health nursing role. This qualitative study was undertaken to explore the extent to which community mental health nurses are currently engaged in expanded forms of practice. Focus groups were undertaken with community mental health nurses (n = 27) from metropolitan and rural Victoria, Australia. Thematic analysis identified the following major themes: reported practice, consumers as beneficiaries of expanded practice, risk of harm and litigation, and barriers to expanded practice. The findings emphasize the need for significant changes in current legislation if expanded practice for nurses is to become a reality.

  18. 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.

  19. The Central San Joaquin Valley Area Health Education Center

    PubMed Central

    Rosinski, Edwin F.

    1978-01-01

    With federal financial support, an area health education center was established in the central San Joaquin Valley of California. The center is a cooperative health sciences education and health care program organized by the University of California and some of the educational and health care institutions of the valley. The center's goals include providing and improving primary health care education, and improving the distribution of health personnel. These goals are achieved through the cooperative development of a number of independent and interdependent activities. An extensive evaluation of the Area Health Education Center has shown that it is a highly effective program. PMID:664636

  20. Service planning in the Victorian community health sector.

    PubMed

    Roussy, Véronique; Livingstone, Charles

    2015-01-01

    Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.

  1. Species-time-area and phylogenetic-time-area relationships in tropical tree communities

    PubMed Central

    Swenson, Nathan G; Mi, Xiangcheng; Kress, W John; Thompson, Jill; Uriarte, María; Zimmerman, Jess K

    2013-01-01

    The species-area relationship (SAR) has proven to be one of the few strong generalities in ecology. The temporal analog of the SAR, the species-time relationship (STR), has received considerably less attention. Recent work primarily from the temperate zone has aimed to merge the SAR and the STR into a synthetic and unified species-time-area relationship (STAR) as originally envisioned by Preston (1960). Here we test this framework using two tropical tree communities and extend it by deriving a phylogenetic-time-area relationship (PTAR). The work finds some support for Preston's prediction that diversity-time relationships, both species and phylogenetic, are sensitive to the spatial scale of the sampling. Contrary to the Preston's predictions we find a decoupling of diversity-area and diversity-time relationships in both forests as the time period used to quantify the diversity-area relationship changes. In particular, diversity-area and diversity-time relationships are positively correlated using the initial census to quantify the diversity-area relationship, but weakly or even negatively correlated when using the most recent census. Thus, diversity-area relationships could forecast the temporal accumulation of biodiversity of the forests, but they failed to “back-cast” the temporal accumulation of biodiversity suggesting a decoupling of space and time. PMID:23762505

  2. Species-time-area and phylogenetic-time-area relationships in tropical tree communities.

    PubMed

    Swenson, Nathan G; Mi, Xiangcheng; Kress, W John; Thompson, Jill; Uriarte, María; Zimmerman, Jess K

    2013-05-01

    The species-area relationship (SAR) has proven to be one of the few strong generalities in ecology. The temporal analog of the SAR, the species-time relationship (STR), has received considerably less attention. Recent work primarily from the temperate zone has aimed to merge the SAR and the STR into a synthetic and unified species-time-area relationship (STAR) as originally envisioned by Preston (1960). Here we test this framework using two tropical tree communities and extend it by deriving a phylogenetic-time-area relationship (PTAR). The work finds some support for Preston's prediction that diversity-time relationships, both species and phylogenetic, are sensitive to the spatial scale of the sampling. Contrary to the Preston's predictions we find a decoupling of diversity-area and diversity-time relationships in both forests as the time period used to quantify the diversity-area relationship changes. In particular, diversity-area and diversity-time relationships are positively correlated using the initial census to quantify the diversity-area relationship, but weakly or even negatively correlated when using the most recent census. Thus, diversity-area relationships could forecast the temporal accumulation of biodiversity of the forests, but they failed to "back-cast" the temporal accumulation of biodiversity suggesting a decoupling of space and time.

  3. Are You Making an Impact? Evaluating the Population Health Impact of Community Benefit Programs.

    PubMed

    Rains, Catherine M; Todd, Greta; Kozma, Nicole; Goodman, Melody S

    2017-08-29

    The Patient Protection and Affordable Care Act includes a change to the IRS 990 Schedule H, requiring nonprofit hospitals to submit a community health needs assessment every 3 years. Such health care entities are challenged to evaluate the effectiveness of community benefit programs addressing the health needs identified. In an effort to determine the population health impact of community benefit programs in 1 hospital outreach department, researchers and staff conducted an impact evaluation to develop priority areas and overarching goals along with program- and department-level objectives. The longitudinal impact evaluation study design consists of retrospective and prospective secondary data analyses. As an urban pediatric hospital, St Louis Children's Hospital provides an array of community benefit programs to the surrounding community. Hospital staff and researchers came together to form an evaluation team. Data from program evaluation and administrative data for analysis were provided by hospital staff. Impact scores were calculated by scoring objectives as met or unmet and averaged across goals to create impact scores that measure how closely programs meet the overarching departmental mission and goals. Over the 4-year period, there is an increasing trend in program-specific impact scores across all programs except one, Healthy Kids Express Asthma, which had a slight decrease in year 4 only. Current work in measuring and assessing the population health impact of community benefit programs is mostly focused on quantifying dollars invested into community benefit work rather than measuring the quality and impact of services. This article provides a methodology for measuring population health impact of community benefit programs that can be used to evaluate the effort of hospitals in providing community benefit. This is particularly relevant in our changing health care climate, as hospitals are being asked to justify community benefit and make meaningful

  4. Recent developments in the health care area.

    PubMed

    Harper, T D; Berg, R N

    1980-09-01

    Of late, there have been several court decisions of significance in the United States in the health care area. In 1 case the Supreme Court was faced with the question of whether or not states were required to fund abortions under the Medicaid program. In a 2nd case, a lower court was required to determine whether a Professional Standards Review Organization (PSRO) was a federal agency subject to the disclosure requirements of the federal Freedom of Information Act. Both of these issues are discussed. The Supreme Court authoritatively and conclusively established that a woman has no constitutional right to a state or federally funded abortion and with this ruling resolved several contrary lower court decisions and extended Congressional power to limit the expenditure of federal funds. Congress has established by a funding exclusion commonly referred to as the "Hyde Amendment," a limitation upon the expenditure of federally appropriated funds provided pursuant to Title 19 of the Social Security Act (Medicaid). A United States District Court in Georgia held that this exclusion was not to affect a state's duty to fund abortions deemed to be "medically necessary." A United States District Court in New York held the Hyde Amendment to be unconstitutional for failing to require funding of abortions that were deemed medically necessary. Contrary to the Georgia Court's ruling, the Supreme Court determined that the Medicaid program provides no unilateral funding obligation for a state which chooses to participate in the system. Contrary to the New York Court's ruling, the Sumpreme Court concluded that the Hyde Amendment is not constitutionally deficient. The Supreme Court determined that the limitation of abortion funding does not constitute a violation of the Establishment Clause of the 1st Amendment and that the limitation upon funding does not constitute a violation of the Equal Protection Clause of the 14th Amendment. The District Court in the District of Columbia

  5. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru

    PubMed Central

    Brown, Angela; Malca, Rosa; Zumaran, Adriana; Miranda, J Jaime

    2006-01-01

    Objective To describe the profile of community health workers – health promoters, traditional birth attendants and traditional healers – in rural Quechua communities from Ayacucho, Peru. Methods Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. Results The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. Conclusion It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues. PMID:16707010

  6. A Community Approach: School-Based Health Care Delivery.

    ERIC Educational Resources Information Center

    Warren, Rueben C.

    1980-01-01

    School based health care systems are a viable alternative to existing health care delivery methods because they can improve the health of all children, especially those that are indigent and living in medically underserved areas. (JD)

  7. [Health for all--the development of community health nursing and public health nursing from the perspective of education].

    PubMed

    Lin, Pay-Fan

    2014-06-01

    The purpose of this article was to examine the development of community health nursing and public health nursing in Taiwan from an educational perspective. Key issues addressed include: teaching strategies and scopes of practice used in community health nursing in Taiwan between 1910 and the 1950s; the philosophical foundations for the concepts of "health for all" and "social justice" in Taiwan's community health nursing; the five "P"s of community health nursing teaching and practice (population, prevention, promotion, policy, and partnership); the core competencies and scope of practice of community health nursing proposed by the TWNA Community Health Nursing Committee; and the core competencies and the tiers of classification proposed by the Quad Council of Public Health Nursing Organizations. This article helps to elucidate the inseparable relationship between community health nursing education and practice at both the micro and macro level and examines possible future directions for community health nursing in Taiwan. The author proposes the following recommendations for future community health nursing education development in Taiwan: 1) implement competence classifications appropriate to each nursing education preparation level, 2) promote multidisciplinary cooperation among education, practice, and policy, and 3) promote collaboration and consensus among community health nursing and public health related associations.

  8. Community Involvement in Community-Based Mental Health Services: A Group Process Approach.

    ERIC Educational Resources Information Center

    McGee, Thomas F.

    A group process approach to community involvement in community based mental health services is discussed. There are numerous difficulties involved in attempting to establish meaningful and effective community participation including program complexities, and interpersonal and staff complexities. It is suggested that to effectively approach…

  9. 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…

  10. 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…

  11. Task-shifting impact of introducing a pilot community health worker cadre into Zambia’s public sector health workforce

    PubMed Central

    Keller, Brett; McCarthy, Elizabeth; Bradford Vosburg, Kathryn; Musonda, Mutinta; Mwila, Jere; van den Broek, Jan Willem

    2017-01-01

    Background The Zambia Ministry of Health (MOH) recruited and trained a new cadre of Community Health Assistants (CHAs) as part of its National Community Health Strategy. The inaugural class of 307 CHAs completed one year of training in July 2012 and deployed to their communities. Methods The impact of the CHA program on the volume and type of health services provided at health posts and their respective referral health centers was measured with a non-randomized difference-in-differences design. Monthly health service provision data was collected for 12 months before and after CHA deployment at 8 health posts along with 8 referral health centers. The analysis controlled for seasonality, changes in non-CHA staffing, and periodic regional child health campaigns, and used facility-level fixed effects. Results Deploying two CHAs to a health post did not lead to a statistically-discernible increase in services at the intervention facilities. Health services provided at referral health centers increased by 697.9 services per month (95% CI: 131.4 to 1,264.3, p = .016), and combined services (at health posts and referral health centers) increased by 848.6 services per month (95% CI: 178.2 to 1,519.1, p = .013). Conclusion In this pilot, the addition of CHAs in rural areas increased health service provision at referral health facilities and at facilities overall, shifting the burden of basic health services away from more highly trained health workers. Shifting tasks to lesser-trained, less-expensive cadres like the CHAs, policymakers can rapidly improve access to care with constrained budgets. Evaluations measuring the direct impact of lower level cadres without accounting for task-shifting may underestimate their contribution to the health workforce. PMID:28767719

  12. 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

  13. The pursuit of healthier communities through a community health medical education program.

    PubMed

    Lamus-Lemus, Francisco; Correal-Muñoz, Camilo; Hernandez-Rincon, Erwin; Serrano-Espinosa, Natalia; Jaimes-deTriviño, Clara; Diaz-Quijano, Diana; García-Manrique, Juan Gabriel

    2017-01-01

    Distinct periods in the community health undergraduate medical program at the University of La Sabana (Colombia) were identified in its evolution from 1999 to 2013. We describe each period and explain the succesion of changes toward improvement. An ordered review of the community health program was constructed based on the retrospective recollection, classification, and analysis of information from document archives and interviews with participants. The review of the experience reconstructs periods of the program, organizing the evolution of its learned lessons and identified changes across the development of community health projects (CHPs) and the phases followed in their implementation. Two principal stages were identified, the first when students' CHPs involved only schools, and the second when students worked in a broader array of community settings. Identified phases of the community health cycle leading to identifying changes across the program timeline were focus of the community-campus partnership; development of relationships among participants; health and health determinants' assessment; defining project goals and objectives; devising a project activity plan; implementing and gathering results; disseminating project achievements; and building sustainability of program activities. Periods were bounded by important new characteristics introduced in the pursuit of healthier communities. Understanding the evolution of the program revealed the key concepts and practices in setting community health apprenticeship scenarios for the various participants. Overall, trust and commitment from stakeholders requires competent facilitators able to build meaningful and sustainable collaborations that can translate the purpose of community health practice into an effective teaching-learning experience. Institutional capacity building and collaborative practice contribute to improvements in the community health program and its ability to be flexible to adapt to different

  14. 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…

  15. 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…

  16. Connecting our resources: Louisiana's approach to community health network development.

    PubMed

    Broussard, Marsha; Blackwell, Robyn; Caillouet, L Philip; Nichols, Kristy Holloway; Shipman, Margaret

    2003-01-01

    Louisiana's rural community health systems are in crisis because of pressures fueled by the rising costs of health care, sustained poor health status, state budget shortfalls and changes in priorities, and a sliding rural economy. The development of community health networks is providing new infrastructure and capacity for communities to reprioritize, formulate innovative partnerships, and leverage new resources. Successful elements of Louisiana's network development experience include community commitment to engage in study and action; the availability of capable and motivated technical assistance; an approach that involves open-engagement, community-driven decision-making; and data-driven problem definition, prioritization, and solutions. Louisiana's experiences illustrate the benefits of developing networks along with, or as a result of, a community health plan. When a community owns its health improvement plan, it is more likely to support the new network as a structure for implementation. Broad-scale participation is also a principle of success. When social service agencies are included along with health agencies, more comprehensive strategies result, and they bring additional resources, resulting in more holistic solutions. The cases of 2 networks are presented as illustrations. One involves the facilitation of a community planning process for an existing network. The plan helped to expand the network's community connections and support and provided the content for a successful application for a Health Resources and Services Administration Community Access Program grant. In the second case, a new network was developed, and it leveraged federal funds from the federal Office of Rural Health Policy's Network Development Grant Program.

  17. [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.

  18. Community pharmacy in Australia: a health hub destination of the future.

    PubMed

    McMillan, Sara S; Wheeler, Amanda J; Sav, Adem; King, Michelle A; Whitty, Jennifer A; Kendall, Elizabeth; Kelly, Fiona

    2013-01-01

    Rates of chronic illness are rising in Australia and as medications are frequently used in the management of a range of chronic conditions, community pharmacists are in an ideal position to better assist these consumers. There is currently limited information as to how pharmacy can do this from the perspective of consumer health organizations, health advocates and professional support organizations. To explore new roles, opportunities and any associated barriers for community pharmacy to better assist consumers with chronic illnesses. Representatives of non-government consumer health organizations (n = 10) were interviewed from the key health priority areas emphasized by the Australian government. Health advocates (n = 3), innovative health care professionals (n = 4) and representatives of health care professional organizations (n = 4) from pharmacy and medicine also participated. Interviews were analyzed via thematic analysis. Twenty-one in-depth interviews were conducted. The core finding was the potential for community pharmacies to become a health hub destination, whereby pharmacy staff assist consumers with chronic conditions to: navigate the health system (e.g., provide information on support services), manage their medications, and provide health advocacy. Participants expressed their concern that consumers may not be aware of the breadth of the pharmacist's expertise and that further collaboration is needed with non-government consumer health organizations and other health providers. Emphasis was placed on the improvement of the pharmacist's current role, particularly in the area of medication advice and accessibility, with the current pharmacy remuneration model identified as a barrier to becoming a health hub destination. The eventual progression toward a health hub destination was seen to be important to better assist consumers with chronic conditions. This focuses on a more proactive approach to care encompassing simple advice, referrals to consumer

  19. Integrating Local Public Health Agencies into the Homeland Security Community

    DTIC Science & Technology

    2007-03-01

    public health needs that require attention (such as poor prenatal health, teen pregnancy , and sexually transmitted diseases) it is not difficult to...such as maternal and child health care or family planning education. One primary educational responsibility best accomplished with state and local...transformation in law enforcement is the concept of community policing. Community policing broadens the nature of police functions and makes better use

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  1. Capacity building for health through community-based participatory nutrition intervention Research in rural communities

    USDA-ARS?s Scientific Manuscript database

    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 ...

  2. Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community

    ERIC Educational Resources Information Center

    Kline, Cathy C.; Godolphin, William J.; Chhina, Gagun S.; Towle, Angela

    2013-01-01

    Communication between health care professionals and Aboriginal patients is complicated by cultural differences and the enduring effects of colonization. Health care providers need better training to meet the needs of Aboriginal patients and communities. We describe the development and outcomes of a community-driven service-learning program in…

  3. Community-based prevention marketing: organizing a community for health behavior intervention.

    PubMed

    Bryant, Carol A; Brown, Kelli R McCormack; McDermott, Robert J; Forthofer, Melinda S; Bumpus, Elizabeth C; Calkins, Susan A; Zapata, Lauren B

    2007-04-01

    This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the "Believe in All Your Possibilities" program, lessons learned that have led to revision and improvement of the CBPM framework are described.

  4. Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?

    PubMed

    Mockshell, Jonathan; Ilukor, John; Birner, Regina

    2014-02-01

    The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.

  5. Community perceptions and attitudes on malaria case management and the role of community health workers.

    PubMed

    Owek, Collins J; Oluoch, Elizabeth; Wachira, Juddy; Estambale, Benson; Afrane, Yaw A

    2017-07-04

    Community Case Management of malaria (CCMm) is one of the new approaches adopted by the World Health Organization for malaria endemic countries to reduce the burden of malaria for vulnerable populations. It is based on the evidence that well-trained and supervised community health workers (CHWs) can provide prompt and adequate treatment to fever cases within 24 h to help reduce morbidity and mortality associated with malaria among under-five children. The perception and attitudes of the community members on the CHWs' role is of greater importance for acceptance of their services. The aim of the study was to assess community's perception and attitude towards CCMm and on CHWs who undertake it. This study was conducted in five districts in western Kenya where Community Case Management was being undertaken. This was a qualitative cross-sectional study in which in-depth interviews and focus group discussions were conducted with mothers of under-five children and key stakeholders. Overall, there were more positive expressions of perceptions and attitudes of the community members towards the CCMm programme and the role of CHWs. The positive perceptions included among others; recognition and appreciation of services of CHWs, bringing health services to close proximity to the community, avoiding long queues in the health facilities, provision of health education that encourages good health practices, and promotion of positive health-seeking behaviour from within the communities. This programme is not without challenges as some of the negative perceptions expressed by the community members included the fact that some clinicians doubt the capacity of CHWs on dispensing drugs in the community, some CHWs do not keep client's secrets and mistrust of CHWs due to conflicting information by government. It was evident that the community had more positive perceptions and attitudes towards the role of CHWs in CCMm than negative ones. There should however, be deliberate efforts

  6. 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

  7. Perceptions of the community on the pricing of community mental health services.

    PubMed

    Ogden, J R; Ogden, D T

    1992-01-01

    In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

  8. Factors affecting the mental health of older adults in rural and urban communities: an exploration.

    PubMed

    McGee, Phyllis; Tuokko, Holly; Maccourt, Penny; Donnelly, Martha

    2004-01-01

    Stakeholders in rural and mid-size urban communities were asked to share their views concerning factors that affect the mental health of older adults, and indicate how, and how well, these factors were addressed in their community. The identified factors clustered into six categories: clinical, physical, organizational, educational, psychosocial, and spiritual. Additional factors impacting care providers and caregivers and their ability to support the mental health of older adults also emerged. Similarities and distinct differences between rural and urban communities were reported and call for innovative strategies to meet the needs of seniors, particularly those living in rural areas.

  9. Conversations on telemental health: listening to remote and rural First Nations communities.

    PubMed

    Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

    2011-01-01

    Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

  10. Toward a model of psychological health empowerment: implications for health care in multicultural communities.

    PubMed

    Menon, Sanjay T

    2002-01-01

    This article presents a model of health empowerment from an individual psychological perspective. Building on Menon's (2001) model of psychological empowerment in organizations, psychological health empowerment is developed as a construct to capture the individual community member's feelings of empowerment with regard to health and health care. The context for health empowerment is first conceptualized as an interactive system of three elements, namely, the individual community member, health service providers, and the regulatory environment consisting of health policy and systems. The individual manages his or her own health on a daily basis, interacts with health service providers when in need of specialized medical assistance, and is affected by the 'health policy and systems' element. Perceived control, perceived competence, and goal internalization, the three facets of Menon's empowerment model, are then adapted to the health context. A scale for measuring psychological health empowerment is also proposed. The implications of this approach for health care in multicultural communities are then explored.

  11. Health professional and community perspectives on reducing barriers to accessing specialist health care in metropolitan Aboriginal communities: A semi-structured interview study.

    PubMed

    Young, Christian; Tong, Allison; Gunasekera, Hasantha; Sherriff, Simone; Kalucy, Deanna; Fernando, Peter; Craig, Jonathan C

    2017-03-01

    To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas. Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS. Interviews took place at four Aboriginal Community Controlled Health Services in metropolitan Australia or by telephone. Interview transcripts were analysed thematically. We identified five major themes: leveraging partnerships (building on collaborative research, integrating and expanding existing networks, engaging the Aboriginal community), intrinsic and extrinsic motivation (seizing opportunities for altruism, empowered by collegiality, taking pride in achievements), removing common barriers (circumventing waiting times and cost, providing culturally appropriate services, raising awareness), strategic service delivery (proactive service delivery, encouraging flexibility and innovation, offering convenience and support), and service shortfall (pressured timeframes, desire for more sustainable services). HEALS facilitated improved health-care access by providing prompt, no-cost services that were strategically targeted to address multiple barriers. HEALS' model of care was built upon strong pre-existing research partnerships, the knowledge and support of five Aboriginal Community Controlled Health Services, and the willingness and motivation of local health-care professionals to help Close the Gap. HEALS highlights the importance of tailoring health services to the needs of Aboriginal families, and provides a framework for other health service delivery initiatives. © 2016 Paediatrics and Child Health Division (The Royal

  12. Optimizing community and stakeholder engagement in a merger of community health centres.

    PubMed

    Cohen, Andrea; Fairclough, Lee; Jass, Janak

    2011-01-01

    Community Health Centres (CHCs) are grounded in a model of care that includes engagement with the community and have a history of working with communities to respond to emerging needs. Although most CHCs consider themselves to be integrated, mergers in this sector are uncommon. In Ontario, the first voluntary merger of CHCs showed the importance of community engagement to realize the intended benefits of the integration and to effectively manage change.

  13. 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.

  14. Turning the tide: preserving community mental health services.

    PubMed

    2003-02-01

    As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from the fields of philanthropy, research, government, and health care on September 19, 2002 to examine the status of community-based services for people with mental disorders. This Issue Dialogue, "Turning the Tide: Preserving Community Mental Health Services," explored how health grantmakers can support community programs that provide critical mental health intervention and treatment services to children and adults. This Issue Brief synthesizes key points from the day's discussion with a background paper previously prepared for Issue Dialogue participants. It includes quantitative and qualitative information on mental health, as well as profiles of public sector, private sector, and grantmaker strategies for promoting improvements.

  15. Integrating He