Building Capacity in a Rural North Carolina Community to Address Prostate Health Using a Lay Health Advisor Model

PubMed Central

Vines, Anissa I.; Hunter, Jaimie C.; White, Brandolyn S.; Richmond, Alan N.

2018-01-01

Background Prostate cancer is a critical concern for African Americans in North Carolina (NC), and innovative strategies are needed to help rural African American men maximize their prostate health. Engaging the community in research affords opportunities to build capacity for teaching and raising awareness. Approach and Strategies A community steering committee of academicians, community partners, religious leaders, and other stakeholders modified a curriculum on prostate health and screening to include interactive knowledge- and skill-building activities. This curriculum was then used to train 15 African American lay health advisors, dubbed Prostate Cancer Ambassadors, in a rural NC community. Over the 2-day training, Ambassadors achieved statistically significant improvements in knowledge of prostate health and maintained confidence in teaching. The Ambassadors, in turn, used their personal networks to share their knowledge with over 1,000 individuals in their community. Finally, the Ambassadors became researchers, implementing a prostate health survey in local churches. Discussion and Conclusions It is feasible to use community engagement models for raising awareness of prostate health in NC African American communities. Mobilizing community coalitions to develop curricula ensures that the curricula meet the communities’ needs, and training lay health advisors to deliver curricula helps secure community buy-in for the information. PMID:26232777

Important Trends for California Community Colleges, 1992 Update. Background Data.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

Designed to serve as background material for the development of the Board of Governors of the California Community Colleges' 1992-93 basic agenda, this report examines several statewide trends affecting community colleges. Data presented in the report supersede papers prepared for previous Board retreats. Among the trends examined are those…

Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds

PubMed Central

2012-01-01

Background Australia is a culturally diverse nation with one in seven Australians born in a non-English speaking country. Culturally and Linguistically Diverse (CALD) populations are at a high risk of developing preventable chronic diseases such as cardiovascular disease, type 2 diabetes mellitus, renal disease, and chronic respiratory disease, especially communities from the Pacific Islands, the Middle East, North Africa, the Indian subcontinent and China. Previous studies have shown that access to services may be a contributing factor. This study explores the experiences, attitudes and opinions of immigrants from different cultural and linguistic backgrounds and their health care providers with regard to chronic disease care. Methods Five focus groups were conducted comprising participants from an Arabic speaking background, or born in Sudan, China, Vietnam or Tonga. A total of 50 members participated. All focus groups were conducted in the participants’ language and facilitated by a trained multicultural health worker. In addition, 14 health care providers were interviewed by telephone. Interviews were digitally recorded and transcribed. All qualitative data were analysed with the assistance of QSR NVivo 8 software. Results Participants were generally positive about the quality and accessibility of health services, but the costs of health care and waiting times to receive treatment presented significant barriers. They expressed a need for greater access to interpreters and culturally appropriate communication and education. They mentioned experiencing racism and discriminatory practices. Health professionals recommended recruiting health workers from CALD communities to assist them to adequately elicit and address the needs of patients from CALD backgrounds. Conclusions CALD patients, carers and community members as well as health professionals all highlighted the need for establishing culturally tailored programs for chronic disease prevention and management

Community-Based Participatory Research to Improve Preconception Health among Northern Plains American Indian Adolescent Women

ERIC Educational Resources Information Center

Richards, Jennifer; Mousseau, Alicia

2012-01-01

Background: Sacred Beginnings is a community-based participatory research project that examines the effectiveness of a culturally appropriate preconception health educational intervention developed by tribal community members and elders. The primary goal is to increase knowledge of preconception health and its benefits among adolescent females and…

A Three Decade Evolution to Transdisciplinary Research: Community Health Research in California-Mexico Border Communities

PubMed Central

Elder, John P.; Ayala, Guadalupe X.; McKenzie, Thomas L.; Litrownik, Alan J.; Gallo, Linda C.; Arredondo, Elva M.; Talavera, Gregory A.; Kaplan, Robert M.

2013-01-01

Background The Institute for Behavioral and Community Health (IBACH) is a transdisciplinary organization with a team-oriented approach to the translation of research to practice and policy within the context of behavioral medicine. Objectives This paper tracks the growth of IBACH — in the context of evolving multi-university transdisciplinary research efforts — from a behavioral medicine research focus to community approaches to disease prevention and control, ultimately specializing in Latino health research and practice. We describe how this growth was informed by our partnerships with community members and organizations, and training a diverse array of students and young professionals. Methods Since 1982, IBACH’s research has evolved to address a greater breadth of factors associated with health and well-being. This was driven by our strong community focus and emphasis on collaborations, the diversity of our investigative teams, and our emphasis on training. Although behavioral science still forms the core of IBACH’s scientific orientation, research efforts extend beyond those traditionally examined. Conclusions IBACH’s “team science” successes have been fueled by a specific population emphasis making IBACH one of the nation’s leaders in Latino health behavior research. PMID:25435566

Social capital in Japan: What characteristics do public health nurses see in their communities?

PubMed

Honda, Hikaru; Kawaharada, Mariko; Shindo, Yukari; Tanaka, Rie; Nakajima, Ayaka; Nimura, Yuki

2018-04-01

A concept of social capital that accounts for a community's cultural background and incorporates social capital into public health nursing practice are needed. This study aimed to describe the characteristics of social capital in the context of public health nursing in Japan. The study interviewed 11 veteran public health nurses from five municipalities across Japan and undertook a qualitative research analysis. A digital voice recorder was used to collect qualitative data by using a background data sheet and semistructured interviews. Trustworthiness in interpreting the data was ensured by conducting 13 additional interviews with residents and collating the two sets of results. All the participants were female: 10 were veterans with ≥15 years' experience. Nine worked in management. The methods yielded six categories: (i) the richness of the interactions among the residents; (ii) the community residents who showed concern for those in need; (iii) community civic activities; (iv) the residents' willingness to contribute to the community; (v) the health promotion volunteers who work alongside the public health nurses; and (vi) an enriched community environment. The results contribute to an understanding of social capital in the context of public health nursing activities and further research on social capital. It also is discussed how social capital can be incorporated into public health nursing activities in the future. © 2017 Japan Academy of Nursing Science.

Using CBPR for Health Research in American Muslim Mosque Communities: Lessons Learned

PubMed Central

Killawi, Amal; Heisler, Michele; Hamid, Hamada; Padela, Aasim I.

2015-01-01

Background American Muslims are understudied in health research, and there are few studies documenting community-based participatory research (CBPR) efforts among American Muslim mosque communities. Objectives We highlight lessons learned from a CBPR partnership that explored the health care beliefs, behaviors, and challenges of American Muslims. Methods We established a collaboration between the University of Michigan and four Muslim-focused community organizations in Michigan. Our collaborative team designed and implemented a two-phase study involving interviews with community stakeholders and focus groups and surveys with mosque congregants. Lessons Learned Although we were successful in meeting our research goals, maintaining community partner involvement and sustaining the project partnership proved challenging. Conclusions CBPR initiatives within mosque communities have the potential for improving community health. Our experience suggests that successful research partnerships with American Muslims will utilize social networks and cultural insiders, culturally adapt research methods, and develop a research platform within the organizational infrastructures of the American Muslim community. PMID:25981426

Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds.

PubMed

Komaric, Nera; Bedford, Suzanne; van Driel, Mieke L

2012-09-18

Australia is a culturally diverse nation with one in seven Australians born in a non-English speaking country. Culturally and Linguistically Diverse (CALD) populations are at a high risk of developing preventable chronic diseases such as cardiovascular disease, type 2 diabetes mellitus, renal disease, and chronic respiratory disease, especially communities from the Pacific Islands, the Middle East, North Africa, the Indian subcontinent and China. Previous studies have shown that access to services may be a contributing factor. This study explores the experiences, attitudes and opinions of immigrants from different cultural and linguistic backgrounds and their health care providers with regard to chronic disease care. Five focus groups were conducted comprising participants from an Arabic speaking background, or born in Sudan, China, Vietnam or Tonga. A total of 50 members participated. All focus groups were conducted in the participants' language and facilitated by a trained multicultural health worker. In addition, 14 health care providers were interviewed by telephone. Interviews were digitally recorded and transcribed. All qualitative data were analysed with the assistance of QSR NVivo 8 software. Participants were generally positive about the quality and accessibility of health services, but the costs of health care and waiting times to receive treatment presented significant barriers. They expressed a need for greater access to interpreters and culturally appropriate communication and education. They mentioned experiencing racism and discriminatory practices. Health professionals recommended recruiting health workers from CALD communities to assist them to adequately elicit and address the needs of patients from CALD backgrounds. CALD patients, carers and community members as well as health professionals all highlighted the need for establishing culturally tailored programs for chronic disease prevention and management in CALD populations. Better health care

Developing a Bidirectional Academic–Community Partnership with an Appalachian-American Community for Environmental Health Research and Risk Communication

PubMed Central

Beidler, Caroline; Wittberg, Richard; Meloncon, Lisa; Parin, Megan; Kopras, Elizabeth J.; Succop, Paul; Dietrich, Kim N.

2011-01-01

Background: Marietta, Ohio, is an Appalachian-American community whose residents have long struggled with understanding their exposure to airborne manganese (Mn). Although community engagement in research is strongly endorsed by the National Institutes of Health and the National Institute of Environmental Health Sciences in particular, little has been documented demonstrating how an academic–community partnership that implements the community-based participatory research (CBPR) principles can be created and mobilized for research. Objectives: We created a bidirectional, academic–community partnership with an Appalachian-American community to a) identify the community’s thoughts and perceptions about local air quality, its effect on health, and the perception of risk communication sources and b) jointly develop and conduct environmental health research. Methods: We formed a community advisory board (CAB), jointly conducted pilot research studies, and used the results to develop a community-driven research agenda. Results: Persons in the community were “very concerned” to “concerned” about local air quality (91%) and perceived the air quality to have a direct impact on their health and on their children’s health (93% and 94%, respectively). The CAB identified the primary research question: “Does Mn affect the cognition and behavior of children?” Although the community members perceived research scientists as the most trusted and knowledgeable regarding risks from industrial emissions, they received very little risk information from research scientists. Conclusions: Engaging a community in environmental health research from its onset enhanced the quality and relevance of the research investigation. The CBPR principles were a useful framework in building a strong academic–community partnership. Because of the current disconnect between communities and research scientists, academic researchers should consider working collaboratively with community

HealthMpowerment.org: Building Community through a Mobile-Optimized, Online Health Promotion Intervention

ERIC Educational Resources Information Center

Hightow-Weidman, Lisa B.; Muessig, Kathryn E.; Pike, Emily C.; LeGrand, Sara; Baltierra, Nina; Rucker, Alvin Justin; Wilson, Patrick

2015-01-01

Background: Both young Black men who have sex with men as well as young Black transgender women (YBMSM/TW) continue to experience a significant increase in HIV incidence. HealthMpowerment.org (HMP) is a mobile phone-optimized, online intervention for both YBMSM/TW to build community and facilitate supportive relationships. Methods: To assess the…

Effectiveness of Kenya's Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: non-randomized pre-test post test study

PubMed Central

Wangalwa, Gilbert; Cudjoe, Bennett; Wamalwa, David; Machira, Yvonne; Ofware, Peter; Ndirangu, Meshack; Ilako, Festus

2012-01-01

Background Maternal mortality ratio and neonatal mortality rate trends in Kenya have remained unacceptably high in a decade. In 2007, the Ministry of Public Health and Sanitation adopted a community health strategy to reverse the poor health outcomes in order to meet Millennium Development Goals 4 and 5. It aims at strengthening community participation and its ability to take action towards health. The study aimed at evaluating the effectiveness of the strategy in improving maternal and neonatal health outcomes in Kenya. Methods Between 2008 and 2010, the African Medical and Research Foundation implemented a community-based maternal and newborn care intervention package in Busia County using the community health strategy approach. An interventional, non-randomized pre-test post test study design was used to evaluate change in essential maternal and neonatal care practices among mothers with children aged 0 - 23 months. Results There was statistically significant (p < 0.05) increase in attendance of at least four antenatal care visits (39% to 62%), deliveries by skilled birth attendants (31% to 57%), receiving intermittent preventive treatment (23% to 57%), testing for HIV during pregnancy (73% to 90%) and exclusive breastfeeding (20% to 52%). Conclusion The significant increase in essential maternal and neonatal care practices demonstrates that, community health strategy is an appropriate platform to deliver community based interventions. The findings will be used by actors in the child survival community to improve current approaches, policies and practice in maternal and neonatal care. PMID:23467438

Sleep-disordered Breathing in Hispanic/Latino Individuals of Diverse Backgrounds. The Hispanic Community Health Study/Study of Latinos

PubMed Central

Sotres-Alvarez, Daniela; Loredo, Jose; Hall, Martica; Patel, Sanjay R.; Ramos, Alberto; Shah, Neomi; Ries, Andrew; Arens, Raanan; Barnhart, Janice; Youngblood, Marston; Zee, Phyllis; Daviglus, Martha L.

2014-01-01

Rationale: Hispanic/Latino populations have a high prevalence of cardiovascular risk factors and may be at risk for sleep-disordered breathing (SDB). An understanding of SDB among these populations is needed given evidence that SDB increases cardiovascular risk. Objectives: To quantify SDB prevalence in the U.S. Hispanic/Latino population and its association with symptoms, risk factors, diabetes, and hypertension; and to explore variation by sex and Hispanic/Latino background. Methods: Cross-sectional analysis from the baseline examination of the Hispanic Community Health Study/Study of Latinos. Measurements and Main Results: The apnea–hypopnea index (AHI) was derived from standardized sleep tests; diabetes and hypertension were based on measurement and history. The sample of 14,440 individuals had an age-adjusted prevalence of minimal SDB (AHI ≥ 5), moderate SDB (AHI ≥ 15), and severe SDB (AHI ≥ 30) of 25.8, 9.8, and 3.9%, respectively. Only 1.3% of participants reported a sleep apnea diagnosis. Moderate SDB was associated with being male (adjusted odds ratio, 2.7; 95% confidence interval, 2.3–3.1), obese (16.8; 11.6–24.4), and older. SDB was associated with an increased adjusted odds of impaired glucose tolerance (1.7; 1.3–2.1), diabetes (2.3; 1.8–2.9), and hypertension. The association with hypertension varied across background groups with the strongest associations among individuals of Puerto Rican and Central American background. Conclusions: SDB is prevalent in U.S. Latinos but rarely associated with a clinical diagnosis. Associations with diabetes and hypertension suggest a large burden of disease may be attributed to untreated SDB, supporting the development and evaluation of culturally relevant detection and treatment approaches. PMID:24392863

Drake Chemical Workers' Health Registry: coping with community tension over toxic exposures.

PubMed Central

Leviton, L C; Marsh, G M; Talbott, E; Pavlock, D; Callahan, C

1991-01-01

BACKGROUND: Programs to communicate health risk information and to protect the health of groups exposed to toxic substances need to tailor interventions to the political, economic, and cultural situation of the at-risk group. In particular, such programs must often cope with exceptional community tension and conflict over these exposures. METHODS: This article uses interviews and written materials to document and describe the state of affairs that led up to community tension over an occupational exposure to a bladder carcinogen. The article describes the planning and design of a program to provide medical surveillance to workers, which also alleviated community concern. RESULTS: The Drake Chemical Workers' Health Registry coped successfully with community conflict and obtained a high participation rate. CONCLUSIONS: General recommendations include the following: avoid identification with extraneous agendas; know the community and maintain communication; and match the intervention to the evolution of the community conflict. PMID:2029036

Community Health Warriors: Marshallese Community Health Workers' Perceptions and Experiences with CBPR and Community Engagement.

PubMed

Purvis, Rachel S; Bing, Williamina Ioanna; Jacob, Christopher J; Lang, Sharlynn; Mamis, Sammie; Ritok, Mandy; Rubon-Chutaro, Jellesen; McElfish, Pearl Anna

2017-01-01

Our manuscript highlights the viewpoints and reflections of the native Marshallese community health workers (CHWs) engaged in research with the local Marshallese community in Northwest Arkansas. In particular, this paper documents the vital role Marshallese CHWs play in the success of programs and research efforts. The negative health effects of nuclear testing in the Marshall Islands has been passed down through many generations, along with unfavorable attitudes toward the U.S. government and researchers. However, the community-based participatory research (CBPR) approach used by the University of Arkansas for Medical Sciences (UAMS) has allowed the native Marshallese CHWs to become advocates for the Marshallese community. The use of native CHWs has also leveled the power dynamics that can be a barrier to community-based research, and has strengthened trust with community stakeholders. Our paper shows how using Marshallese CHWs can produce positive health outcomes for the Marshallese community.

Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research.

PubMed

Xia, Ruiping; Stone, John R; Hoffman, Julie E; Klappa, Susan G

2016-03-01

In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted. © 2016 American Physical Therapy Association.

Peer Training of Community Health Workers to Improve Heart Health Among African American Women

PubMed Central

Willock, Robina Josiah; Mayberry, Robert M.; Yan, Fengxia; Daniels, Pamela

2015-01-01

Introduction Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. Background African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs' (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. Results This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. Discussion/Conclusion CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations. PMID:24891525

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…

From Community to Meta-Community Mental Health Care.

PubMed

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-04-20

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care.

From Community to Meta-Community Mental Health Care

PubMed Central

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-01-01

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. PMID:29677100

Building Sustainable Health and Education Partnerships: Stories from Local Communities

ERIC Educational Resources Information Center

Blank, Martin J.

2015-01-01

Background: Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high…

Aging & Community Health: A University-Community Partnership Project

ERIC Educational Resources Information Center

Robinson-Dooley, Vanessa; Dumont, Kelly; Riapos, Jennifer A.

2018-01-01

The purpose of this paper is to discuss how university-community partnerships can be utilized to provide affordable and accessible health care for the elderly at community health clinics. A review of community health clinics, usage data from 2013 to 2014 by a sample of aging individuals will be described along with faculty perspectives about the…

Building Sustainable Health and Education Partnerships: Stories From Local Communities

PubMed Central

Blank, Martin J

2015-01-01

BACKGROUND Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. METHODS Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. RESULTS The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. CONCLUSIONS To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. PMID:26440823

Community health development: a strategy for reinventing America's health care system one community at a time.

PubMed

Felix, Michael R J; Burdine, James N; Wendel, Monica L; Alaniz, Angie

2010-04-01

The purpose of this article is to propose a set of ideas for reinventing America's health care system, one community at a time. Community health development is proposed as a strategy and approach to population health improvement, the ultimate goal of health care reform. The practice of community health development, particularly the partnership approach, provides guidance about how this approach might be employed as a national health care reform strategy. Examples of two communities successfully using the partnership approach illustrate the methods described. Six specific recommendations for policy makers and public administrators in the new administration resulting from our experience with community health development are presented. First, adopt and apply community health development (CHD) as the American approach for facilitating population health improvement and building community capacity. Second, the partnership approach should be promoted as a model for communities to use in implementing CHD. Third, make the community-level the focus for planning, implementing, evaluating, and sustaining a full continuum of health and human services. Fourth, formally recognize the social determinants of health as a key component of a new population/community health status model and as a public policy driver for health care reform, marketplace issues, and population health status improvement at all levels of society. Fifth is a call for a national strategy for the recruitment, training, education, and support of individuals to facilitate this community movement. Sixth, Congress and the Obama Administration adopt and apply CHD as a national strategy and utilize American community-based experiences to bring about a national plan.

The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

PubMed Central

2013-01-01

Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (p<0.05 for t statistics) in

An analysis of National Health Service Trust websites on the occupational backgrounds of 'Non-Executive Directors' on England's Acute Trusts.

PubMed

Pritchard, Colin; Harding, Andrew Je

2014-05-01

To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Data extrapolated from Trust websites of NED' occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Data were available on all but 24 of the 166 Acute Trusts' from all regions. Trust Chairs and NED were categorised by their dominant occupation. Differentiating NED with and without health or social care leadership experience. The ratings of NED' occupations positively correlated (p < 0.001). Occupational categories were Commerce and Finance from private and public sectors or with Medical or Community leadership experience. Only 4% of Chairs were Medical, 2% from Community - the majority (61%) from Commerce and Finance. Of the 1001 NED, 8% and 6% respectively had Medical or Community leadership experience; most (86%) were Commerce, Finance and non-clinical Managerial backgrounds. Females made up 27% of NED. With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently 'doing the system's business' (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the 'patient's agenda' to create 'a common culture' that places 'patients at the centre of everything we do' (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis' terms of reference excluded, an issue that is briefly discussed.

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.

COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

PubMed Central

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-01-01

Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

Indian Health Service: Community Health

MedlinePlus

... Community Health Representatives (CHRs) Office of Environmental Health & Engineering (OEHE) Environmental Health Support Center Training (EHSCT) IHS ... Contracting Tribes - 08E17 Office of Environmental Health and Engineering - 10N14C Office of Finance and Accounting - 10E54 Office ...

Answers to Health Questions: Internet Search Results Versus Online Health Community Responses

PubMed Central

Vermeesch, Amber; Given, Barbara; Huh, Jina

2016-01-01

Background About 6 million people search for health information on the Internet each day in the United States. Both patients and caregivers search for information about prescribed courses of treatments, unanswered questions after a visit to their providers, or diet and exercise regimens. Past literature has indicated potential challenges around quality in health information available on the Internet. However, diverse information exists on the Internet—ranging from government-initiated webpages to personal blog pages. Yet we do not fully understand the strengths and weaknesses of different types of information available on the Internet. Objective The objective of this research was to investigate the strengths and challenges of various types of health information available online and to suggest what information sources best fit various question types. Methods We collected questions posted to and the responses they received from an online diabetes community and classified them according to Rothwell’s classification of question types (fact, policy, or value questions). We selected 60 questions (20 each of fact, policy, and value) and the replies the questions received from the community. We then searched for responses to the same questions using a search engine and recorded the Results Community responses answered more questions than did search results overall. Search results were most effective in answering value questions and least effective in answering policy questions. Community responses answered questions across question types at an equivalent rate, but most answered policy questions and the least answered fact questions. Value questions were most answered by community responses, but some of these answers provided by the community were incorrect. Fact question search results were the most clinically valid. Conclusions The Internet is a prevalent source of health information for people. The information quality people encounter online can have a large impact

Community Psychology and Community Mental Health: A Call for Reengagement.

PubMed

Townley, Greg; Brown, Molly; Sylvestre, John

2018-03-01

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross-cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under-examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health. © Society for Community Research and Action 2018.

Community health information sources--a survey in three disparate communities.

PubMed

Dart, Jared; Gallois, Cindy; Yellowlees, Peter

2008-02-01

To determine the current utilisation, importance, trust and future preference for contemporary sources of health information in three different socioeconomic groups. A pilot study including key informant interviews and direct observation was conducted in a low socioeconomic community. From this work a survey questionnaire was designed and implemented across three different communities. Semi-structured key informant interviews and focus groups capturing 52 respondents. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic (LSE) community on the outskirts of Ipswich, Queensland, a mid-high socioeconomic (MSE) community in the western suburbs of Brisbane, and at a local university. Rank of current and preferred future sources of health information, importance and trustworthiness of health information sources. Across all three communities the local doctor was the most currently used, important, trusted and preferred future source of health information. The most striking difference between the three communities related to the current use and preferred future use of the internet. The internet was a more currently used source of health information and more important source in the university population than the LSE or MSE populations. It was also a less preferred source of future health information in the LSE population than the MSE or university populations. Importantly, currently used sources of health information did not reflect community members' preferred sources of health information. People in different socioeconomic communities obtain health information from various sources. This may reflect access issues, education and awareness of the internet as a source of health information, less health information seeking as well as a reluctance by the e-health community to address the specific needs of this group.

Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

PubMed

Lovell, Sarah A; Gray, Andrew R; Boucher, Sara E

2017-12-01

Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

Collaboration Challenges and Opportunities: A Survey of School Foodservice Directors and Community Health Coalition Members

ERIC Educational Resources Information Center

Mansfield, Jennifer L.; Savaiano, Dennis A.

2018-01-01

Background: The Healthy, Hunger-Free Kids Act (HHFKA) presents challenges for foodservice directors (FSDs) in sourcing and preparing foods that meet nutrition standards. Concurrently, community health coalition members (CHCs) are engaging schools through community and school nutrition initiatives. We hypothesized significant differences in…

Assessing participation in a community-based health planning and services programme in Ghana

PubMed Central

2013-01-01

Background Community participation is increasingly seen as a pre-requisite for successful health service uptake. It is notoriously difficult to assess participation and little has been done to advance tools for the assessment of community participation. In this paper we illustrate an approach that combines a ‘social psychology of participation’ (theory) with ‘spider-grams’ (method) to assess participation and apply it to a Community-based Health Planning and Services (CHPS) programme in rural Ghana. Methods We draw on data from 17 individual in-depth interviews, two focus group discussions and a community conversation with a mix of service users, providers and community health committee members. It was during the community conversation that stakeholders collectively evaluated community participation in the CHPS programme and drew up a spider-gram. Results Thematic analysis of our data shows that participation was sustained through the recognition and use of community resources, CHPS integration with pre-existing community structures, and alignment of CHPS services with community interests. However, male dominance and didactic community leadership and management styles undermined real opportunities for broad-based community empowerment, particularly of women, young people and marginalised men. Conclusion We conclude that combining the ‘spider-gram’ tool and the ‘social psychology of participation’ framework provide health professionals with a useful starting point for assessing community participation and developing recommendations for more participatory and empowering health care programmes. PMID:23803140

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.

A mental health training program for community health workers in India: impact on knowledge and attitudes

PubMed Central

2011-01-01

Background Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy. Methods A pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India. Results 70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment. Conclusion The findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course. PMID:21819562

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

PubMed

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

PubMed Central

Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

2014-01-01

Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

Corporate Philanthropy Toward Community Health Improvement in Manufacturing Communities.

PubMed

McHugh, Megan; Farley, Diane; Maechling, Claude R; Dunlop, Dorothy D; French, Dustin D; Holl, Jane L

2018-06-01

Virtually all large employers engage in corporate philanthropy, but little is known about the extent to which it is directed toward improving community health. We conducted in-depth interviews with leaders of corporate philanthropy from 13 of the largest manufacturing companies in the US to understand how giving decisions were made, the extent to which funding was directed towards improving community health, and whether companies coordinate with local public health agencies. We found that corporate giving was sizable and directed towards communities in which the manufacturers have a large presence. Giving was aligned with the social determinants of health (i.e., aimed at improving economic stability, the neighborhood and physical environment, education, food security and nutrition, the community and social context, and the health care system). However, improving public health was not often cited as a goal of corporate giving, and coordination with public health agencies was limited. Our results suggest that there may be opportunities for public health agencies to help guide corporate philanthropy, particularly by sharing community-level data and offering their measurement and evaluation expertise.

The impact of community context on children's health and nutritional status in China.

PubMed

Lei, Lei

2017-04-01

The link between community environment and individual health outcomes has been widely documented in Western literature, but little is known about whether community context influences children's health over and above individual characteristics in developing countries. This study examines how community socioeconomic status (SES) influences children's self-rated health and nutritional status in urban and rural China and explores whether the effects of community SES vary by a child's gender and family background. Using data from the China Family Penal Studies in 2010, this study focuses on children aged 10-15 years old living in 261 urban neighborhoods and 293 rural villages in China. Multilevel regression models are estimated to examine the effect of community SES on the probability of reporting poor/fair health and nutritional status measured by height for age while controlling for individual and family characteristics. The results suggest that community SES has a positive and curvilinear effect on children's health and nutritional status in urban China, and it only positively influences children's nutrition in rural China. Community SES has a stronger effect for boys than for girls, and for children in poorer families and families with lower levels of parental involvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diet Quality and Its Association with Cardiometabolic Risk Factors Vary by Hispanic and Latino Ethnic Background in the Hispanic Community Health Study/Study of Latinos123

PubMed Central

Gallo, Linda C; Gellman, Marc; Hu, Frank B; Siega-Riz, Anna Maria; Kaplan, Robert C

2016-01-01

Background: Healthful diet quality has been associated with a lower risk of metabolic syndrome (MetS) in several populations, but reports on Hispanic and Latino cohorts, grouped or by ethnic background, have been limited and inconsistent. Objective: We aimed to examine diet quality by using the 2010 Alternate Healthy Eating Index [(AHEI) range: 0–110, lowest to highest quality] and its cross-sectional association with MetS and its cardiometabolic components across 6 Hispanic and Latino backgrounds. Methods: We studied 12,406 US Hispanics and Latinos, aged 18–74 y and free of diabetes, from the multicenter, population-based Hispanic Community Health Study/Study of Latinos cohort. Food and nutrients were assessed from two 24-h recalls. MetS was defined by using the 2009 harmonized guidelines. Complex survey procedures were used in multivariable-adjusted linear regression models to test the association of the AHEI with continuous markers and in logistic regression models with MetS as an outcome. Results: The prevalence of MetS was 24.2%. Overall, Hispanics and Latinos had low scores for intakes of sugar-sweetened beverages and fruit juices, whole grains, and fruit and favorable scores for trans fats and nuts and legumes, according to AHEI criteria. Adjusted mean AHEI and its individual components differed by ethnic background (P < 0.001), ranging from 43.0 for Puerto Ricans to 52.6 for Mexicans. Overall, adjusted odds (95% CIs) of having MetS were 22% (9%, 33%) lower for each 10-unit increase in AHEI. This association was modified by ethnic background (P-interaction = 0.03), with significantly lower odds observed only for Mexicans (30%; 95% CIs: 13%, 44%) and Central Americans (42%; 95% CIs: 9%, 64%) for each 10-unit increase in AHEI. AHEI was inversely associated with waist circumference, blood pressure, and glucose among Mexicans and Puerto Ricans and with triglycerides among Mexicans only, and positively associated with HDL cholesterol among Puerto Ricans and

What Is Community? An Evidence-Based Definition for Participatory Public Health

PubMed Central

MacQueen, Kathleen M.; McLellan, Eleanor; Metzger, David S.; Kegeles, Susan; Strauss, Ronald P.; Scotti, Roseanne; Blanchard, Lynn; Trotter, Robert T.

2001-01-01

Increased emphasis on community collaboration indicates the need for consensus regarding the definition of community within public health. This study examined whether members of diverse US communities described community in similar ways. To identify strategies to support community collaboration in HIV vaccine trials, qualitative interviews were conducted with 25 African Americans in Durham, NC; 26 gay men in San Francisco, Calif; 25 injection drug users in Philadelphia, Pa; and 42 HIV vaccine researchers across the United States. Verbatim responses to the question “What does the word community mean to you?” were analyzed. Cluster analysis was used to identify similarities in the way community was described. A common definition of community emerged as a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings. The participants differed in the emphasis they placed on particular elements of the definition. Community was defined similarly but experienced differently by people with diverse backgrounds. These results parallel similar social science findings and confirm the viability of a common definition for participatory public health. PMID:11726368

Estimating community health needs against a Triple Aim background: What can we learn from current predictive risk models?

PubMed

Elissen, Arianne M J; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

2015-05-01

To support providers and commissioners in accurately assessing their local populations' health needs, this study produces an overview of Dutch predictive risk models for health care, focusing specifically on the type, combination and relevance of included determinants for achieving the Triple Aim (improved health, better care experience, and lower costs). We conducted a mixed-methods study combining document analyses, interviews and a Delphi study. Predictive risk models were identified based on a web search and expert input. Participating in the study were Dutch experts in predictive risk modelling (interviews; n=11) and experts in healthcare delivery, insurance and/or funding methodology (Delphi panel; n=15). Ten predictive risk models were analysed, comprising 17 unique determinants. Twelve were considered relevant by experts for estimating community health needs. Although some compositional similarities were identified between models, the combination and operationalisation of determinants varied considerably. Existing predictive risk models provide a good starting point, but optimally balancing resources and targeting interventions on the community level will likely require a more holistic approach to health needs assessment. Development of additional determinants, such as measures of people's lifestyle and social network, may require policies pushing the integration of routine data from different (healthcare) sources. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Developing a Community-Based Participatory Research Curriculum to Support Environmental Health Research Partnerships: An Initiative of the GROWH Community Outreach and Dissemination Core

PubMed Central

Canfield, Caitlin; Angove, Rebekah; Boselovic, Joseph; Brown, Lisanne F.; Gauthe, Sharon; Bui, Tap; Gauthe, David; Bogen, Donald; Denham, Stacey; Nguyen, Tuan; Lichtveld, Maureen Y.

2017-01-01

Background The Transdisciplinary Research Consortium for Gulf Resilience on Women’s Health (GROWH) addresses reproductive health disparities in the Gulf Coast by linking communities and scientists through community-engaged research. Funded by the National Institutes of Environmental Health Sciences, GROWH’s Community Outreach and Dissemination Core (CODC) seeks to utilize community-based participatory research (CBPR) and other community-centered outreach strategies to strengthen resilience in vulnerable Gulf Coast populations. The CODC is an academic-community partnership comprised of Tulane University, Mary Queen of Vietnam Community Development Corporation, Bayou Interfaith Shared Community Organizing, and the Louisiana Public Health Institute (LPHI). Methods Alongside its CODC partners, LPHI collaboratively developed, piloted and evaluated an innovative CBPR curriculum. In addition to helping with curriculum design, the CODC’s community and academic partners participated in the pilot. The curriculum was designed to impart applied, practical knowledge to community-based organizations and academic researchers on the successful formulation, execution and sustaining of CBPR projects and partnerships within the context of environmental health research. Results The curriculum resulted in increased knowledge about CBPR methods among both community and academic partners as well as improved relationships within the GROWH CODC partnership. Conclusion The efforts of the GROWH partnership and curriculum were successful. This curriculum may serve as an anchor for future GROWH efforts including: competency development, translation of the curriculum into education and training products, community development of a CBPR curriculum for academic partners, community practice of CBPR, and future environmental health work. PMID:28890934

Building community and public health nursing capacity: a synthesis report of the National Community Health Nursing Study.

PubMed

Underwood, Jane M; Mowat, David L; Meagher-Stewart, Donna M; Deber, Raisa B; Baumann, Andrea O; MacDonald, Mary B; Akhtar-Danesh, Noori; Schoenfeld, Bonnie M; Ciliska, Donna K; Blythe, Jennifer M; Lavoie-Tremblay, Mélanie; Ehrlich, Anne S; Knibbs, Kristin M; Munroe, Valerie J

2009-01-01

1) To describe the community health nursing workforce in Canada; 2) To compare, across political jurisdictions and community health sectors, what helps and hinders community nurses to work effectively; 3) To identify organizational attributes that support one community subsector--public health nurses--to practise the full scope of their competencies. Our study included an analysis of the Canadian Institute for Health Information nursing databases (1996-2007), a survey of over 13,000 community health nurses across Canada and 23 focus groups of public health policy-makers and front-line public health nurses. Over 53,000 registered and licensed practical nurses worked in community health in Canada in 2007, about 16% of the nursing workforce. Community nurses were older on average than the rest of their profession. Typical practice settings for community nurses included community health centres, home care and public health units/departments. To practise effectively, community nurses need professional confidence, good team relationships, supportive workplaces and community support. Most community nurses felt confident in their practice and relationships with other nurses and professionals, though less often with physicians. Their feelings about salary and job security were mixed, and most community nurses would like more learning opportunities, policy and practice information and chances to debrief about work. They needed their communities to do more to address social determinants of health and provide good quality resources. Public health nursing needs a combination of factors to succeed: sound government policy, supportive organizational culture and good management practices. Organizational attributes identified as supports for optimal practice include: flexibility in funding, program design and job descriptions; clear organizational vision driven by shared values and community needs; coordinated public health planning across jurisdictions; and strong leadership that

Community Engagement in Health-Related Research: A Case Study of a Community-Linked Research Infrastructure, Jefferson County, Arkansas, 2011–2013

PubMed Central

Felix, Holly C.; Olson, Mary; Cottoms, Naomi; Bachelder, Ashley; Smith, Johnny; Ford, Tanesha; Dawson, Leah C.; Greene, Paul G.

2015-01-01

Background Underrepresentation of racial minorities in research contributes to health inequities. Important factors contributing to low levels of research participation include limited access to health care and research opportunities, lack of perceived relevance, power differences, participant burden, and absence of trust. We describe an enhanced model of community engagement in which we developed a community-linked research infrastructure to involve minorities in research both as participants and as partners engaged in issue selection, study design, and implementation. Community Context We implemented this effort in Jefferson County, Arkansas, which has a predominantly black population, bears a disproportionate burden of chronic disease, and has death rates above state and national averages. Methods Building on existing community–academic partnerships, we engaged new partners and adapted a successful community health worker model to connect community residents to services and relevant research. We formed a community advisory board, a research collaborative, a health registry, and a resource directory. Outcome Newly formed community–academic partnerships resulted in many joint grant submissions and new projects. Community health workers contacted 2,665 black and 913 white community residents from December 2011 through April 2013. Eighty-five percent of blacks and 88% of whites were willing to be re-contacted about research of potential interest. Implementation challenges were addressed by balancing the needs of science with community needs and priorities. Interpretation Our experience indicates investments in community-linked research infrastructure can be fruitful and should be considered by academic health centers when assessing institutional research infrastructure needs. PMID:26203813

Does community health care require different competencies from physicians and nurses?

PubMed Central

2014-01-01

Background Recently competency approach in Health Professionals’ Education (HPE) has become quite popular and for an effective competency based HPE, it is important to design the curriculum around the health care needs of the population to be served and on the expected roles of the health care providers. Unfortunately, in community settings roles of health providers tend to be described less clearly, particularly at the Primary Health Care (PHC) level where a multidisciplinary and appropriately prepared health team is generally lacking. Moreover, to tailor the education on community needs there is no substantial evidence on what specific requirements the providers must be prepared for. Methods This study has explored specific tasks of physicians and nurses employed to work in primary or secondary health care units in a context where there is a structural scarcity of community health care providers. In-depth Interviews of 11 physicians and 06 nurses working in community settings of Pakistan were conducted along with review of their job descriptions. Results At all levels of health settings, physicians’ were mostly engaged with diagnosing and prescribing medical illness of patients coming to health center and nurses depending on their employer were either providing preventive health care activities, assisting physicians or occupied in day to day management of health center. Geographical location or level of health facility did not have major effect on the roles being expected or performed, however the factors that determined the roles performed by health providers were employer expectations, preparation of health providers for providing community based care, role clarity and availability of resources including health team at health facilities. Conclusions Exploration of specific tasks of physicians and nurses working in community settings provide a useful framework to map competencies, and can help educators revisit the curricula and instructional designs

Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia

PubMed Central

Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

Background The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. Method We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. Results The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. Discussion The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of

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)

An integrated approach of community health worker support for HIV/AIDS and TB care in Angónia district, Mozambique

PubMed Central

2009-01-01

Background The need to scale up treatment for HIV/AIDS has led to a revival in community health workers to help alleviate the health human resource crisis in sub-Saharan Africa. Community health workers have been employed in Mozambique since the 1970s, performing disparate and fragmented activities, with mixed results. Methods A participant-observer description of the evolution of community health worker support to the health services in Angónia district, Mozambique. Results An integrated community health team approach, established jointly by the Ministry of Health and Médecins Sans Frontières in 2007, has improved accountability, relevance, and geographical access for basic health services. Conclusion The community health team has several advantages over 'disease-specific' community health worker approaches in terms of accountability, acceptability, and expanded access to care. PMID:19615049

Technology for community health alliances.

PubMed

Luce, Peggy; Phillips, Jill; Benjamin, Regina; Wasson, John H

2004-01-01

A community health alliance brings together divergent interests within a community for the betterment of personal and population health. In this report we describe how a community responsive strategy in Chicago is facilitating the improvement of healthcare by providing local information of what needs to be done, supporting change at the practice level to meet these needs, and initiating community-wide approaches to manage prevalent and important needs without waiting for direct involvement of health professionals.

Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

ERIC Educational Resources Information Center

Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

2009-01-01

This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

[Community health course--student's evaluation].

PubMed

Juresa, Vesna; Musil, Vera; Sosić, Zvonko; Majer, Marjeta; Pavleković, Gordana

2010-12-01

Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar

Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya

PubMed Central

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

2014-01-01

Background 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. Methods 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. Results 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%. Conclusion 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. PMID:25090111

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

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

PubMed

Maes, Kenneth; Closser, Svea; Kalofonos, Ippolytos

2014-05-01

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

Increasing Health Research Literacy through Outreach and Networking: Why Translational Research Should Matter to Communities

ERIC Educational Resources Information Center

Dwyer-White, Molly; Choate, Celeste; Markel, Dorene S

2015-01-01

Background: Increasingly clinical and health research awareness is a priority for health and medical research communities. Translational research, including the prevention and treatment of conditions, relies upon proper funding as well as public participation in research studies. This requires executing more effective communication strategies to…

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

PubMed

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

2010-04-01

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

Children's Mental Health: Problems and Services. Background Paper.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This background paper on children's mental health indicates that less than one-third of the children who have mental health problems receive treatment. Types of mental health problems are discussed, including intellectual, developmental, behavior, emotional, psychophysiological, and adjustment disorders. Enviromental risk factors of poverty and…

Context matters: A community-based study of urban minority parents’ views on child health

PubMed Central

Bolar, Cassandra L.; Hernandez, Natalie; Akintobi, Tabia Henry; McAllister, Calvin; Ferguson, Aneeqah S.; Rollins, Latrice; Wrenn, Glenda; Okafor, Martha; Collins, David; Clem, Thomas

2016-01-01

Background Among children, there are substantial ethno-racial minority disparities across a broad range of health-related behaviors, experiences, and outcomes. Addressing these disparities is important, as childhood and adolescence establish health trajectories that extend throughout life. Methods The current study employed a community-based participatory research approach to gain community insight on child health priorities and to frame an intervention aimed at improving the health of minority children. Eight focus groups were conducted among seventy-five African American parents in a Southeastern city. The current study was guided by an ecological theoretical framework. Results Although the focus of this investigation was on community identification of child health priorities, participants cited, as root determinants, contextual factors, which included lack of healthy food options, lack of spaces for physical activity, and community violence. These co-occurring factors were related to limited engagement in outdoor activities and physical activity, increased obesity, and poor mental health and coping. Poor parenting was cited as the most substantial barrier to improving child health outcomes, and quality parenting was identified as the most important issue to address for community programs focused on promoting the health and success of children. For improving health outcomes for children in their neighborhoods, establishment of positive social capital and constructive activities were also cited. Conclusions These results reinforce social determinants of health as influences on child health outcomes and describe how community engagement can address potential solutions through interventions that resonate with program participants. PMID:27275021

The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review.

PubMed

de Vries, Daniel H; Pool, Robert

2017-01-01

Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs). So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability. This review includes peer-reviewed articles which meet three eligibility criteria: 1) specific focus on CLHWs or equivalent; 2) randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3) description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result of this lack of

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

“You’ve Gotta Know the Community”: Minority Women Make Recommendations About Community-Focused Health Research

PubMed Central

Pinto, Rogério M.; McKay, Mary M.; Escobar, Celeste

2009-01-01

Objectives To determine what ethnic and racial minority women recommend as the best approaches to participatory health research in their communities. To achieve this goal, this study focused on HIV prevention research. Methods In 2003, Seven African American and seven Latina women (ages 33 to 52), all members of an HIV Prevention Collaborative Board, participated in individual interviews, lasting about 90 minutes each. Participants discussed their involvement in participatory research, and made recommendations as to how health researchers might better engage their communities. Data were coded independently by two coders following standard procedure for content analysis. Results Women’s voices and expertise can help guide health-related research. This study shows that: (1) participatory HIV prevention research should be founded on trust and commitment, leading to social support; (2) research partners ought to come from diverse backgrounds and be knowledgeable about the community and willing to work on common objectives; and (3) collaborative partnerships ought to portray an image of strength and cohesion, and a clear articulation of the mission around a research project. Implications To develop meaningful health research, researchers need to establish long-term ongoing relationships with community collaborators, including minority women from diverse backgrounds. Researchers ought to take a holistic approach working with communities, and ought to consider their research interests vis-à-vis the community’s needs. PMID:18581694

Findings from the Community Health Intervention Program in South Carolina: Implications for Reducing Cancer-Related Health Disparities

PubMed Central

McCracken, James Lyndon; Friedman, Daniela B.; Brandt, Heather M.; Adams, Swann Arp; Xirasagar, Sudha; Ureda, John R.; Mayo, Rachel M.; Comer, Kimberly; Evans, Miriam; Fedrick, Delores; Talley, Jacqueline; Broderick, Madeline; Hebert, James R.

2013-01-01

BACKGROUND The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. OBJECTIVE To support the SC-CPCRN’s goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. METHODS Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute’s evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. RESULTS The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. CONCLUSIONS The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state. PMID:23645547

Health education and community participation in the control of urinary schistosomiasis in Ghana.

PubMed

Aryeetey, M E; Aholu, C; Wagatsuma, Y; Bentil, G; Nkrumah, F K; Kojima, S

1999-06-01

To study the role of health education and community participation for the provision of facilities necessary for the control of urinary schistosomiasis in southern Ghana. Health education facilitates community participation in the provision of facilities for the control of bilharzia. Three rural communities drained by the Densu river in southern Ghana. Individuals aged 14 years and above formed groups of 10-12 persons by age, sex, ethnic and educational background; 15-16 groups were formed. Based on existing structures, one community received active, another passive health education and the third had no education. All three communities received chemotherapy. Study was carried out in three phases: pre-intervention phase--during which baseline data on residents' knowledge, attitude, beliefs and perception about bilharzia were collected using focus group discussions (FGD) prior to the second phase, intervention. Another FGD was held after 18 months to evaluate the intervention--third phase. This study suggests that most community members were aware of schistosomiasis but not as a disease. Before the health education, some residents believed bilharzia was a sign of manhood while others attributed the red colour of the urine to the red colour of a variety of sugar cane eaten in the area. After the health education, residents in the three areas constructed hand-dug wells. In addition, those who received active health education constructed two toilets for the schools and weeded the banks of the rivers. Residents also associated the disease with the water snail. Health education was useful in changing community perception on bilharzia.

Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

PubMed Central

Wassertheil-Smoller, Sylvia; Arredondo, EM; Cai, JianWen; Castenada, Sheila; Choca, James P; Gallo, Linda; Jung, Molly; LaVange, Lisa M; Lee-Rey, Elizabeth T; Mosley, Thomas; Penedo, Frank J; Santistaban, DA; Zee, PC

2014-01-01

Purpose Describe prevalence and relationships to cardiovascular morbidity of depression, anxiety and medication use among Hispanic/Latinos of different ethnic backgrounds. Methods Cross-sectional analysis of 15,864 men and women ages 18–74 in the population-based Hispanic Community Health Study/Study of Latinos. Depressive and anxiety symptoms were assessed with shortened Center for Epidemiological Studies Depression scale and Spielberger Trait Anxiety Scale. Results Prevalence of high depressive symptoms ranged from low of 22.3% (95%CI: 20.4–24.3) to high of 38.0% (95%CI: 35.2–41.0) among those of Mexican or Puerto Rican background respectively. Adjusted odds ratios for depression rose monotonically with number of CVD risk factors from 1.46 (95%CI: 1.18, 1.75) for those with no risk factors to 4.36 (95%CI: 2.47, 7.70) for those with 5 risk factors. Antidepressant medication was used by 5% with striking differences between those with and without history of CVD (15.4% and 4.6% respectively) and between insured (8.2%) and uninsured (1.8%). Conclusions Among US Hispanics/Latinos, high depression and anxiety symptoms varied nearly twofold by Hispanic background and sex, history of CVD and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population, suggesting under treatment especially among those who had no health insurance. PMID:25439033

Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana

PubMed Central

Chatio, Samuel; Akweongo, Patricia

2017-01-01

Background The shortage of formal health workers has led to the utilization of Community-Based Health Volunteers (CBHV) to provide health care services to people especially in rural and neglected communities. Community-based health volunteers have been effective partners in health care delivery at the community level for many years. The challenge is how to retain these volunteers and also sustain their activities. This study explored factors affecting retention and sustainability of community-based health volunteers’ activities in a rural setting in Northern Ghana. Methods This was a qualitative study comprising thirty-two in-depth interviews (IDIs) with health volunteers and health workers in-charge of health volunteers’ activities. Purposive sampling technique was used to select study participants for the interviews. The interviews were transcribed and coded into themes using Nvivo 10 software. The thematic analysis framework was used to analyze the data. Results Study participants reported that the desire to help community members, prestige and recognition as doctors in community mainly motivated them to work as health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected the work. They suggested that lack of these things discouraged them from working as health volunteers. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots, bicycles, awards to hard working volunteers are mechanisms that can help retain community-based health volunteers and also sustain their activities. Conclusion Providing means of transport and non-monetary incentives would help to retain community-based health volunteers and also

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.

Increasing access to healthful foods: a qualitative study with residents of low-income communities

PubMed Central

2015-01-01

Background Inadequate access to healthful foods has been identified as a significant barrier to healthful dietary behaviors among individuals who live in low-income communities. The purpose of this study was to gather low-income community members’ opinions about their food purchasing choices and their perceptions of the most effective ways to increase access to healthful foods in their communities. Methods Spanish and English focus groups were conducted in low-income, ethnically-diverse communities. Participants were asked about their knowledge, factors influencing their food purchasing decisions, and their perceptions regarding solutions to increase access to healthful foods. Results A total of 148 people participated in 13 focus groups. The majority of participants were female and ethnically diverse (63% Hispanic, 17% African American, 16% Caucasian, and 4% “other”). More than 75% of the participants reported making less than $1999 USD per month. Participants reported high levels of knowledge and preference for healthful foods. The most important barriers influencing healthful shopping behaviors included high price of healthful food, inadequate geographical access to healthful food, poor quality of available healthful food, and lack of overall quality of the proximate retail stores. Suggested solutions to inadequate access included placement of new chain supermarkets in their communities. Strategies implemented in convenience stores were not seen as effective. Farmers’ markets, with specific stipulations, and community gardens were regarded as beneficial supplementary solutions. Conclusion The results from the focus groups provide important input from a needs assessment perspective from the community, identify gaps in access, and offer potential effective solutions to provide direction for the future. PMID:26222910

Using Community Advisory Boards to Reduce Environmental Barriers to Health in American Indian Communities, Wisconsin, 2007–2012

PubMed Central

Scott, Jamie R.; Prince, Ron; Williamson, Amy

2014-01-01

Background American Indian communities have a high prevalence of chronic diseases including diabetes, obesity, cardiovascular disease, and cancer. Innovative community-based approaches are needed to identify, prioritize, and create sustainable interventions to reduce environmental barriers to healthy lifestyles and ultimately improve health. Community Context Healthy Children, Strong Families was a family-based and community-based intervention to increase healthy lifestyles on Wisconsin American Indian reservations. This intervention arose from a long-standing partnership between University of Wisconsin researchers and 3 of these American Indian communities. Methods In each community, community advisory boards (CABs) were established by the residents and university partners. CAB meetings were open and held at various times and locations to increase member participation. CABs featured continual, snowball recruitment; internal and external expert consultation; and coordination with standing tribal committees. Meetings initially focused on understanding community supports for and barriers to healthy lifestyles but quickly turned toward community action for change. Outcome CAB interventions decreased environmental barriers to health at each site and improved options for healthy lifestyle choices. Over 5 years, 71 CAB meetings occurred with a total of 1,070 participants. Successful CAB interventions included planting community gardens and an apple orchard, conducting gardening and canning workshops, instituting food-related policies and dog control regulations, building an environmentally friendly playground, and providing access to recreational facilities. The CABs are now self-sustaining. Interpretation CABs can be highly effective action teams capable of improving community environments. Our experience shows that academic researchers can partner with community residents to generate programs and policies that will expand access to local food, increase people�

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.

Improving Community Health While Satisfying a Critical Community Need: A Case Study for Nonprofit Hospitals

PubMed Central

Kephart, Donna K.; Dillon, Judith F.; McCullough, Jody R.; Blatt, Barbara J.; Kraschnewski, Jennifer L.

2015-01-01

Background School-based student health screenings identify issues that may affect physical and intellectual development and are an important way to maintain student health. Nonprofit hospitals can provide a unique resource to school districts by assisting in the timely completion of school-based screenings and meet requirements of the Affordable Care Act. This case study describes the collaboration between an academic medical center and a local school district to conduct school-based health screenings. Community Context Penn State Milton S. Hershey Medical Center and Penn State Hershey PRO Wellness Center collaborated with Lebanon School District to facilitate student health screenings, a need identified in part by a community health needs assessment. Methods From June 2012 through February 2013, district-wide student health screenings were planned and implemented by teams of hospital nursing leadership, school district leadership, and school nurses. In fall 2013, students were screened through standardized procedures for height, weight, scoliosis, vision, and hearing. Outcomes In 2 days, 3,105 students (67% of all students in the district) were screened. Letters explaining screening results were mailed to parents of all students screened. Debriefing meetings and follow-up surveys for the participating nurses provided feedback for future screenings. Interpretation The 2-day collaborative screening event decreased the amount of time spent by school nurses in screening students throughout the year and allowed them more time in their role as school wellness champion. Additionally, parents found out early in the school year whether their child needed physician follow-up. Partnerships between school districts and hospitals to conduct student health screenings are a practical option for increasing outreach while satisfying community needs. PMID:26513441

CommunityRx: A Population Health Improvement Innovation That Connects Clinics To Communities.

PubMed

Lindau, Stacy T; Makelarski, Jennifer; Abramsohn, Emily; Beiser, David G; Escamilla, Veronica; Jerome, Jessica; Johnson, Daniel; Kho, Abel N; Lee, Karen K; Long, Timothy; Miller, Doriane C

2016-11-01

The CommunityRx system, a population health innovation, combined an e-prescribing model and community engagement to strengthen links between clinics and community resources for basic, wellness, and disease self-management needs in Chicago. The components of CommunityRx were a youth workforce, whose members identified 19,589 public-serving entities in the 106-square-mile implementation region between 2012 and 2014; community health information specialists, who used the workforce's findings to generate an inventory of 14,914 health-promoting resources; and a health information technology (IT) platform that was integrated with three electronic health record systems at thirty-three clinical sites. By mapping thirty-seven prevalent social and medical conditions to community resources, CommunityRx generated 253,479 personalized HealtheRx prescriptions for more than 113,000 participants. Eighty-three percent of the recipients found the HealtheRx very useful, and 19 percent went to a place they learned about from the HealtheRx. All but one organization continued using the CommunityRx system after the study period ended. This study demonstrates the feasibility of using health IT and workforce innovation to bridge the gap between clinical and other health-promoting sectors. Project HOPE—The People-to-People Health Foundation, Inc.

The influence of community and individual health literacy on self-reported health status.

PubMed

Sentell, Tetine; Zhang, Wei; Davis, James; Baker, Kathleen Kromer; Braun, Kathryn L

2014-02-01

Individual health literacy is an established predictor of individual health outcomes. Community-level health literacy may also impact individual health, yet limited research has simultaneously considered the influence of individual and community health literacy on individual health. The study goal was to determine if community health literacy had an independent relationship with individual self-reported health beyond individual health literacy. We used data from the 2008 and 2010 Hawai'i Health Survey, a representative statewide telephone survey. Multilevel models predicted individual self-reported health by both individual and community health literacy, controlling for relevant individual-level (education, race/ethnicity, gender, poverty, insurance status, age, and marital status) and community-level variables (community poverty and community education). The sample included 11,779 individuals within 37 communities. Individual health literacy was defined by validated self-reported measurement. Communities were defined by zip code combinations. Community health literacy was defined as the percentage of individuals within a community reporting low health literacy. Census data by ZIP Code Tabulation Areas provided community-level variables. In descriptive results, 18.2 % self-reported low health literacy, and 14.7 % reported self-reported poor health. Community-level low health literacy ranged from 5.37 % to 35.99 %. In final, multilevel models, both individual (OR: 2.00; 95 % CI: 1.63-2.44) and community low health literacy (OR: 1.02; 95 % CI: 1.00-1.03) were significantly positively associated with self-reported poor health status. Each percentage increase of average low health literacy within a community was associated with an approximately 2 % increase in poor self-reported health for individuals in that community. Also associated with poorer health were lower educational attainment, older age, poverty, and non-White race. Both individual and community health

Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

PubMed

Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

2018-01-01

To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

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

PubMed

Crossley, Mary

2016-01-01

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

Improving Asian American, Native Hawaiian, and Pacific Islander Health: National Organizations Leading Community Research Initiatives

PubMed Central

Cook, Won Kim; Weir, Rosy Chang; Ro, Margeurite; Ko, Kathy Lim; Panapasa, Sela; Bautista, Roxanna; Asato, Lloyd; Chung, Corina; Cabllero, Jeffery; Islam, Nadia

2012-01-01

Background Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role. Objectives To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research. Methods Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations Results Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research. Conclusions Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research. PMID:22643786

Oral Health in Rural Communities

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... community water supplies than large ones. This paper report that it is six times more costly per ...

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

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.

Current Methods in Health Behavior Research Among U.S. Community College Students: A Review of the Literature

PubMed Central

Pokhrel, Pallav; Little, Melissa A.; Herzog, Thaddeus A.

2016-01-01

The majority of health behavior research involving college students in the United States has focused on 4-year college students. Two-year or community college students have been less studied, although a significant proportion of U.S. undergraduates, primarily those from disadvantaged socioeconomic and/or racial/ethnic background, are enrolled in community colleges. Thus, there is a need to enhance health behavior and health promotion research among community college students. This study systematically reviewed 42 published, peer-reviewed health behavior studies conducted among U.S. community college students in order to determine the current state of research in the area with regard to behaviors studied, research designs used, recruitment and data collection strategies practiced, rates of student participation, and characteristics of the participants represented. Findings identified the methodological limitations of current research and suggested optimal recruitment and data collection methods suitable for various research needs. Findings are discussed in the context of enhancing health behavior research among U.S. community college students. PMID:24227658

Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

PubMed

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

2013-01-01

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.

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

Community mental health in India: A rethink

PubMed Central

Thara, Rangawsamy; Padmavati, Ramachandran; Aynkran, Jothy R; John, Sujit

2008-01-01

Background Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF), an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes. Methods One hundred and eighty five patients with chronic mental illness were followed up and their present treatment status determined using a modified version of the Psychiatric and Personal History Schedule (PPHS). The resources created earlier were assessed and qualitative information was gathered during interviews with patient and families and other stakeholders to identify the reasons behind the sustenance or failure of these initiatives. Results Of the 185 patients followed up, 15% had continued treatment, 35% had stopped treatment, 21% had died, 12% had wandered away from home and 17% were untraceable. Of the patients who had discontinued treatment 25% were asymptomatic while 75% were acutely psychotic. The referral service was used by only 15% of the patients and mental health services provided by the PHC stopped within a year. The Citizen's group was functional for only a year and apart from chicken rearing, all other self-employment schemes were discontinued within a period of 6 months to 3 years. There were multiple factors contributing to the failure, the primary reasons being the limited access and associated

Attitudes towards primary care career in community health centers among medical students in China.

PubMed

Zhang, Lingling; Bossert, Thomas; Mahal, Ajay; Hu, Guoqing; Guo, Qing; Liu, Yuanli

2016-07-16

Very few of the primary care doctors currently working in China's community health centers have a college degree (issued by 5-year medical schools). How to attract college graduates to community services in the future, therefore, has major policy relevance in the government's ongoing efforts to reform community health care and fill in the long-absent role of general physicians in China. This paper examined medical school students' attitudes towards working in communities and the factors that may affect their career choices in primary care to inform policy on this subject. A cross-sectional survey was designed upon the issuance of community health reform policy in 2006 by the Chinese government. The survey was conducted among 2714 medical students from three medical schools in representative regions in China. Binomial and multinomial regression analyses were carried out using a collection of plausible predictors such as place of rearing, income, etc. to assess their willingness to work in communities. Of the 2402 valid responses, besides 5.7 % objection to working in communities, 19.1 % expressed definite willingness. However, the majority (41.5 %) of students only consider community job as a temporary transition, in addition to 33.7 % using it as their backup option. The survey analyses found that medical students who are more likely to be willing to work in communities tend to come from rural backgrounds, have more exposure to community health reform, and possess certain personally held value and fit. To attract more graduates from 5-year medical schools to work in communities, a targeted recruiting approach or admission policy stands a better chance of success. The findings on the influencing factors of medical students' career choice can help inform policymakers, medical educators, and community health managers to improve the willingness of swing students to enter primary care to strengthen basic health services.

Community Perceptions on Integrating Animal Vaccination and Health Education by Veterinary and Public Health Workers in the Prevention of Brucellosis among Pastoral Communities of South Western Uganda

PubMed Central

Kansiime, Catherine; Atuyambe, Lynn M.; Asiimwe, Benon B.; Mugisha, Anthony; Mugisha, Samuel; Guma, Victor; Rwego, Innocent B.; Rutebemberwa, Elizeus

2015-01-01

Background Brucellosis is a zoonotic disease of veterinary, public health, and economic significance in most developing countries, yet there are few studies that show integrated human and veterinary health care intervention focusing on integration at both activity and actors levels. The aim of our study, therefore, was to explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis in Uganda. Methods This study used a qualitative design where six Focus Group Discussions (FGDs) that were homogenous in nature were conducted, two from each sub-county, one with the local leaders, and another with pastoralists and farmers. Five Key Informant Interviews (KIIs) with two public health workers and three veterinary extension workers from three sub-counties in Kiruhura district, Uganda were conducted. All FGDs were conducted in the local language and tape recorded with consent from the participants. KIIs were in English and later transcribed and analyzed using latent content data analysis method. Results All the groups mentioned that they lacked awareness on brucellosis commonly known as Brucella and its vaccination in animals. Respondents perceived improvement in human resources in terms of training and recruiting more health personnel, facilitation of the necessary activities such as sensitization of the communities about brucellosis, and provision of vaccines and diagnostic tests as very important in the integration process in the communities. The FGD participants also believed that community participation was crucial for sustainability and ownership of the integration process. Conclusions The respondents reported limited knowledge of brucellosis and its vaccination in animals. The community members believed that mass animal vaccination in combination with health education about the disease is important and possible if it involves government and all other stakeholders such

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.

Ethical dilemmas in community mental health care.

PubMed

Liégeois, A; Van Audenhove, C

2005-08-01

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

Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey

PubMed Central

2014-01-01

Background The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective The aim was to determine the use and factors predicting the use of social media for health care–related purposes among medically underserved primary care patients. Methods A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Conclusions Understanding use and factors predicting use can increase adoption and utilization of social media for health care–related purposes among underserved patients in community health centers. PMID:25427823

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…

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

An analysis of National Health Service Trust websites on the occupational backgrounds of ‘Non-Executive Directors’ on England’s Acute Trusts

PubMed Central

Harding, Andrew JE

2014-01-01

Summary Objectives To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Design Data extrapolated from Trust websites of NED’ occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Setting Data were available on all but 24 of the 166 Acute Trusts’ from all regions. Participants Trust Chairs and NED were categorised by their dominant occupation. Main outcome measure Differentiating NED with and without health or social care leadership experience. Results The ratings of NED’ occupations positively correlated (p < 0.001). Occupational categories were Commerce and Finance from private and public sectors or with Medical or Community leadership experience. Only 4% of Chairs were Medical, 2% from Community – the majority (61%) from Commerce and Finance. Of the 1001 NED, 8% and 6% respectively had Medical or Community leadership experience; most (86%) were Commerce, Finance and non-clinical Managerial backgrounds. Females made up 27% of NED. Conclusions With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently ‘doing the system's business’ (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the ‘patient’s agenda’ to create ‘a common culture’ that places ‘patients at the centre of everything we do’ (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis’ terms of reference excluded, an issue that is briefly discussed. PMID:25057396

The Role of the Community Nurse in Promoting Health and Human Dignity-Narrative Review Article

PubMed Central

Muntean, Ana; Tomita, Mihaela; Ungureanu, Roxana

2013-01-01

Abstract Background: Population health, as defined by WHO in its constitution, is out “a physical, mental and social complete wellbeing”. At the basis of human welfare is the human dignity. This dimension requires an integrated vision of health care. The ecosystemical vision of Bronfenbrenner allows highlighting the unexpected connections between social macro system based on values and the micro system consisting of individual and family. Community nurse is aimed to transgression in practice of education and care, the respect for human dignity, the bonds among values and practices of the community and the physical health of individuals. In Romania, the promotion of community nurse began in 2002, through the project promoting the social inclusion by developing human and institutional resources within community nursery of the National School of Public Health, Management and Education in Healthcare Bucharest. The community nurse became apparent in 10 counties included in the project. Considering the respect for human dignity as an axiomatic value for the community nurse interventions, we stress the need for developing a primary care network in Romania. The proof is based on the analysis of the concept of human dignity within health care, as well as the secondary analysis of health indicators, in the year of 2010, of the 10 counties included in the project. Our conclusions will draw attention to the need of community nurse and, will open directions for new researches and developments needed to promote primary health in Romania. PMID:26060614

Evaluation of a Health Professionals' Training Program to Conduct Research in New York City's Asian American Community

ERIC Educational Resources Information Center

Zhang, Pao San Lucy; Sim, Shao-Chee; Pong, Perry; Islam, Nadia; Trinh-Shevrin, Chau; Li, Shijian; Tsang, Thomas; Rey, Mariano

2014-01-01

Background: Because health disparities among Asian Americans are understudied, a partnership program between the Charles B. Wang Community Health Center and the Center for the Study of Asian American Health was created to increase awareness and interest in Asian American research. Purpose: To evaluate the process, outcome, and impact of a health…

Food-group and nutrient-density intakes by Hispanic and Latino backgrounds in the Hispanic Community Health Study/Study of Latinos123

PubMed Central

Siega-Riz, Anna Maria; Sotres-Alvarez, Daniela; Ayala, Guadalupe X; Ginsberg, Mindy; Himes, John H; Liu, Kiang; Loria, Catherine M; Mossavar-Rahmani, Yasmin; Rock, Cheryl L; Rodriguez, Brendaly; Gellman, Marc D; Van Horn, Linda

2014-01-01

Background: Hispanics are a heterogeneous group of individuals with a variation in dietary habits that is reflective of their cultural heritage and country of origin. It is important to identify differences in their dietary habits because it has been well established that nutrition contributes substantially to the burden of preventable diseases and early deaths in the United States. Objective: We estimated the distribution of usual intakes (of both food groups and nutrients) by Hispanic and Latino backgrounds by using National Cancer Institute methodology. Design: The Hispanic Community Health Study/Study of Latinos is a population-based cohort study that recruited participants who were 18–74 y of age from 4 US cities in 2008–2011 (Miami, Bronx, Chicago, and San Diego). Participants who provided at least one 24-h dietary recall and completed a food propensity questionnaire (n = 13,285) were included in the analyses. Results were adjusted for age, sex, field center, weekend, sequencing, and typical amount of intake. Results: Overall, Cubans (n = 2128) had higher intakes of total energy, macronutrients (including all subtypes of fat), and alcohol than those of other groups. Mexicans (n = 5371) had higher intakes of vitamin C, calcium, and fiber. Lowest intakes of total energy, macronutrients, folate, iron, and calcium were reported by Dominicans (n = 1217), whereas Puerto Ricans (n = 2176) had lowest intakes of vitamin C and fiber. Food-group servings reflected nutrient intakes, with Cubans having higher intakes of refined grains, vegetables, red meat, and fats and Dominicans having higher intakes of fruit and poultry, whereas Puerto Ricans had lowest intakes of fruit and vegetables. Central and South Americans (n = 1468 and 925, respectively) were characterized by being second in their reported intakes of fruit and poultry and the highest in fish intake in comparison with other groups. Conclusion: Variations in diet noted in this study, with additional analysis

Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective.

PubMed

Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba

2018-03-20

Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been

Identifying Key Hospital Service Quality Factors in Online Health Communities

PubMed Central

Jung, Yuchul; Hur, Cinyoung; Jung, Dain

2015-01-01

Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is

The Role of Community Resource Assessments in the Development of 15 Adolescent Health Community-Researcher Partnerships

PubMed Central

Deeds, Bethany Griffin; Straub, Diane M.; Willard, Nancy; Castor, Judith; Ellen, Jonathan; Peralta, Ligia

2009-01-01

Background Connect to Protect (C2P): Partnerships for Youth Prevention Interventions is an initiative that alters the community’s structural elements to reduce youth HIV rates. Objectives This study details a community resource assessment and describes how resources were evaluated in the context of local needs. Methods Fifteen sites developed a community resource list, conducted a brief survey, created a youth service directory, and mapped where disease prevalence and community resources intersected. Sites also completed a survey to review and verify local site findings. Results On average, sites identified 267 potential community resources. Sites narrowed their resource list to conduct a brief survey with 1,162 agencies; the site average was 78. Final products of this process included maps comparing resources with risk data. Conclusions The evaluation of local resources is an important initial step in partnership development and is essential for the success of health promotion and disease prevention interventions that target adolescents. PMID:20208189

Community desires for an online health information strategy.

PubMed

Dart, Jared M; Gallois, Cindy

2010-11-01

To determine whether the community's attitudes to components of a community eHealth strategy differ across three different socioeconomic groups. A survey questionnaire was designed and implemented across three different communities. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic community on the outskirts of Ipswich, Queensland (n = 262), a mid-high socioeconomic community in the western suburbs of Brisbane (n = 256) and at a local university (n = 200). Ascribed importance and comfort with proposed components of a community eHealth strategy. A community-oriented health website was perceived as useful in getting access to relevant health information. Those who were most comfortable with accessing online health information were those who were: experienced, had home internet access and were frequent internet users. The most important types of health information for the website were: information about the treatment of conditions, how to manage a chronic illness, how to stay healthy and patient clinical pathways. The low socioeconomic community had different information priorities – all categories were considered more important, particularly information about how the public system operates, local health support groups, and the roles of health professionals. Different communities have different information demands but there is a strong demand for information which empowers community members to take control of their own health and become active participants in their health care. Tools such as a community health portal and patient clinical pathways should become more available.

The community health worker cultural mentoring project: preparing professional students for team work with health workers from urban communities.

PubMed

Sherwen, Laurie N; Schwolsky-Fitch, Elena; Rodriquez, Romelia; Horta, Greg; Lopez, Ivanna

2007-01-01

Community Health Workers or CHWs (also known by a variety of alternative titles) are health workers drawn from communities to provide access to care for members of their communities. CHWs have been documented as effective in delivering a variety of services in a culturally-sensitive manner, and in providing a bridge between health professionals and underserved or minority communities. Yet, CHWs have not been well incorporated into interdisciplinary health care teams. The majority of health professionals are not even aware of the possible role and skills of CHWs. Believing that the best time to educate professionals about this valuable health worker and ensure that CHWs become part of interdisciplinary health care teams is during the student years, the Hunter College Schools of the Health Professions, and the Community Health Worker Network of New York City developed a pilot project, the Community Health Worker Cultural Mentoring Project. Community Health Workers, who were members of the Network, served as "community mentors" for health professions students drawn from the programs of community health education, nursing, and nutrition. CHWs worked with faculty of selected courses in each of the professional programs, and served as panelists in these courses, presenting information about health beliefs and alternative health practices of diverse cultural groups in communities of New York City. Class sessions were first held in the fall of 2004; subsequent sessions were held in following semesters. Approximately 40 students participated in 7 classes, with 6 CHWs serving as mentors - two per class. At the end of the classroom presentations, students wrote reflections relating to their understanding of the CHW role and relevance for their future interdisciplinary practice. The majority of reflections met the goal of increasing professional students' understanding of the CHW role and skills. At this point, quantitative and qualitative data will need to be collected to

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

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…

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…

Trust of community health workers influences the acceptance of community-based maternal and child health services.

PubMed

Grant, Merridy; Wilford, Aurene; Haskins, Lyn; Phakathi, Sifiso; Mntambo, Ntokozo; Horwood, Christiane M

2017-05-29

Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings. To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves. Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa. A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing. Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW's role; if they appeared to question the CHW's competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community. Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

Community Health Advisor Programs. An Issue Paper.

ERIC Educational Resources Information Center

National Rural Health Association, Kansas City, MO.

Third World countries have used community health advisors (CHAs) for many years to deliver health services, health education, and linkages to isolated and underserved communities. In 1998 the National Community Health Advisor Study estimated there were at least 600 such programs in the United States using about 12,500 CHAs. Program activities and…

Mental Health and Exposure to the United States: Key Correlates from the Hispanic Community Health Study of Latinos.

PubMed

Perreira, Krista M; Gotman, Nathan; Isasi, Carmen R; Arguelles, William; Castañeda, Sheila F; Daviglus, Martha L; Giachello, Aida L; Gonzalez, Patricia; Penedo, Frank J; Salgado, Hugo; Wassertheil-Smoller, Sylvia

2015-09-01

We examined the association between exposure to the U.S. and symptoms of poor mental health among adult Hispanic/Latinos (N = 15,004) overall and by Hispanic/Latino background. Using data from the Hispanic Community Health Study of Latinos (HCHS/SOL), we estimated logistic regressions to model the risk of moderate to severe symptoms of psychological distress, depression, and anxiety as a function of years in the U.S. and six key psychosocial risk and protective factors. In unadjusted models, increased time in the U.S. was associated with higher risk of poor mental health. After adjustment for just three key factors--perceived discrimination, perceived U.S. social standing, and the size of close social networks--differences in the odds of poor mental health by years in the U.S became insignificant for Hispanics/Latinos overall. However, analyses by Hispanic/Latino background revealed different patterns of association with exposure to the U.S. that could not be fully explained.

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

PubMed

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

2006-05-17

To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. 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. 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. 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.

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

A Mixed-Methods Approach to Understanding Community Participation in Community Health Needs Assessments.

PubMed

Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

Nonprofit hospitals are exempt from paying taxes. To maintain this status, they must provide benefit to the community they serve. In an attempt to improve accountability to these communities and the federal government, the Patient Protection and Affordable Care Act of 2010 includes a provision that requires all nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address identified health priorities every 3 years. This Act's provision, operationalized by a regulation developed and enforced by the Internal Revenue Service, mandates the involvement of public health agencies and other community stakeholders in the completion of the CHNA. To better understand community participation in nonprofit hospital-directed community health assessment and health improvement planning activities. Using a 2-phased, mixed-methods study design, we (1) conducted content analysis of 95 CHNA/implementation plan reports and (2) interviewed hospital and health system key informants, consultants, and community stakeholders involved in CHNA and planning processes. Community participation was assessed in terms of types of stakeholders involved and the depth of their involvement. Our findings suggest that many hospitals engaged and involved community stakeholders in certain aspects of the assessment process, but very few engaged a broad array of community stakeholder and community members in meaningful participation throughout the CHNA and health improvement planning process. Vast improvements in community participation and collaborative assessment and planning can be made in future CHNAs. On the basis of the findings, recommendations are made for further research. Practice implications include expanding community engagement and participation by stakeholder and activity type and using a common community health improvement model that better aligns hospital CHNA processes and implementation strategies with other organizations and agencies.

[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.

Toward a Healthy Community (Organizing Events for Community Health Promotion).

ERIC Educational Resources Information Center

Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

This booklet suggests the first steps communities can take in assessing their needs and resources and mobilizing public interest and support for health promotion. It is based on an approach to health education and community organization that recognizes the value of a highly visible, time-limited event, such as a health fair, a marathon, or an…

Promoting community participation in priority setting in district health systems: experiences from Mbarali district, Tanzania

PubMed Central

Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict; Byskov, Jens; Hurtig, Anna-Karin

2013-01-01

Background Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Design Key informant interviews were conducted with the Council Health Management Team (CHMT), community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. Results A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective working arrangement

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…

Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010–2016

PubMed Central

Vargas, Roberto A.; Fleisher, Paula; Aragón, Tomás J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

2017-01-01

Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children’s oral health. Methods SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science–informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Outcome Through SFHIP’s efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. Interpretation The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity. PMID:28333598

Motivating and demotivating factors for community health workers: A qualitative study in urban slums of Delhi, India.

PubMed

George, Mathew Sunil; Pant, Shradha; Devasenapathy, Niveditha; Ghosh-Jerath, Suparna; Zodpey, Sanjay P

2017-04-01

Background Community health workers play an important role in delivering health-care services, especially to underserved populations in low- and middle-income countries. They have been shown to be successful in providing a range of preventive, promotive and curative services. This qualitative study investigated the factors motivating or demotivating community health workers in urban settings in Delhi, India. Methods In this sub-study of the ANCHUL (Ante Natal and Child Healthcare in Urban Slums) implementation research project, four focus-group discussions and nine in-depth interviews were conducted with community health workers and medical officers. Utilizing a reflexive and inductive qualitative methodology, the data set was coded, to allow categories of motivating and demotivating factors to emerge. Results Motivating factors identified were: support from family members for their work, improved self-identity, job satisfaction and a sense of social responsibility, prior experiences of ill health, the opportunity to acquire new skills and knowledge, social recognition and status conferred by the community, and flexible work and timings. Negative experiences in the community and at health centres, constraints in the local health system in response to the demand generated by the community health workers, and poor pay demotivated community health workers in this study, even causing some to quit their jobs. Conclusion Community-health-worker programmes that focus on ensuring the technical capacity of their staff may not give adequate attention to the factors that motivate or discourage these workers. As efforts get under way to ensure universal access to health care, it is important that these issues are recognized and addressed, to ensure that community health worker programmes are effective and sustainable.

Addressing the Health of Formerly Imprisoned Persons in a Distressed Neighborhood Through a Community Collaborative Board

PubMed Central

Smith, Vivian C.; Jemal, Alexis

2016-01-01

This article provides a case study evaluating the structure and dynamic process of a Community Collaborative Board that had the goal of creating an evidence-based substance abuse/health intervention for previously incarcerated individuals. Meeting agendas, attendance, minutes, video recording of meetings, and in-depth interviews with 13 Community Collaborative Board members were used to conduct an independent process evaluation. Open coding identified quotes exemplifying specific themes and/or patterns across answers related to the desired domain. Several themes were identified regarding membership engagement, retention, and power distribution. Results showed member retention was due to strong personal commitment to the targeted problem. Analysis also revealed an unequal power distribution based on participants' background. Nevertheless, the development of an innovative, community-based health intervention manual was accomplished. Aspects of the process, such as incentives, subcommittees, and trainings, enhanced the Board's ability to integrate the community and scientific knowledge to accomplish its research agenda. Community-based participatory research was a useful framework in enhancing quality and efficiency in the development of an innovative, substance abuse/health intervention manual for distressed communities. Overall, this article sheds light on a process that illustrates the integration of community-based and scientific knowledge to address the health, economic, and societal marginalization of low-income, minority communities. PMID:26055460

Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

PubMed Central

Allotey, Pascale; Reidpath, Daniel D.; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharmalingam; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy

2014-01-01

Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement. PMID:24804983

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. © 2013 Wiley Periodicals, Inc.

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

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

Making it Work 2: using a virtual community to focus on rural health issues.

PubMed

Godden, David J; Aaraas, Ivar J

2006-01-01

Between 21 and 23 September 2005, over 200 delegates from eight countries gathered in Tromsö, within the Arctic Circle, to discuss challenges and solutions to rural health issues. This conference was a sequel to a previous event entitled 'Making it Work', held in Scotland in 2003, in which it was identified that service delivery in remote and rural areas needed to be innovative to ensure equity. A major aim of this event was to move the debate forward to describe specific examples of practice that could be adopted in participating countries. The delegates included clinicians, managers and administrators, senior policymakers and educationalists, elected local and national politicians, patients and their representatives. In order to focus debate, the organisers provided an outline of a virtual remote community ('Hope'), including some geographic and demographic information, together with four case studies of individual health problems faced by residents of the community. During the introductory session, a short film was shown featuring the 'residents' of this community, introducing delegates to the specific problems they faced. Throughout the conference, delegates were asked to reflect back to how any recommendations made might apply to the citizens of Hope. The clinical scenarios presented included: (1) a 37 year old pregnant woman in labour during adverse weather conditions; (2) a 17 year old island resident with acute psychosis who attempts suicide; (3) an 80 year old woman living alone who suffers a stroke; and (4) a family of four with a complex range of chronic health issues including smoking, alcoholism, diabetes, teenage pregnancy, asthma and depression on a background of deprivation and unemployment. Parallel discussions and workshops focussed on a number of key themes linked to the examples highlighted in the 'Hope' scenario. These included: maternity services; mental health; chronic disease management; health improvement and illness prevention; supporting

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.

Community perceptions of mental health needs: a qualitative study in the Solomon Islands

PubMed Central

Blignault, Ilse; Bunde-Birouste, Anne; Ritchie, Jan; Silove, Derrick; Zwi, Anthony B

2009-01-01

Background Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems. Methods This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly. Results Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict. Conclusion Communities identify and are

Factors related to mental health and hearing in community-dwelling elderly

PubMed Central

Nabeshima, Sumiyo; Yamada, Kiyomi

2018-01-01

ABSTRACT The purpose of this study was to clarify the factors related to mental health and hearing in community-dwelling elderly. Elderly participants in a project to prevent long-term care need were given a self-administered questionnaire and tested by pure-tone audiometry. One hundred fifty were taken as subjects. Forty-one of these subjects (27.3%) were found to have poor mental health. The results of multiple logistic regression analysis with mental health level as the dependent variable indicated that subjects 65–74 years old who did not think their own hearing was bad had better mental health than those who did think their hearing was bad (odds ratio 10.800). Among subjects 75 years and older, those who had not been certified as needing long-term care had better mental health than those who had been certified (odds ratio 3.937). When planning mental health support for community-dwelling elderly in the future, it will be necessary to consider differences in background due to age group. The present results suggest that appropriate support for awareness of hearing and acceptance of decreased hearing ability in people in early old age (65–74 years old) may help to prevent declining mental health in later old age.

Sexual Violence and Reproductive Health among Young People in Three Communities in Jamaica

ERIC Educational Resources Information Center

Geary, Cynthia Waszak; Wedderburn, Maxine; McCarraher, Donna; Cuthbertson, Carmen; Pottinger, Audrey

2006-01-01

A secondary analysis of data collected from 1,130 young people ages 15 to 24 in a population-based household survey to assess the reproductive health needs of young people in three communities in Jamaica was conducted to determine the relationships among three measures of sexual violence, background variables, three measures of sexual risk taking…

Training of Community Health Agents in health hearing children: current perspectives.

PubMed

Castro, Taís Teixeira de Oliveira; Zucki, Fernanda

2015-01-01

To characterize the training of Community Health Workers in the field of child hearing health. A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed. The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese. A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review. The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified. Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

Developing and Sustaining a Healthy School Community: Essential Elements Identified by School Health Champions

ERIC Educational Resources Information Center

Stolp, Sean; Wilkins, Emma; Raine, Kim D.

2015-01-01

Background: Comprehensive School Health (CSH) approaches to developing a healthy school community can be effective in supporting chronic disease prevention while positively impacting on student behaviour and academic performance. Although a CSH framework provides principles for action, there is a lack of evidence regarding the processes that best…

Building Capacity in the Sikh Asian Indian Community to Lead Participatory Oral Health Projects

PubMed Central

Kavathe, Rucha; Islam, Nadia; Zanowiak, Jennifer; Wyatt, Laura; Singh, Hardayal; Northridge, Mary E.

2018-01-01

Background Lack of access to oral health care is a significant burden for disadvantaged populations, yet rarely draws the attention of policymakers or community leaders. Objectives To understand how UNITED SIKHS identified oral health care as a priority need through its involvement in community-based participatory research (CBPR) initiatives and local data collection, thereby building its capacity to lead participatory oral health projects. Methods The foundation for the partnership between UNITED SIKHS and the New York University (NYU) Prevention Research Center (PRC) was the joint implementation of a CBPR project to prevent diabetes in the Sikh Asian Indian community. Project partners also included a community coalition composed of religious leaders, health providers, members of the media, and dental students and faculty at the NYU College of Dentistry (NYU Dentistry). A community needs and resources assessment survey was jointly developed and conducted in 2010 to better understand health needs in the Sikh community. Results Fewer than one-half of the Sikh participants (43.0%) reported ever receiving a check-up or screening by a dentist, and of those who did, only one-half (50.0%) reported that it occurred in the past 12 months. Upon clinical assessment, more than one-half of Sikh adults (58.2%) had untreated dental decay. The collection and analysis of local data motivated UNITED SIKHS to develop new priorities based upon the findings. Conclusions UNITED SIKHS applied for and received external funding to lead a CBPR project that developed, implemented, evaluated, and disseminated a culturally tailored oral health and healthy living curriculum for the Sikh Asian Indian community. PMID:29606688

Student Health and the Community College.

ERIC Educational Resources Information Center

Whitaker, Linda A.

Research and statistical surveys on student health services and problems at community colleges are reviewed to ascertain administrative attitudes, student health care needs, and areas for improvement. Providing health care for students is said to be generally overlooked by community college professionals who feel it should not be the college's…

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults with Type 2 Diabetes?

ERIC Educational Resources Information Center

Murayama, Hiroshi; Spencer, Michael S.; Sinco, Brandy R.; Palmisano, Gloria; Kieffer, Edith C.

2017-01-01

Background: Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective…

Social capital and health: civic engagement, community size, and recall of health messages.

PubMed

Viswanath, Kasisomayajula; Randolph Steele, Whitney; Finnegan, John R

2006-08-01

We explored the effects of community integration and pluralism on recall of cardiovascular disease health information messages. With 1980-1983 data from the Minnesota Heart Health Program, we examined whether ties to community groups were associated with recall of health messages, and whether this relation was modified by size and degree of differentiation of the community. A higher level of civic engagement through ties to community groups was associated with better recall of health messages. Ties to community groups independently contributed to better message recall even after control for gender, education, and other variables. The moderating role of community size was non-significant but intriguing. Community group membership could increase exposure to health messages, providing a critical pathway for social capital to influence health promotion and, thus, public health outcomes.

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

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

PubMed Central

2011-01-01

Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and applying knowledge through direct

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…

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. Project HOPE—The People-to-People Health Foundation, Inc.

Lessons Learned From a Community-Based Participatory Research Mental Health Promotion Program for American Indian Youth.

PubMed

Langdon, Sarah E; Golden, Shannon L; Arnold, Elizabeth Mayfield; Maynor, Rhonda F; Bryant, Alfred; Freeman, V Kay; Bell, Ronny A

2016-05-01

Background American Indian (AI) youth have the highest rates of suicide among racial/ethnic minority groups in the United States. Community-based strategies are essential to address this issue, and community-based participatory research (CBPR) offers a model to engage AI communities in mental health promotion programming. Objectives This article describes successes and challenges of a CBPR, mixed-method project, The Lumbee Rite of Passage (LROP), an academic-community partnership to develop and implement a suicide prevention program for Lumbee AI youth in North Carolina. Method LROP was conducted in two phases to (1) understand knowledge and perceptions of existing mental health resources and (2) develop, implement, and evaluate a cultural enrichment program as a means of suicide prevention. Discussion/Results LROP implemented an effective community-academic partnership by (1) identifying and understanding community contexts, (2) maintaining equitable partnerships, and (3) implementing a culturally tailored research design targeting multilevel changes to support mental health. Strategies formed from the partnership alleviated challenges in each of these key CBPR concept areas. Conclusions LROP highlights how a CBPR approach contributes to positive outcomes and identifies opportunities for future collaboration in a tribal community. Using culturally appropriate CBPR strategies is critical to achieving sustainable, effective programs to improve mental health of AI youth. © 2016 Society for Public Health Education.

Students Seeking Access to Four-Year Institutions: Community College Transfers [Background Information].

ERIC Educational Resources Information Center

Moore, Jamillah

This publication provides background information for a hearing by the California Senate Select Committee on Higher Education and Outreach on December 3, 1997. The Introduction presents the Committee announcement, press release, agenda, information about transfer efforts in California, facts and figures about the community colleges, and the text of…

Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition.

PubMed

Luo, Wei; Harvey, Richard; Tran, Truyen; Phung, Dinh; Venkatesh, Svetha; Connor, Jason P

2016-04-27

The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres. A regional mental health service with both acute and community facilities. 111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded. The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen's κ and effect size. Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen's κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background. Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Community mental health care in India.

PubMed

Padmavati, R

2005-04-01

Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

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.

Social Capital and Health: Civic Engagement, Community Size, and Recall of Health Messages

PubMed Central

Viswanath, Kasisomayajula; Randolph Steele, Whitney; Finnegan, John R.

2006-01-01

Objectives. We explored the effects of community integration and pluralism on recall of cardiovascular disease health information messages. Methods. With 1980–1983 data from the Minnesota Heart Health Program, we examined whether ties to community groups were associated with recall of health messages, and whether this relation was modified by size and degree of differentiation of the community. Results. A higher level of civic engagement through ties to community groups was associated with better recall of health messages. Ties to community groups independently contributed to better message recall even after control for gender, education, and other variables. The moderating role of community size was non-significant but intriguing. Conclusions. Community group membership could increase exposure to health messages, providing a critical pathway for social capital to influence health promotion and, thus, public health outcomes. PMID:16809608

Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

PubMed Central

Asuzu, Michael C.

2015-01-01

Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation. PMID:26245600

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.

Patient Continued Use of Online Health Care Communities: Web Mining of Patient-Doctor Communication

PubMed Central

2018-01-01

Background In practice, online health communities have passed the adoption stage and reached the diffusion phase of development. In this phase, patients equipped with knowledge regarding the issues involved in health care are capable of switching between different communities to maximize their online health community activities. Online health communities employ doctors to answer patient questions, and high quality online health communities are more likely to be acknowledged by patients. Therefore, the factors that motivate patients to maintain ongoing relationships with online health communities must be addressed. However, this has received limited scholarly attention. Objective The purpose of this study was to identify the factors that drive patients to continue their use of online health communities where doctor-patient communication occurs. This was achieved by integrating the information system success model with online health community features. Methods A Web spider was used to download and extract data from one of the most authoritative Chinese online health communities in which communication occurs between doctors and patients. The time span analyzed in this study was from January 2017 to March 2017. A sample of 469 valid anonymous patients with 9667 posts was obtained (the equivalent of 469 respondents in survey research). A combination of Web mining and structural equation modeling was then conducted to test the research hypotheses. Results The results show that the research framework for integrating the information system success model and online health community features contributes to our understanding of the factors that drive patients' relationships with online health communities. The primary findings are as follows: (1) perceived usefulness is found to be significantly determined by three exogenous variables (ie, social support, information quality, and service quality; R2=0.88). These variables explain 87.6% of the variance in perceived usefulness

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

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.

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.

Community Based Cardiovascular Health Interventions in Vulnerable Populations: A Systematic Review

PubMed Central

Walton-Moss, Benita; Samuel, Laura; Nguyen, Tam H; Commodore-Mensah, Yvonne; Hayat, Matthew J.; Szanton, Sarah L.

2013-01-01

Background Although cardiovascular health has been improving for many Americans, this is not true of those in “vulnerable populations.” To address this growing disparity communities and researchers have worked for decades, and as a result of their work a growing body of literature supports the use of community engagement as a component of successful interventions. However, little literature synthesizes community-based interventions that address this disparity among a wide range of vulnerable populations. Objective This paper provides a critical review of community-based cardiovascular disease (CVD) interventions to improve cardiovascular health behaviors and factors among vulnerable populations based on the American Heart Association’s 7 metrics of ideal cardiovascular health. Methods In February 2011, four databases (PubMed, PsychInfo, CINAHL, and Scopus) were searched using the following keywords: vulnerable populations OR healthcare disparities AND cardiovascular disease AND clinical trials OR public health practice AND English. Results This search strategy resulted in the retrieval of 7,120 abstracts. Each abstract was reviewed by at least two authors and eligibility for the systematic review was confirmed after reading the full article. Thirty two studies met eligibility criteria. Education was the most common intervention (41%), followed by counseling or support (38%), and exercise classes (28%). Half of the interventions were multi-component. Health care providers were the most frequent interventionists. Interventions aimed at decreasing blood pressure were the most promising while behavior change interventions were the most challenging. Almost all of the interventions were at the individual level, and were proof of concept or efficacy trials. Conclusions This analysis provides a step towards understanding the current literature on cardiovascular interventions for vulnerable population. The next step should be integrating the identified successful

Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

ERIC Educational Resources Information Center

Shah, Megha K.; Kieffer, Edith C.; Choi, Hwajung; Schumann, Christina; Heisler, Michele

2015-01-01

Background. Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar,…

Rural Religious Leaders' Perspectives on their Communities' Health Priorities and Health.

PubMed

Schoenberg, Nancy E; Swanson, Mark

2017-07-01

In traditionally underserved communities, faith-based interventions have been shown to be effective for health promotion. Religious leaders-generally the major partner in such interventions-however, are seldom are consulted about community health priorities and health promotion preferences. These insights are critical to ensure productive partnerships, effective programming, and sustainability. Mixed-methods surveys were administered in one of the nation's most under-resourced regions: rural Appalachia. A sample of 60 religious leaders, representing the main denominations in central Appalachia, participated. Measures included closed- and open-ended survey questions on health priorities and recommendations for health promotion. Descriptive statistics were used for closed-ended survey items and conventional qualitative content analysis was used for open-ended responses. Substance abuse, diabetes mellitus, suboptimal dietary intake and obesity/overweight, and cardiovascular and respiratory illnesses constitute major health concerns. Addressing these challenging conditions requires realistically acknowledging sparse community resources (particularly healthcare provider shortages); building in accountability; and leveraging local assets and traditions such as testimonials, intergenerational support, and witnessing. With their extensive reach within the community and their accurate understanding of community health threats, practitioners and researchers may find religious leaders to be natural allies in health-promotion and disease-prevention activities.

A gender-informed model to train community health workers in maternal mental health.

PubMed

Smith, Megan V; Kruse-Austin, Anna

2015-08-01

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers. Copyright © 2014. Published by Elsevier Ltd.

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)

Improving local health through community health workers in Cambodia: challenges and solutions.

PubMed

Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

2018-01-06

Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently

The roles of community health workers in management of non-communicable diseases in an urban township

PubMed Central

Puoane, Thandi; Schneider, Helen; Levitt, Naomi S.; Steyn, Krisela

2014-01-01

Background Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce in South Africa and other parts of the world. CHWs have taken on a variety of roles, including community empowerment, provision of services and linking communities with health facilities. Their roles are better understood in the areas of maternal and child health and infectious diseases (HIV infection, malaria and tuberculosis). Aim This study seeks to explore the current roles of CHWs working with non-communicable diseases (NCDs). Setting The study was conducted in an urban township in Cape Town, South Africa. Method A qualitative naturalistic research design utilising observations and in-depth interviews with CHWs and their supervisors working in Khayelitsha was used. Results CHWs have multiple roles in the care of NCDs. They act as health educators, advisors, rehabilitation workers and support group facilitators. They further screen for complications of illness and assist community members to navigate the health system. These roles are shaped both by expectations of the health system and in response to community needs. Conclusion This study indicates the complexities of the roles of CHWs working with NCDs. Understanding the actual roles of CHWs provides insights into not only the competencies required to enable them to fulfil their daily functions, but also the type of training required to fill the present gaps. PMID:26245419

ENGAGING THE COMMUNITY IN HEALTH RESEARCH IN INDIA

PubMed Central

Wells, Kristen J.; Preuss, Charles; Pathak, Yashwant; Kosambiya, J. K.; Kumar, Ambuj

2013-01-01

Community-engaged research approaches involve members of the community in various aspects of a research endeavor to improve the health of populations. Engaging the community in research is important in the development, dissemination, and evaluation of new interventions, technologies, and other medical advancements to improve population health globally. A review of published community-engaged research studies conducted in India was performed. Fifteen published studies were identified and reviewed to evaluate the state of community-engaged research in India. The review indicated that community-engaged research in India is limited. Most published community-engaged research focused on health promotion, especially in the prevention or management of HIV/AIDS and other STIs. Community members were involved in a variety of aspects of the research, but there was not one published article indicating that community members had defined the disease of focus. Community-engaged research often led to valuable insights into the views, experiences, and behaviors of community members and also led to increased community participation in health initiatives. It is anticipated that future community-engaged research will lead to improvements in global health through increased empowerment of communities and a better ability to implement new and innovative medical advances, technologies, and interventions. PMID:24353757

Effectiveness of community health financing in meeting the cost of illness.

PubMed Central

Preker, Alexander S.; Carrin, Guy; Dror, David; Jakab, Melitta; Hsiao, William; Arhin-Tenkorang, Dyna

2002-01-01

How to finance and provide health care for the more than 1.3 billion rural poor and informal sector workers in low- and middle-income countries is one of the greatest challenges facing the international development community. This article presents the main findings from an extensive survey of the literature of community financing arrangements, and selected experiences from the Asia and Africa regions. Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Micro-level household data analysis indicates that community financing improves access by rural and informal sector workers to needed heath care and provides them with some financial protection against the cost of illness. Macro-level cross-country analysis gives empirical support to the hypothesis that risk-sharing in health financing matters in terms of its impact on both the level and distribution of health, financial fairness and responsiveness indicators. The background research done for this article points to five key policies available to governments to improve the effectiveness and sustainability of existing community financing schemes. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) insurance to protect against expenditure fluctuations and re-insurance to enlarge the effective size of small risk pools; (c) effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks. PMID:11953793

The Impact of Integrating Community Advocacy Into Community Health Worker Roles on Health-Focused Organizations and Community Health Workers in Southern Arizona.

PubMed

Reinschmidt, Kerstin M; Ingram, Maia; Schachter, Kenneth; Sabo, Samantha; Verdugo, Lorena; Carvajal, Scott

2015-01-01

Organizational environments may encourage community health workers (CHWs) to engage community members in improving their communities. We conducted open-ended interviews and focus groups to explore how participation in the Acción intervention, which trained CHWs in community advocacy, affected organizational capacity to support their CHWs. Supervisors described improved organizational recognition and trust of CHWs. Organizational leaders reported organizational benefits and increased appreciation of CHW leadership. Both expressed increased interest in future advocacy trainings. Limiting factors included organizational mission, CHW position descriptions, and funding. Findings indicate that, with training and funding, CHW community advocacy can be integrated into organizations with congruent missions.

Work of community health agents in the Family Health Strategy: meta-synthesis

PubMed Central

Alonso, Carolina Maria do Carmo; Béguin, Pascal Daniel; Duarte, Francisco José de Castro Moura

2018-01-01

ABSTRACT OBJECTIVE To systematize and analyze the evidence from qualitative studies that address the perception of Brazilian Community Health Agents about their work. METHODS This is a systematic review of the meta-synthesis type on the work of community health agents, carried out from the Virtual Health Library using the descriptors “Agente Comunitário de Saúde” and “Trabalho”, in Portuguese. The strategy was constructed by crossing descriptors, using the Boolean operator “AND”, and filtering Brazilian articles, published from 2004 to 2014, which resulted in 129 identified articles. We removed quantitative or quanti-qualitative research articles, essays, debates, literature reviews, reports of experiences, and research that did not include Brazilian Community Health Agents as subjects. Using these criteria, we selected and analyzed 33 studies that allowed us to identify common subjects and differences between them, to group the main conclusions, to classify subjects, and to interpret the content. RESULTS The analysis resulted in three thematic units: characteristics of the work of community health agents, problems related to the work of community health agents, and positive aspects of the work of community health agents. On the characteristics, we could see that the work of the community health agents is permeated by the political and social dimensions of the health work with predominant use of light technologies. The main input is the knowledge that this professional obtains with the contact with families, which is developed with home visits. On the problems in the work of community health agents, we could identify the lack of limits in their attributions, poor conditions, obstacles in the relationship with the community and teams, weak professional training, and bureaucracy. The positive aspects we identified were the recognition of the work by families, resolution, bonding, work with peers, and work close to home. CONCLUSIONS This review provided

Work of community health agents in the Family Health Strategy: meta-synthesis.

PubMed

Alonso, Carolina Maria do Carmo; Béguin, Pascal Daniel; Duarte, Francisco José de Castro Moura

2018-01-01

OBJECTIVE To systematize and analyze the evidence from qualitative studies that address the perception of Brazilian Community Health Agents about their work. METHODS This is a systematic review of the meta-synthesis type on the work of community health agents, carried out from the Virtual Health Library using the descriptors "Agente Comunitário de Saúde" and "Trabalho", in Portuguese. The strategy was constructed by crossing descriptors, using the Boolean operator "AND", and filtering Brazilian articles, published from 2004 to 2014, which resulted in 129 identified articles. We removed quantitative or quanti-qualitative research articles, essays, debates, literature reviews, reports of experiences, and research that did not include Brazilian Community Health Agents as subjects. Using these criteria, we selected and analyzed 33 studies that allowed us to identify common subjects and differences between them, to group the main conclusions, to classify subjects, and to interpret the content. RESULTS The analysis resulted in three thematic units: characteristics of the work of community health agents, problems related to the work of community health agents, and positive aspects of the work of community health agents. On the characteristics, we could see that the work of the community health agents is permeated by the political and social dimensions of the health work with predominant use of light technologies. The main input is the knowledge that this professional obtains with the contact with families, which is developed with home visits. On the problems in the work of community health agents, we could identify the lack of limits in their attributions, poor conditions, obstacles in the relationship with the community and teams, weak professional training, and bureaucracy. The positive aspects we identified were the recognition of the work by families, resolution, bonding, work with peers, and work close to home. CONCLUSIONS This review provided an overview of the

Drinking water quality in Indigenous communities in Canada and health outcomes: a scoping review

PubMed Central

Bradford, Lori E. A.; Bharadwaj, Lalita A.; Okpalauwaekwe, Udoka; Waldner, Cheryl L.

2016-01-01

Background Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. Objective The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. Design A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar). Online searches for grey literature using relevant government websites were completed. Results Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature) met criteria for inclusion (contained keywords; publication year 2000–2015; peer-reviewed and from Canada). Studies were quantitative (8), qualitative (5) or mixed (3) and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of “health” was given (14/16), and the primary health issue described was gastrointestinal illness (12/16). Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Conclusions Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a database to store

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

PubMed

Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

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

From theory to practice: community health nursing in a public health neighborhood team.

PubMed

Westbrook, L O; Schultz, P R

2000-12-01

An interdisciplinary team in a local public health district tested its ability to implement the core public health functions of assessment, policy development, and assurance by changing its practice to a community-driven model of building partnerships for health with groups and communities in a designated locale. Evaluation of this innovation revealed that the public health nurse members of the team enacted their community health nursing knowledge to strengthen agency to cocreate health. Interdisciplinary collaboration was essential to the team's community mobilization efforts. Additional findings suggested that this organizational innovation was associated with developing a more participatory organizational climate, increasing system effectiveness, and building community capacity.

Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia

PubMed Central

Gibbs, Lisa; Waters, Elizabeth; Christian, Bradley; Gold, Lisa; Young, Dana; de Silva, Andrea; Calache, Hanny; Gussy, Mark; Watt, Richard; Riggs, Elisha; Tadic, Maryanne; Hall, Martin; Gondal, Iqbal; Pradel, Veronika; Moore, Laurence

2015-01-01

Objectives The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. Design An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. Setting The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Participants Families with 1–4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. Intervention The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. Outcome measures This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Results Significant differences in the Debris Index (OR=0.44 (0.22 to 0.88)) and the Modified Gingival Index (OR=0.34 (0.19 to 0.61)) indicated increased tooth brushing and/or improved toothbrushing technique in the intervention group. An increased proportion of intervention parents, compared to those in the comparison group reported that they had been shown how to brush their child's teeth (OR=2.65 (1.49 to 4.69)). Process evaluation results highlighted the problems with recruitment and retention of the study sample (275 complete case families). The child dental screening encouraged involvement in the study, as did linking attendance with other community/cultural activities. Conclusions The Teeth Tales intervention was promising in terms of improving oral hygiene and parent knowledge of tooth brushing technique. Adaptations to delivery of the intervention are required to increase uptake and likely impact. A future cluster randomised controlled trial

Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia.

PubMed

Gibbs, Lisa; Waters, Elizabeth; Christian, Bradley; Gold, Lisa; Young, Dana; de Silva, Andrea; Calache, Hanny; Gussy, Mark; Watt, Richard; Riggs, Elisha; Tadic, Maryanne; Hall, Martin; Gondal, Iqbal; Pradel, Veronika; Moore, Laurence

2015-06-11

The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Significant differences in the Debris Index (OR=0.44 (0.22 to 0.88)) and the Modified Gingival Index (OR=0.34 (0.19 to 0.61)) indicated increased tooth brushing and/or improved toothbrushing technique in the intervention group. An increased proportion of intervention parents, compared to those in the comparison group reported that they had been shown how to brush their child's teeth (OR=2.65 (1.49 to 4.69)). Process evaluation results highlighted the problems with recruitment and retention of the study sample (275 complete case families). The child dental screening encouraged involvement in the study, as did linking attendance with other community/cultural activities. The Teeth Tales intervention was promising in terms of improving oral hygiene and parent knowledge of tooth brushing technique. Adaptations to delivery of the intervention are required to increase uptake and likely impact. A future cluster randomised controlled trial would provide strongest evidence of effectiveness if appropriate to the community, cultural and

Hope and despair: community health assistants’ experiences of working in a rural district in Zambia

PubMed Central

2014-01-01

Background In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. Methods A phenomenological approach was used to examine CHAs’ experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Results Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs’ ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs’ ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA’s self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs’ ability to deliver services

Recovery practice in community mental health teams: national survey

PubMed Central

Leamy, M.; Clarke, E.; Le Boutillier, C.; Bird, V.; Choudhury, R.; MacPherson, R.; Pesola, F.; Sabas, K.; Williams, J.; Williams, P.; Slade, M.

2016-01-01

Background There is consensus about the importance of ‘recovery’ in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Method In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). Results Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31–0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery. PMID:27340113

Incorporating consideration of health impacts into land use development approval processes: Development of a Health Background Study Framework.

PubMed

Moloughney, Brent W; Bursey, Gayle E; Neumann, Jana; Leeming, Daniel H; Gutmann, Christine E; Sivanand, Bhavna; Mowat, David L

2014-09-12

This project involved development of a Health Background Study (HBS) Framework to support consideration of health impacts within municipalities' approval process for land use development. Peel Public Health and Toronto Public Health led the project with the participation of planners, urban designers, engineers, public health staff and development industry representatives. Historical growth in the Region of Peel and suburban Toronto has resulted in extensive low-density development, creating car-dependent communities with disconnected streets and segregated land uses. The inclusion of an HBS in developers' applications to municipalities is one approach by which health-related expectations for the built environment can be established within the approval process. Development of the HBS Framework used the six core elements of the built environment with the strongest evidence for impact on health and was informed by analysis of the provincial and local policy contexts, practices of other municipalities and stakeholder interviews. The Framework's contents were refined according to feedback from multidisciplinary stakeholder workshops. The HBS Framework identifies minimum standards for built environment core elements that developers need to address in their applications. The Framework was created to be simple and instructive with applicability to a range of development locations and scales, and to various stages of the development approval process. Peel Public Health is leading several initiatives to support the use of the HBS as a part of the development application process. The HBS Framework is a tool that public health and planning can use to support the consideration of health impacts within municipalities' land use development processes.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Community governance in primary health care: towards an international Ideal Type.

PubMed

Meads, Geoffrey; Russell, Grant; Lees, Amanda

2017-10-01

Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non

A Comparative Study of Backgrounds and Attitudes of Community College Academic Staff.

ERIC Educational Resources Information Center

Melone, Rudolph Joseph

Community colleges should be responsive to the shifting needs of society. As in the case of other organizations, however, the ability to initiate and adapt to the necessary changes is dependent on the attitudes and backgrounds of the people in the institution. A primary concern of this study was determining whether junior colleges accept the…

Public health preparedness of health providers: meeting the needs of diverse, rural communities.

PubMed

Hsu, Chiehwen Ed; Mas, Francisco Soto; Jacobson, Holly E; Harris, Ann Marie; Hunt, Victoria I; Nkhoma, Ella T

2006-11-01

Meeting the needs of public health emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to public health emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of public health emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies.

Digital storytelling: a tool for health promotion and cancer awareness in rural Alaskan communities

PubMed Central

Cueva, Melany; Kuhnley, Regina; Revels, Laura; Schoenberg, Nancy E.; Dignan, Mark

2015-01-01

Background The purpose of this study was to learn community members’ perspectives about digital storytelling after viewing a digital story created by a Community Health Aide/Practitioner (CHA/P). Methods Using a qualitative research design, we explored digital storytelling likeability as a health-messaging tool, health information viewers reported learning and, if viewing, cancer-related digital stories facilitated increased comfort in talking about cancer. In addition, we enquired if the digital stories affected how viewers felt about cancer, as well as if viewing the digital stories resulted in health behaviour change or intent to change health behaviour. Findings A total of 15 adult community members participated in a 30–45 minute interview, 1–5 months post-viewing of a CHA/P digital story. The majority (13) of viewers interviewed were female, all were Alaska Native and they ranged in age from 25 to 54 years with the average age being 40 years. Due to the small size of communities, which ranged in population from 160 to 2,639 people, all viewers knew the story creator or knew of the story creator. Viewers reported digital stories as an acceptable, emotionally engaging way to increase their cancer awareness and begin conversations. These conversations often served as a springboard for reflection, insight, and cancer-prevention and risk-reduction activities. PMID:26343881

Digital storytelling: a tool for health promotion and cancer awareness in rural Alaskan communities.

PubMed

Cueva, Melany; Kuhnley, Regina; Revels, Laura; Schoenberg, Nancy E; Dignan, Mark

2015-01-01

Background The purpose of this study was to learn community members' perspectives about digital storytelling after viewing a digital story created by a Community Health Aide/Practitioner (CHA/P). Methods Using a qualitative research design, we explored digital storytelling likeability as a health-messaging tool, health information viewers reported learning and, if viewing, cancer-related digital stories facilitated increased comfort in talking about cancer. In addition, we enquired if the digital stories affected how viewers felt about cancer, as well as if viewing the digital stories resulted in health behaviour change or intent to change health behaviour. Findings A total of 15 adult community members participated in a 30-45 minute interview, 1-5 months post-viewing of a CHA/P digital story. The majority (13) of viewers interviewed were female, all were Alaska Native and they ranged in age from 25 to 54 years with the average age being 40 years. Due to the small size of communities, which ranged in population from 160 to 2,639 people, all viewers knew the story creator or knew of the story creator. Viewers reported digital stories as an acceptable, emotionally engaging way to increase their cancer awareness and begin conversations. These conversations often served as a springboard for reflection, insight, and cancer-prevention and risk-reduction activities.

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

PubMed

Ratnaike, R N; Chinner, T L

1992-04-01

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

Factors associated with job satisfaction among Chinese community health workers: a cross-sectional study

PubMed Central

2011-01-01

Background With the medical reform, the function of community health centres emerged to be more important recently in China. However, the health service capabilities were tremendously different between metropolitan cities and small cities. This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan (Shenyang) and a small city (Benxi) in Liaoning province and explore its associated factors. Methods A cross-sectional survey was conducted from December 2009 to February 2010. A multi-stage sample was used and a total of 2,100 Chinese community health workers from the two cities completed self-administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristic and working situations, stress and job burnout. The effective response rate was 80.7%. Hierarchical regression analysis was performed to explore the related factors. All data analyses for the two cities were performed separately. Results The averages of overall job satisfaction score of Chinese community health workers were 67.17 in Shenyang and 69.95 in Benxi. Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi (p < 0.05). In Shenyang, hierarchical regression analysis showed that the fourth model explained 36%, 32% of the variance of intrinsic and extrinsic job satisfactions, respectively. In Benxi, the fourth model explained 48%, 52% of the variance of intrinsic and extrinsic job satisfactions, respectively. Three significant predictors of intrinsic and extrinsic job satisfactions for the two cities were the two dimensions (social support and decision latitude) of stress and cynicism of burnout. Conclusion From this study, the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions, which represented they are not fully

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…

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…

Developing the national community health assistant strategy in Zambia: a policy analysis

PubMed Central

2013-01-01

Background In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Methodology Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. Results The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. Conclusions This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the

Environmental Profile of a Community's Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

PubMed Central

Chow, Clara K.; Lock, Karen; Madhavan, Manisha; Corsi, Daniel J.; Gilmore, Anna B.; Subramanian, S. V.; Li, Wei; Swaminathan, Sumathi; Lopez-Jaramillo, Patricio; Avezum, Alvaro; Lear, Scott A.; Dagenais, Gilles; Teo, Koon; McKee, Martin; Yusuf, Salim

2010-01-01

Background The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. Method/Principal Findings The Environmental Profile of Community Health (EPOCH) instrument comprises two parts: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient - ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4–0.75) for 14 of 38 items. Conclusion This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings. PMID:21170320

Health and Social Care Practitioners' Experiences of Assessing Mental Capacity in a Community Learning Disability Team

ERIC Educational Resources Information Center

Ratcliff, Daniel; Chapman, Melanie

2016-01-01

Background: The study explored experiences of health and social care practitioners within a community learning disability team in undertaking mental capacity assessments with people with learning disabilities. Materials and Methods: Eight practitioners were interviewed using a semi-structured interview schedule. Results: The information gained was…

Evaluating the health impacts of participation in Australian community arts groups.

PubMed

Kelaher, Margaret; Dunt, David; Berman, Naomi; Curry, Steve; Joubert, Lindy; Johnson, Victoria

2014-09-01

This study evaluates the impacts of three well-established community arts programmes in Victoria, Australia, on the mental health and well-being outcomes of participants typically from disadvantaged backgrounds during 2006-07. It employs a theoretical framework that reconciles evidence-based practice in health and the phenomenological nature of community arts practice. Self-determination theory (SDT) was used to do this with SDT-derived psychometric instruments [arts climate and Basic Psychological Needs Scales (BPNS)]. Self-administered surveys using these instruments as well as a measure of social support were undertaken on two occasions. Two overlapping but distinct samples were defined and analysed cross-sectionally. These were a (pre-)survey at the commencement of rehearsals for the annual performance (n = 103) and a (post-)survey following the performance (n = 70). The most significant change (MSC) technique was used to study the arts-making process and how it contributes to outcomes. Using these mixed-methods approach, impacts on the climate of the arts organizations, participant access to supportive relationships and participant's mental health and well-being were studied. There were positive changes in the BPNS (p = 0.00), as well as its autonomy (p = 0.04) and relatedness (p = 0.00) subscales. Social support increased from 65.3% in the pre-survey to 82.4% in the post-survey (p = 0.03). MSC data indicated that the supportive, collaborative environment provided by the arts organizations was highly valued by participants and was perceived to have mental health benefits.Overall, the study demonstrated the potential health promoting effects of community arts programmes in disadvantaged populations. Its multi-method approach should be further studied in evaluating other community arts programmes. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Development of the community mental health system and activities of the community mental health team in Kawasaki City].

PubMed

Ito, Masato

2012-01-01

Since the 1960s, Kawasaki City has been leading the nation in its efforts regarding community mental health practices. Public institutions such as the Psychiatric Rehabilitation Center in the central area of the city and the Mental Health and Welfare Center in the southern area have mainly developed the psychiatric rehabilitation system. However, since 2000, new mental health needs have emerged, as the target of mental health and welfare services has been diversified to include people with developmental disorders, higher brain dysfunction, or social withdrawal, in addition to those with schizophrenia. Therefore, Kawasaki City's plan for community-based rehabilitation was drawn up, which makes professional support available for individuals with physical, intellectual, and mental disabilities. As the plan was being implemented, in 2008, the Northern Community Rehabilitation Center was established by both the public and private sectors in partnership. After the community mental health teams were assigned to both southern and northern areas of the city, the community partnership has been developed not only for individual support but also for other objectives that required the partnership. Takeshima pointed out that the local community should be inclusive of the psychiatric care in the final stage of community mental health care in Japan. Because of the major policies regarding people with disabilities, the final stage has been reached in the northern area of Kawasaki City. This also leads to improvement in measures for major issues in psychiatry, such as suicide prevention and intervention in psychiatric disease at an early stage.

Marketing and Community Mental Health Centers.

ERIC Educational Resources Information Center

Ferniany, Isaac W.; Garove, William E.

1983-01-01

Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

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

A community approach to health.

PubMed

Hagland, M

1997-01-01

Improving the health and well-being of a community may seem like a daunting task-particularly when you consider the vast number of factors that can influence the quality of life of a neighborhood or a region. It's not impossible, however, as six widely different communities across the U.S. are discovering. The Accelerating Community Transformation (ACT) project--now underway by The Healthcare Forum through a five-year, $5 million grant from pharmaceutical joint venture Astra Merck Inc.--is an innovative attempt to create real-life learning laboratories in communities as diverse as an inner-city neighborhood on the west side of Chicago; the small southern town of Aiken, S.C.: the semi-desert city of San Bernardino, Calif.; a corner of America's heartland where Missouri, Kansas. Nebraska and Iowa meet; the new town of Celebration, Fla.; and St. Louis, Mo. The goals: to evaluate and accelerate community-wide efforts that result in healthier, more desirable places for people to live, work and play; to build community capacity; and to achieve measurable improved health and quality of life outcomes.

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.

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

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

Recruiting community health centers into pragmatic research: Findings from STOP CRC

PubMed Central

Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B

2015-01-01

Background Challenges of recruiting participants into pragmatic trials, particularly at the level of the health system, remain largely unexplored. As part of Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), we recruited eight separate community health centers (consisting of 26 individual safety net clinics) into a large comparative effectiveness pragmatic study to evaluate methods of raising the rates of colorectal cancer screening. Methods In partnership with STOP CRC’s advisory board, we defined criteria to identify eligible health centers and applied these criteria to a list of health centers in Washington, Oregon, and California affiliated with OCHIN (formerly Oregon Community Health Information Network), a 16-state practice-based research network of federally sponsored health centers. Project staff contacted centers that met eligibility criteria and arranged in-person meetings of key study investigators with health center leadership teams. We used the Consolidated Framework for Implementation Research to thematically analyze the content of discussions during these meetings to identify major facilitators of and barriers to health center participation. Results From an initial list of 41 health centers, 11 met the initial inclusion criteria. Of these, leaders at three centers declined and at eight centers (26 clinic sites) agreed to participate (73%). Participating and nonparticipating health centers were similar with respect to clinic size, percent Hispanic patients, and percent uninsured patients. Participating health centers had higher proportions of Medicaid patients and higher baseline colorectal cancer screening rates. Common facilitators of participation were perception by center leadership that the project was an opportunity to increase colorectal cancer screening rates and to use electronic health record tools for population management. Barriers to participation were concerns of center leaders about ability to

Health promotion community development and the tyranny of individualism.

PubMed

Shiell, A; Hawe, P

1996-01-01

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

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.

Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review

PubMed Central

2013-01-01

Background Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. Objective Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. Methods In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. Results The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few

Ethical considerations in community oral health.

PubMed

Naidoo, Sudeshni

2015-05-01

As the public's oral health care needs increase in complexity, there is renewed attention to the ethical dimensions of community oral health decision making and the development of public health ethics in teaching and research in dentistry. Despite their reduction globally, oral diseases persist with a particular distribution pattern that is a reflection of the increasingly widespread inequality in access to community oral health preventive and dental care. This is due to differences in the appropriateness, availability, accessibility, and acceptability of oral health education and the care provided. This article provides an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care to the underserved. The need for a paradigm shift from highly technical and individualistic dental training curricula is discussed, together with the need to instill a holistic approach to ethical and social responsibility in new dental graduates. It concludes with some possible strategies, using the overarching principles of ethics and bioethics that are applicable to practice among vulnerable populations.

[Community health agents: profile and education].

PubMed

Marzari, Carla Kowalski; Junges, José Roque; Selli, Lucilda

2011-01-01

This research discusses the profile and education of the community health agents. There is no clarity about the kind of professional needed and the appropriate training to the fulfillment of the function. The research is a case study with exploratory methodology and qualitative approach. The data was collected with a focused group, formed by ten agents, intentional selected from those with more time in service in Family Health Strategy teams from the municipality of Santa Maria, Rio Grande do Sul State. The discussions were recorded and transcribed by the researcher. The data was interpreted by content analysis. The results pointed to some important questions concerning the identity of the community health agents: integration on the health team, insertion in the community, profile and education. The profile which emerges from the research, is not different from the one proposed by the Ministry of Health. However, the difference is the professionalization, an initiative assumed by the agent, guided by reality, which he faces in his activity. The gaps, perceived in his formation, cause the agent to construct his professional identity, determined more by the technical aspect of the scientific knowledge than by his social competence as a community agent.

The Southeastern Minnesota Beacon Project for Community-driven Health Information Technology: Origins, Achievements, and Legacy

PubMed Central

Chute, Christopher G.; Hart, Lacey A.; Alexander, Alex K.; Jensen, Daniel W.

2014-01-01

Introduction: The Southeastern (SE) Minnesota Beacon organized all the health care providers, county public health organizations, and school districts in the deployment and integration of health information exchange (HIE) and targeted health communication around childhood asthma and diabetes. The community cooperated to establish a clinical data repository for all residents in the 11-county region. Through this community of practice approach that involved traditional and nontraditional providers, the SE Minnesota Beacon was able to realize unique applications of this technology. This manuscript overviews the associated organization and infrastructure of this community collaboration. Background: The Office of the National Coordinator for Health Information Technology (ONC), as part of the American Recovery and Reinvestment Act of 2009 (ARRA) stimulus, established 17 projects throughout the United States targeting the introduction and meaningful use of health information technology (HIT). These 17 communities were intended to serve as an example of what could be accomplished. The SE Minnesota Beacon is one of these communities. Methods: The community ultimately opted for peer-to-peer HIE, using Nationwide Health Information Network (NwHIN) Connect software. The clinical data repository was established using the infrastructure developed by the Regenstrief Institute, which operated as a trusted third party. As an extension to HIE, the consortium of county public health departments created a patient data portal for use by school nurses and parents. Childhood asthma was addressed by creating, exchanging, and maintaining an “asthma action plan” for each affected child, shared throughout the community, including through the patient portal. Diabetes management introduced patient treatment decision tools and patient quality of life measures, facilitating care. Influenza vaccination was enhanced by large-scale community reporting in partnership with the state vaccination

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.

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.

Development of the Tongan American Health Professionals Association: Sharing, Mentoring and Networking for Community Health.

PubMed

Tui'one, Vanessa; Tulua-Tata, Alisi; Hui, Brian; Tisnado, Diana M

Tongan-Americans face severe disparities in health including diabetes, cardiovascular disease, and cancer. Educational disparities also affect health opportunities and well-being, influencing health status and community capacity to address disparities. Few resources have been identified within the Tongan-American community to address these concerns. The Tongan American Health Professionals Association (TAHPA) was conceived to identify and develop health and health career resources for the Tongan community. Through TAHPA, the Tongan-American community is utilizing a community-empowerment approach to address disparities and well-being. TAHPA was formed in 2008 through the leadership of individuals with a vision of a healthier Tongan-American community. TAHPA's purpose was to inspire and empower the Tongan-American community by developing an organization of Tongan-American health care professionals and pre-professionals, celebrating their accomplishments, and providing resources and support for educational and career development. Founders gathered in small work groups in community settings to discuss health concerns, well-being and solutions. Key community members facilitated the process to establish goals and objectives. To date, 40 Tongan health professionals and pre-professionals have become members. TAHPA's vision and outreach processes have been developed. TAHPA's uniqueness and strength is that it is rooted in the community, created by the community to serve the community.

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

PubMed Central

2013-01-01

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

The experience of community health workers training in Iran: a qualitative study

PubMed Central

2012-01-01

Background The role of Community Health Workers (CHWs) in improving access to basic healthcare services, and mobilising community actions on health is broadly recognised. The Primary Health Care (PHC) approach, identified in the Alma Ata conference in 1978, stressed the role of CHWs in addressing community health needs. Training of CHWs is one of the key aspects that generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people. This study aimed to analyse the CHW training process in Iran and how different components of training have impacted on CHW performance and satisfaction. Methods Data were collected from both primary and secondary sources. Training policies were reviewed using available policy documents, training materials and other relevant documents at national and provincial levels. Documentary analysis was supplemented by individual interviews with ninety-one Iranian CHWs from 18 provinces representing a broad range of age, work experience and educational levels, both male and female. Results Recognition of the CHW program and their training in the national health planning and financing facilitates the implementation and sustainability of the program. The existence of specialised training centres managed by district health network provides an appropriate training environment that delivers comprehensive training and increases CHWs’ knowledge, skills and motivation to serve local communities. Changes in training content over time reflect an increasing number of programs integrated into PHC, complicating the work expected of CHWs. In-service training courses need to address better local needs. Conclusion Although CHW programs vary by country and context, the CHW training program in Iran offers transferable lessons for countries intending to improve training as one of the key elements in their CHW program. PMID:22938138

Community as a source of health in three racial/ethnic communities in Oregon: a qualitative study.

PubMed

Mendez-Luck, Carolyn A; Bethel, Jeffrey W; Goins, R Turner; Schure, Marc B; McDermott, Elizabeth

2015-02-12

A 2011 report by the Oregon Health Authority and the Department of Human Services documented disparities in its Latino and American Indian populations on multiple individual-level health indicators. However, research is lacking on the social contexts in which Latinos and American Indians in Oregon live and how these environments influence the health of communities as a whole. To help fill this gap, this study sought to contextualize the social environments that influence the health of Latinos and American Indian residents in three Oregon communities. Guided by an ecological framework, we conducted one-time semi-structured qualitative interviews with 26 study participants to identify the prominent health-related issues in the communities and to examine the factors that study participants perceived as enabling or inhibiting healthy lifestyles of community residents. We used a grounded theory approach to perform content and thematic analyses of the data. Study participants identified preventable chronic conditions, such as diabetes, obesity, and hypertension, as the most pressing health concerns in their communities. Results showed that traditional and cultural activities and strong family and community cohesion were viewed as facilitators of good community health. Poverty, safety concerns, insufficient community resources, and discrimination were perceived as barriers to community health. Three themes emerged from the thematic analyses: social connectedness is integral to health; trauma has an ongoing negative impact on health; and invisibility of residents in the community underlies poor health. This study's findings provide insight to the social contexts which operate in the lives of some Latinos and American Indians in Oregon. While participants identified community-level factors as important to health, they focused more on the social connections of individuals to each other and the relationships that residents have with their communities at-large. Our findings

Who is a community health worker? – a systematic review of definitions

PubMed Central

Olaniran, Abimbola; Smith, Helen; Unkels, Regine; Bar-Zeev, Sarah; van den Broek, Nynke

2017-01-01

ABSTRACT Background: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. Objective: To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers. Design: A systematic review of peer-reviewed papers and grey literature. Results: We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. CHWs can be categorised into three groups by education and pre-service training. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried. Conclusions: This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research. PMID:28222653

[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.

Design and Implementation of the Hispanic Community Health Study / Study of Latinos

PubMed Central

Sorlie, Paul D.; Avilés-Santa, Larissa M.; Wassertheil-Smoller, Sylvia; Kaplan, Robert C.; Daviglus, Martha L.; Giachello, Aida L.; Schneiderman, Neil; Raij, Leopoldo; Talavera, Gregory; Allison, Matthew; LaVange, Lisa; Chambless, Lloyd E.; Heiss, Gerardo

2010-01-01

PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a comprehensive multi-center community based cohort study of Hispanics/Latinos in the United States. Its rationale, objectives, design and implementation are described in this paper. METHODS The HCHS/SOL will recruit 16,000 men and women who self-identify as Hispanic or Latino, age 18-74 years, from a random sample of households in defined communities in the Bronx, Chicago, Miami and San Diego. The sites were selected so that the overall sample would consist of at least 2000 persons in each of the following origin designations: Mexican, Puerto Rican and Dominican, Cuban, and Central and South American. The study includes research in the prevalence of and risk factors for heart, lung, blood and sleep disorders, kidney and liver function, diabetes, cognitive function, dental conditions, and hearing disorders. CONCLUSIONS The HCHS/SOL will 1) characterize the health status and disease burden in the largest minority population in the U.S; 2) describe the positive and negative consequences of immigration and acculturation of Hispanics/Latinos to the mainstream U.S. life-styles, environment and health care opportunities; and 3) identify likely causal factors of many diseases in a population with diverse environmental exposures, genetic backgrounds and early life experiences. PMID:20609343

Community unemployment and immigrants' health in Montreal.

PubMed

Zunzunegui, Maria-Victoria; Forster, Mathieu; Gauvin, Lise; Raynault, Marie-France; Douglas Willms, J

2006-07-01

This research examines the relationship between community unemployment and the physical and mental health of immigrants in comparison to non-immigrants in Montreal under the hypothesis that high unemployment in the community may generate more negative effects on the health of immigrants than on non-immigrants. Possible gender differences in these associations are also examined. Montreal residents were studied via multilevel analysis, using both individual survey data and neighbourhood data from 49 police districts. Individual-level data were excerpted from a 1998 health survey of Montreal residents, while neighbourhood data originated from survey data collected in the 49 Montreal police districts and the 1996 Canadian Census. The associations between community unemployment and self-rated health, psychological distress and obesity are examined, and hypotheses regarding the modifying mechanisms via which male and female immigrants may run a greater risk of poor health than non-immigrants when living in areas of high unemployment were tested. Between neighbourhoods, variations in the three health outcomes were slight, and differences in health were not associated with differences in community unemployment. The associations between community unemployment and health varied according to immigration status. At the individual level, immigrants do not differ from non-immigrants with respect to the three health indicators, except that second-generation males are slightly heavier. However, when living in areas of high unemployment, immigrants tend to report poor physical and mental health in comparison to non-immigrants. Among first-generation immigrants, community unemployment was associated with psychological distress. Among second-generation immigrants, the probability of obesity and poor self-rated health increased significantly for those living in areas with high unemployment, but these associations reached statistical significance only for men. Findings among first

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.

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.

Interrelation of Sport Participation, Physical Activity, Social Capital and Mental Health in Disadvantaged Communities: A SEM-Analysis

PubMed Central

Marlier, Mathieu; Van Dyck, Delfien; Cardon, Greet; De Bourdeaudhuij, Ilse; Babiak, Kathy; Willem, Annick

2015-01-01

Background The Health through Sport conceptual model links sport participation with physical, social and psychological outcomes and stresses the need for more understanding between these outcomes. The present study aims to uncover how sport participation, physical activity, social capital and mental health are interrelated by examining these outcomes in one model. Methods A cross-sectional survey was conducted in nine disadvantaged communities in Antwerp (Belgium). Two hundred adults (aged 18–56) per community were randomly selected and visited at home to fill out a questionnaire on socio-demographics, sport participation, physical activity, social capital and mental health. A sample of 414 adults participated in the study. Results Structural Equation Modeling analysis showed that sport participation (β = .095) and not total physical activity (β = .027) was associated with better mental health. No association was found between sport participation and community social capital (β = .009) or individual social capital (β = .045). Furthermore, only community social capital was linked with physical activity (β = .114), individual social capital was not (β = -.013). In contrast, only individual social capital was directly associated with mental health (β = .152), community social capital was not (β = .070). Conclusion This study emphasizes the importance of sport participation and individual social capital to improve mental health in disadvantaged communities. It further gives a unique insight into the functionalities of how sport participation, physical activity, social capital and mental health are interrelated. Implications for policy are that cross-sector initiatives between the sport, social and health sector need to be supported as their outcomes are directly linked to one another. PMID:26451731

Women's Health Leadership to Enhance Community Health Workers as Change Agents.

PubMed

Ingram, Maia; Chang, Jean; Kunz, Susan; Piper, Rosie; de Zapien, Jill Guernsey; Strawder, Kay

2016-05-01

Objectives A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women's Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates' leadership skills to the national sample. Results Participants reported statistically significant pre-/postimprovements in all competencies. Interviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities. © 2016 Society for Public Health Education.

Unravelling Soil Fungal Communities from Different Mediterranean Land-Use Backgrounds

PubMed Central

Nilsson, R. Henrik; Girlanda, Mariangela; Vizzini, Alfredo; Bonfante, Paola; Bianciotto, Valeria

2012-01-01

Background Fungi strongly influence ecosystem structure and functioning, playing a key role in many ecological services as decomposers, plant mutualists and pathogens. The Mediterranean area is a biodiversity hotspot that is increasingly threatened by intense land use. Therefore, to achieve a balance between conservation and human development, a better understanding of the impact of land use on the underlying fungal communities is needed. Methodology/Principal Findings We used parallel pyrosequencing of the nuclear ribosomal ITS regions to characterize the fungal communities in five soils subjected to different anthropogenic impact in a typical Mediterranean landscape: a natural cork-oak forest, a pasture, a managed meadow, and two vineyards. Marked differences in the distribution of taxon assemblages among the different sites and communities were found. Data analyses consistently indicated a sharp distinction of the fungal community of the cork oak forest soil from those described in the other soils. Each soil showed features of the fungal assemblages retrieved which can be easily related to the above-ground settings: ectomycorrhizal phylotypes were numerous in natural sites covered by trees, but were nearly completely missing from the anthropogenic and grass-covered sites; similarly, coprophilous fungi were common in grazed sites. Conclusions/Significance Data suggest that investigation on the below-ground fungal community may provide useful elements on the above-ground features such as vegetation coverage and agronomic procedures, allowing to assess the cost of anthropogenic land use to hidden diversity in soil. Datasets provided in this study may contribute to future searches for fungal bio-indicators as biodiversity markers of a specific site or a land-use degree. PMID:22536336

An argument against the focus on Community Resilience in Public Health

PubMed Central

2014-01-01

Background It has been suggested that Public Health professionals focus on community resilience in tackling chronic problems, such as poverty and deprivation; is this approach useful? Discussion Resilience is always i) of something ii) to something iii) to an endpoint, as in i) a rubber ball, ii) to a blunt force, iii) to its original shape. “Community resilience” might be: of a neighbourhood, to a flu pandemic, with the endpoint, to return to normality. In these two examples, the endpoint is as-you-were. This is unsuitable for some examples of resilience. A child that is resilient to an abusive upbringing has an endpoint of living a happy life despite that upbringing: this is an as-you-should-be endpoint. Similarly, a chronically deprived community cannot have the endpoint of returning to chronic deprivation: so what is its endpoint? Roughly, it is an as-you-should-be endpoint: to provide an environment for inhabitants to live well. Thus resilient communities will be those that do this in the face of challenges. How can they be identified? One method uses statistical outliers, neighbourhoods that do better than would be expected on a range of outcomes given a range of stressors. This method tells us that a neighbourhood is resilient but not why it is. In response, a number of researchers have attributed characteristics to resilient communities; however, these generally fail to distinguish characteristics of a good community from those of a resilient one. Making this distinction is difficult and we have not seen it successfully done; more importantly, it is arguably unnecessary. There already exist approaches in Public Health to assessing and developing communities faced with chronic problems, typically tied to notions such as Social Capital. Community resilience to chronic problems, if it makes sense at all, is likely to be a property that emerges from the various assets in a community such as human capital, built capital and natural capital. Summary Public

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.

Keep Kids in School: A Collaborative Community Effort to Increase Compliance with State-Mandated Health Requirements

ERIC Educational Resources Information Center

Rogers, Valerie; Salzeider, Christine; Holzum, Laura; Milbrandt, Tracy; Zahnd, Whitney; Puczynski, Mark

2016-01-01

Background: It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. Methods: A collaborative relationship in Illinois involving an academic…

How Community Organizing Promotes Health Equity, And How Health Equity Affects Organizing.

PubMed

Pastor, Manuel; Terriquez, Veronica; Lin, May

2018-03-01

Public health scholarship increasingly recognizes community organizing as a vehicle for unleashing the collective power necessary to uproot socioeconomic inequities at the core of health disparities. In this article we reverse the analytical focus from how organizing can affect health equity, and we consider how the frame of health equity has shaped grassroots organizing. Using evidence from a range of cases in California, we suggest that the health equity frame can guide and justify grassroots groups' efforts to improve the health outcomes of marginalized populations; connect issues such as housing and school discipline to health; and provide a rationale for community organizing groups to directly address the trauma experienced by their own members and staff, who often come from communities at risk for poor health outcomes.

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.

Building Capacity to Increase Health Promotion Funding to American Indian Communities: Recommendations From Community Members.

PubMed

Pedersen, Maja; Held, Suzanne Christopher; Brown, Blakely

2016-11-01

Foundations and government agencies have historically played a critical role in supporting community-based health promotion programs. Increased access to health promotion funding may help address significant health issues existing within American Indian (AI) communities, such as childhood obesity, type 2 diabetes, and cardiovascular disease. Understanding the capacity of AI communities to successfully apply for and receive funding may serve to increase resources for health promotion efforts within AI communities in Montana. This exploratory qualitative study completed 17 semistructured interviews across three AI reservations in the state of Montana. Dimensions of community capacity within the context of the funding application process and partnership with funding agencies were identified, including resources, leadership, community need, networks, and relationship with the funding agency. Dimensions of AI community capacity were then used to suggest capacity-building strategies for improved partnership between AI communities in Montana and the funding agencies. © 2016 Society for Public Health Education.

Sense of community-belonging and health-behaviour change in Canada.

PubMed

Hystad, Perry; Carpiano, Richard M

2012-03-01

Research indicates that primary prevention targeting individual behaviours should incorporate contextual factors. The objectives of this study are to examine the role of community-belonging and contextual factors on health-behaviour change in Canada, and whether the influence of community-belonging on behaviour change varies by specific types of behaviours and contextual factors. Data on individual-level community-belonging, socio-demographics and self-rated health were obtained for 119 693 respondents from the 2007/2008 Canadian Community Health Survey located within 100 health regions across Canada. Contextual factors were based on health-region groupings of socio-economic determinants of health. Multilevel models were used to estimate the influence of community-belonging and health-region contextual factors on general, and specific, health-behaviour changes in the past year. After controlling for individual and contextual factors, community-belonging showed a positive dose-response relationship with health-behaviour change. Health-region contextual factors were only slightly associated with behaviour change; however, the influence of community-belonging on behaviour change showed significant variability based on health-region contextual factors. The influence of community-belonging also varied by specific health-behaviour changes, but for most prominent health behaviours (exercise, weight loss and improved diet) the effect was consistent. Community-belonging was strongly related to health-behaviour change in Canada and may be an important component of population health prevention strategies. Efforts to increase community-belonging, however, need to be considered along with contextual factors.

Community-based health and schools of nursing: supporting health promotion and research.

PubMed

Shannon, Crystal

2014-01-01

This article examines the role of community-based schools of nursing in the promotion of public health and research in poverty-stricken areas. This was a three-phase study (questionnaire and key-informants' interviews) that surveyed representatives of prelicensure associate and baccalaureate nursing schools (n=17), nursing-school key informants (n=6) and community leaders (n=10). A 13-question web-based survey and semi-structured interview of key informants elicited data on demographics, nursing program design, exposure of faculty and students to various research and health promotion methods, and beliefs about student involvement. Nursing schools participated minimally in community-based health promotion (CBHP) and community-based participatory research saw reduced need for student involvement in such activities, cited multiple barriers to active community collaboration, and reported restricted community partnerships. CBHP was recognized to be a valuable element of health care and student education, but is obstructed by many barriers. This study suggests that nursing schools are not taking full advantage of relationships with community leaders. Recommendations for action are given. © 2013 Wiley Periodicals, Inc.

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

PubMed

Ekberg, Joakim; Timpka, Toomas; Angbratt, Marianne; Frank, Linda; Norén, Anna-Maria; Hedin, Lena; Andersen, Emelie; Gursky, Elin A; Gäre, Boel Andersson

2013-07-04

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

Assisting Vulnerable Communities: Canyon Ranch Institute's and Health Literacy Media's Health Literacy and Community-Based Interventions.

PubMed

Pleasant, Andrew

2017-01-01

Canyon Ranch Institute and Health Literacy Media are a 501(c)3 non-profit public charity working to improve health based on the best evidence-based practices of health literacy and integrative health. As an organization, we offer a spectrum of health literacy work extending from plain language services to intensive community-based interventions. (See www.canyoranchinstitute.org & www.healthliteracy.media) In this chapter, we discuss the methodologies and outcomes of two of those community-based interventions - the Canyon Ranch Institute Life Enhancement Program and our Theater for Health program. Perhaps uniquely, an underpinning approach to both efforts is based on the increasing body of evidence of health literacy as a social determinant of health. Therefore, our research and evaluation of these programs captures not only changes in knowledge, attitudes, and beliefs but explicitly includes changes in informed behavior change and objective health outcomes as well. Our work makes it clear - that if you engage people in a health literate approach to informed behavior change (and respect their knowledge of their own lives and context) you can help people help themselves to better health. Further, from the perspective of health as a right and a resource for living, we find people who advance their health use this resource to continually better their own and their family's lives as well as the communities where they live. Hopefully, the examples provided in this chapter provide a sense of direction and motivation to others to fully explore the potential of health literacy to improve health and well-being, increase satisfaction with life, and produce health outcomes at a lower cost.

Adult community health-promoting interventions in primary health care: A systematic review.

PubMed

March, Sebastià; Torres, Elena; Ramos, María; Ripoll, Joana; García, Atanasio; Bulilete, Oana; Medina, David; Vidal, Clara; Cabeza, Elena; Llull, Micaela; Zabaleta-del-Olmo, Edurne; Aranda, José Manuel; Sastre, Silvia; Llobera, Joan

2015-07-01

To examine evidence on the effectiveness of health-promoting community interventions carried out in primary health care. Systematic review of originals and systematic reviews of health-promoting community interventions with the participation of primary health care. A working definition of community activities was used in the inclusion criteria. Databases searched up to 2013: PUBMED, EMBASE, CINHAL, Web of SCIENCE, IBECS, IME, and PSICODOC. No restrictions on year of publication or design. Articles were reviewed by separate researchers to identify risks of bias. Fifty-one articles published between 1966 and 2013 were included: 11 systematic reviews and 40 originals that described 39 community interventions. There is evidence on the effectiveness of community interventions in reducing cardiovascular risk factors, encouraging physical exercise, preventing falls and improving self-care among chronic patients compared with usual individual care. The effectiveness of some interventions increases when the community is involved in their development. Most assessments show positive results despite design limitations. The community approach may be more effective than the individual in usual preventive interventions in primary care. There is a lack of evidence on many community interventions in primary care and further research is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

How the Whole School, Whole Community, Whole Child Model Works: Creating Greater Alignment, Integration, and Collaboration between Health and Education

ERIC Educational Resources Information Center

Chiang, Rachelle Johnsson; Meagher, Whitney; Slade, Sean

2015-01-01

Background: The Whole School, Whole Community, Whole Child (WSCC) model calls for greater collaboration across the community, school, and health sectors to meet the needs and support the full potential of each child. This article reports on how 3 states and 2 local school districts have implemented aspects of the WSCC model through collaboration,…

Strategic partnering to improve community health worker programming and performance: features of a community-health system integrated approach.

PubMed

Naimoli, Joseph F; Perry, Henry B; Townsend, John W; Frymus, Diana E; McCaffery, James A

2015-09-01

There is robust evidence that community health workers (CHWs) in low- and middle-income (LMIC) countries can improve their clients' health and well-being. The evidence on proven strategies to enhance and sustain CHW performance at scale, however, is limited. Nevertheless, CHW stakeholders need guidance and new ideas, which can emerge from the recognition that CHWs function at the intersection of two dynamic, overlapping systems - the formal health system and the community. Although each typically supports CHWs, their support is not necessarily strategic, collaborative or coordinated. We explore a strategic community health system partnership as one approach to improving CHW programming and performance in countries with or intending to mount large-scale CHW programmes. To identify the components of the approach, we drew on a year-long evidence synthesis exercise on CHW performance, synthesis records, author consultations, documentation on large-scale CHW programmes published after the synthesis and other relevant literature. We also established inclusion and exclusion criteria for the components we considered. We examined as well the challenges and opportunities associated with implementing each component. We identified a minimum package of four strategies that provide opportunities for increased cooperation between communities and health systems and address traditional weaknesses in large-scale CHW programmes, and for which implementation is feasible at sub-national levels over large geographic areas and among vulnerable populations in the greatest need of care. We postulate that the CHW performance benefits resulting from the simultaneous implementation of all four strategies could outweigh those that either the health system or community could produce independently. The strategies are (1) joint ownership and design of CHW programmes, (2) collaborative supervision and constructive feedback, (3) a balanced package of incentives, and (4) a practical monitoring

Community size as a factor in health partnerships in community parks and recreation, 2007.

PubMed

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

2013-07-25

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

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

PubMed Central

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

2013-01-01

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

Community health training for Family and Community Health Nursing residents in a Multiprofessional Teaching Unit. Three years of experience.

PubMed

Torrecilla-Abril, Maravillas; Crespo-Mateos, Ana Patricia; Cartagena-Martínez, Esther; Oyarzabal-Arocena, Milagros; Pérez-Ortiz, Clara Isabel

2018-05-30

To determine the interest of nursing residents in the training areas of Family and Community Nursing (EFyC) at the beginning of their training, to evaluate community activities in health centres and to determine satisfaction with the training received and activities carried out. We present the experience of training in the public and community health competencies of EFyC Nursing from 2014 to 2017 in a multiprofessional teaching unit. The training was divided into 3theoretical modules. The training was completed with 2activities: the design and development of a health education programme and an asset mapping in the basic health area. A questionnaire was completed on satisfaction with the course and the activities carried out. During this period, 27 residents received training. As part of the training process, 26 health education programmes and 17 asset mappings were conducted in accredited health centres. The areas of intervention addressed were: lifestyles, life transitions and health problems. The overall satisfaction with the course was 4.5 ±.1 out of 5. The results show a high degree of interest in this area, as well as high evaluation of the activities carried out and the training received. Training in community health and health education during the period of residence is essential to include these competencies in the professional role. The dedication and involvement of the multiprofessional teaching units is essential in the development of these competences, training the residents through the integration of a biopsychosocial approach, community health and teamwork in primary care. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review

PubMed Central

Jacklin, Kristen; O'Connell, Megan E

2017-01-01

Background Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. Objective The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. Methods Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. Results Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. Conclusions A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. PMID:28729237

Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.

PubMed

Singh, Simone R; Young, Gary J

2017-12-01

To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another. © Health Research and Educational Trust.

Agency, access, and Anopheles: neighborhood health perceptions and the implications for community health interventions in Accra, Ghana

PubMed Central

Jankowska, Marta M.; Stoler, Justin; Ofiesh, Caetlin; Rain, David; Weeks, John R.

2015-01-01

Background Social and environmental factors are increasingly recognized for their ability to influence health outcomes at both individual and neighborhood scales in the developing urban world. Yet issues of spatial heterogeneity in these complex environments may obscure unique elements of neighborhood life that may be protective or harmful to human health. Resident perceptions of neighborhood effects on health may help to fill gaps in our interpretation of household survey results and better inform how to plan and execute neighborhood-level health interventions. Objective We evaluate differences in housing and socioeconomic indicators and health, environment, and neighborhood perceptions derived from the analysis of a household survey and a series of focus groups in Accra, Ghana. We then explore how neighborhood perceptions can inform survey results and ultimately neighborhood-level health interventions. Design Eleven focus groups were conducted across a socioeconomically stratified sample of neighborhoods in Accra, Ghana. General inductive themes from the focus groups were analyzed in tandem with data collected in a 2009 household survey of 2,814 women. In-depth vignettes expand upon the three most salient emergent themes. Results Household and socioeconomic characteristics derived from the focus groups corroborated findings from the survey data. Focus group and survey results diverged for three complex health issues: malaria, health-care access, and sense of personal agency in promoting good health. Conclusion Three vignettes reflecting community views about malaria, health-care access, and sense of personal agency in promoting good health highlight the challenges facing community health interventions in Accra and exemplify how qualitatively derived neighborhood-level health effects can help shape health interventions. PMID:25997424

Catholic health care's community-benefit role.

PubMed

Keehan, Carol

2005-06-16

"While contemporary Catholic health care and other not-for-profit health care institutions excel in quality, innovation and technology, they remain community-benefit organizations, founded and sustained because of community need," Sister Carol Keehan, a Daughter of Charity who chairs the board of trustees of the Catholic Health Association of the United States, said in May 26 testimony in Washington before the House Ways and Means Committee, which conducted a hearing on the tax-exempt hospital sector. Keehan chairs the board of Sacred Heart Health System in Pensacola, Fla. She spoke the day after Sen. Chuck Grassley, R-Iowa, announced that the Senate Finance Committee, which he chairs, had asked 10 nonprofit hospitals or health systems to account for their charitable activities in light of their tax-exempt status. Rep. Bill Thomas, R-Calif., chairman of the Ways and Means Committee, said at the House hearing that "the standards for tax exemption are not just an academic debate." In reviewing the broad ways Catholic hospitals benefit local communities, Keehan stressed that the services of Catholic hospitals are not provided "to justify continued tax exemption" but because serving communities in this way is integral to their identity and mission. Keehan's text follows.

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

PubMed

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

2014-04-01

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

Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

PubMed Central

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

2014-01-01

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

Differences in the Community Built Environment Influence Poor Perceived Health among Persons with Spinal Cord Injury

PubMed Central

Botticello, Amanda L.; Rohrbach, Tanya; Cobbold, Nicolette

2015-01-01

Objectives To assess the association between characteristics of the built environment and differences in perceived health among persons with spinal cord injury (SCI) using objective measures of the local community derived from Geographic Information Systems (GIS) data. Design Secondary analysis of cross-sectional survey data. Setting Community. Participants 503 persons with chronic SCI enrolled in the Spinal Cord Injury Model Systems (SCIMS) database. All cases were residents of New Jersey, completed an interview during the years 2000–2012, had a complete residential address, and were community living at the time of follow-up. Intervention Not applicable. Main Outcome Measure Perceived health. Results Bivariate tests indicated that persons with SCI residing in communities with more (versus less) mixed land use and small (versus large) amounts of open space were more likely to report poor perceived health. No associations were found between perceived health and differences in the residential or destination density of the community. Adjusting for variation in demographic, impairment, quality of life, and community socioeconomic characteristics accounted for the gap in the odds of reporting poor health between persons living in areas with large versus small amounts of open space (OR 0.54; 95% CI 0.28–1.02). However, even after accounting for individual background differences, persons living in communities characterized by more heterogeneous land use were twice as likely to report poor health compared to persons living in less mixed areas (OR 2.14; 95% CI 1.12–4.08). Conclusions Differences in the built characteristics of communities may be important to the long-term health and well-being of persons with SCI who may have greater exposure to the features of their local area due to limited mobility. The results of this study suggest living in a community with more heterogeneous land use was not beneficial to the perceived health of persons with chronic SCI living

Differences in the Community Built Environment Influence Poor Perceived Health Among Persons With Spinal Cord Injury.

PubMed

Botticello, Amanda L; Rohrbach, Tanya; Cobbold, Nicolette

2015-09-01

To assess the association between characteristics of the built environment and differences in perceived health among persons with spinal cord injury (SCI) using objective measures of the local community derived from Geographic Information Systems data. Secondary analysis of cross-sectional survey data. Community. Persons with chronic SCI enrolled in the Spinal Cord Injury Model Systems database (N=503). All cases were residents of New Jersey, completed an interview during the years 2000 through 2012, had a complete residential address, and were community living at the time of follow-up. Not applicable. Perceived health. Bivariate tests indicated that persons with SCI residing in communities with more (vs less) mixed land use and small (vs large) amounts of open space were more likely to report poor perceived health. No associations were found between perceived health and differences in the residential or destination density of the community. Adjusting for variation in demographic, impairment, quality of life, and community socioeconomic characteristics accounted for the gap in the odds of reporting poor health between persons living in areas with large versus small amounts of open space (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.28-1.02). However, even after accounting for individual background differences, persons living in communities characterized by more heterogeneous land use were twice as likely to report poor health compared with persons living in less mixed areas (OR, 2.14; 95% CI, 1.12-4.08). Differences in the built characteristics of communities may be important to the long-term health and well-being of persons with SCI who may have greater exposure to the features of their local area because of limited mobility. The results of this study suggest living in a community with more heterogeneous land use was not beneficial to the perceived health of persons with chronic SCI living in New Jersey. Further investigation is needed to assess if the

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

PubMed

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

2016-09-08

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

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.

Transdisciplinary Research and Evaluation for Community Health Initiatives

PubMed Central

Harper, Gary W.; Neubauer, Leah C.; Bangi, Audrey K.; Francisco, Vincent T.

2010-01-01

Transdisciplinary research and evaluation projects provide valuable opportunities to collaborate on interventions to improve the health and well-being of individuals and communities. Given team members’ diverse backgrounds and roles or responsibilities in such projects, members’ perspectives are significant in strengthening a project’s infrastructure and improving its organizational functioning. This article presents an evaluation mechanism that allows team members to express the successes and challenges incurred throughout their involvement in a multisite transdisciplinary research project. Furthermore, their feedback is used to promote future sustainability and growth. Guided by a framework known as organizational development, the evaluative process was conducted by a neutral entity, the Quality Assurance Team. A mixed-methods approach was utilized to garner feedback and clarify how the research project goals could be achieved more effectively and efficiently. The multiple benefits gained by those involved in this evaluation and implications for utilizing transdisciplinary research and evaluation teams for health initiatives are detailed. PMID:18936267

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

PubMed

Ciriello, James N; Kulatilaka, Nalin

2010-12-01

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

Women's health is a community issue.

PubMed

Irvin, A

1997-01-01

When a member of the Community Life Project in Nigeria led a group of women in a discussion about HIV/AIDS, the women reported that they understood that condom use is the best means of protection but that they were unable to negotiate condom use with their husbands. Even if the women were economically independent, they would rather face the risk of HIV/AIDS than divorce. Thus, efforts to improve women's health have not generated much change on the local level. This can also be seen by the facts that current programs have failed to reduce the numbers of women dying from pregnancy-related causes each year, nearly 3000 women die from tuberculosis each day, women suffer occupational health risks, and domestic violence is an important determinant of health problems for women. Because women lack power in many societies, efforts to effect individual change may be blocked by a woman's particular circumstances. Thus, the involvement of entire communities is necessary to improve the conditions affecting women's health. Community-level discussions may open the door for couples to discuss sexuality and gender-based issues as well as safer sex behavior. Despite the important role they can play, women's community health groups face stiff challenges because of a lack of knowledge or training and because of the difficulty in overcoming gender-based discrimination. The Hesperian Foundation's publication, "Where Women Have No Doctor," is an excellent resource for understanding how poverty and gender issues affect women's health. The book contains practical information, promotes a model of community-based responses to problems with social origins, and shares experiences of grassroots groups world-wide.

The experiences and challenges faced by rehabilitation community service therapists within the South African Primary Healthcare health system

PubMed Central

2017-01-01

Background Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate. The inadequate understanding of the advocacy role that rehabilitation professionals could play in addressing social health determinants remains a challenge in healthcare. Rehabilitation, a pillar of PHC, remains poorly understood in terms of its role within the health system. Aim We argue for rehabilitation as a vehicle for addressing social determinants of health with community service practitioners playing a critical role in addressing the inequities within the healthcare package. Setting The article reflects the opportunities and challenges faced by rehabilitation community service therapists in the delivery of rehabilitation services in a rural area of the Eastern Cape province of South Africa. Methods A single case study from the perspective of a researcher was used to explore the experience and reflection of the first author during her community service as an occupational therapist. Results The case study highlights some existing gaps within the delivery of rehabilitation services in the rural Eastern Cape. A community service package with a specific approach towards addressing social determinants of health for persons with disability at a community level is suggested. Conclusion Advocating for a rehabilitation service package to shift to community-based levels is critical. It is envisaged that a community-based approach will facilitate an understanding of the barriers faced by persons with disabilities as constituting disability, thus

76 FR 38282 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

...-AM39 Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated... TCR will be required to continue using the SSSG methodology. Background There are two methods of... groups; standardized presentation of the carrier's rating method (age, sex, etc.) showing that the factor...

The effects of community pharmacy public health interventions on population health and health inequalities: a systematic review of reviews protocol.

PubMed

Hillier-Brown, Frances; Bambra, Clare; Thomson, Katie; Balaj, Mirza; Walton, Nick; Todd, Adam

2017-08-30

Community pharmacies have great potential to deliver services aimed at promoting health and preventing disease, and are embedded within communities. In the light of a rapid increase in community pharmacy-delivered public health services and an accompanying increase in the evidence base, this systematic review of reviews will synthesise systematic reviews of public health community pharmacy interventions and assess their effects on public health and health inequalities. Systematic review methodology will be used to identify all systematic reviews that describe the health and health equity effects of community pharmacy public health interventions. Twenty databases will be searched using a pre-determined search strategy to evaluate community pharmacy-delivered public health interventions. Findings from the included reviews will be pooled, and a narrative synthesis executed to identify overarching patterns and results. Findings will support future decision-making around how community pharmacy public health services can be used alongside other strategies to promote health, prevent disease and reduce health inequalities. PROSPERO registration number: CRD42017056264 .

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban

The National Library of Medicine's 2004 "Symposium on community-based health information outreach". Introduction.

PubMed

Peay, Wayne J; Rockoff, Maxine L

2005-10-01

This paper introduces the special supplement to the Journal of the Medical Library Association (JMLA) that documents the proceedings of the "Symposium on Community-based Health Information Outreach" held on December 2 and 3, 2004, at the National Library of Medicine (NLM). The goal of the symposium was to explore new models of health information outreach that are emerging as technology dramatically changes the abilities of medical and health services libraries to provide resources and services beyond their traditional institutional boundaries, with particular concern for consumer health information outreach through community-based organizations. The symposium's primary objectives were to learn about successful and promising work that had already been done as well as to develop a vision for the future that could inform the NLM's next National Network of Libraries of Medicine (NN/LM) contract. Another objective was to review and assess the NLM's Strategic Plan to Reduce Health Disparities with special emphasis on Native Americans. The paper describes the background events and rationale that led to the NLM's decision to convene the symposium and summarizes the supplement's ten other papers, some of which were presented at the symposium and some of which were written afterward to capture the symposium's working sessions. The symposium convened approximately 150 invited participants with a wide variety of perspectives and experience. Sessions were held to present exemplary outreach projects, to review the NLM's Strategic Plan to Reduce Health Disparities, to summarize the research underpinnings for evaluating outreach projects, and to provide a futurist's perspective. A panel of community representatives gave voice to the participants in outreach projects, and sixteen posters describing outreach projects were available, many of them with community representatives on hand to explain the work. This JMLA supplement provides a comprehensive summary of the state of the art

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

PubMed Central

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

2016-01-01

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

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

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.

Primary health care, community participation and community-financing: experiences of two middle hill villages in Nepal.

PubMed

Sepehri, A; Pettigrew, J

1996-03-01

Although community involvement in health related activities is generally acknowledged by international and national health planners to be the key to the successful organization of primary health care, comparatively little is known about its potential and limitations. Drawing on the experiences of two middle hill villages in Nepal, this paper reports on research undertaken to compare and contrast the scope and extent of community participation in the delivery of primary health care in a community run and financed health post and a state run and financed health post. Unlike many other health posts in Nepal these facilities do provide effective curative services, and neither of them suffer from chronic shortage of drugs. However, community-financing did not appear to widen the scope and the extent of participation. Villagers in both communities relied on the health post for the treatment of less than one-third of symptoms, and despite the planners' intentions, community involvement outside participation in benefits was found to be very limited.

A “Community Fit” Community-Based Participatory Research Program for Family Health, Happiness, and Harmony: Design and Implementation

PubMed Central

Soong, Cissy SS; Wang, Man Ping; Mui, Moses; Viswanath, Kasisomayajula; Chan, Sophia SC

2015-01-01

Background A principal factor in maintaining positive family functioning and well-being, family communication time is decreasing in modern societies such as Hong Kong, where long working hours and indulgent use of information technology are typical. Objective The objective of this paper is to describe an innovative study protocol, “Happy Family Kitchen,” under the project, “FAMILY: A Jockey Club Initiative for a Harmonious Society,” aimed at improving family health, happiness, and harmony (3Hs) through enhancement of family communication. Methods This study employed the community-based participatory research (CBPR) approach, and adopted 5 principles of positive psychology and the traditional Chinese concepts of cooking and dining, as a means to connect family members to promote family health, happiness, and harmony (3Hs). Results In-depth collaboration took place between an academic institution and a large nongovernmental community organization association (NGO association) with 400 social service agency members. Both groups were deeply involved in the project design, implementation, and evaluation of 23 community-based interventions. From 612 families with 1419 individuals’ findings, significant increases in mean communication time per week (from 153.44 to 170.31 minutes, P=.002) at 6 weeks after the intervention and mean communication scores (from 67.18 to 69.56 out of 100, P<.001) at 12 weeks after the intervention were shown. Significant enhancements were also found for mean happiness scores 12 weeks after the intervention (from 7.80 to 7.82 out of 10, P<.001), and mean health scores (from 7.70 to 7.73 out of 10, P<.001) and mean harmony scores (from 7.70 to 8.07 out of 10, P<.001) 6 weeks after the intervention. Conclusions This was the first CBPR study in a Hong Kong Chinese community. The results should be useful in informing collaborative intervention programs and engaging public health researchers and community social service providers, major

Improving America's health requires community-level solutions: Folsom revisited.

PubMed

2012-08-15

Amidst sweeping changes to health care in the 1960s, the broadly influential Folsom Commission report, "Health is a Community Affair," never fully achieved its vision of galvanizing the creation of Communities of Solution, which were empowered to improve health at the local level. Passage of health care reform, and persistent concern over poor health outcomes despite runaway spending, contemporizes Folsom's call for nationally supported and evaluated, but community-driven, solutions to the nation's health care challenges.

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

PubMed Central

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

2014-01-01

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. PMID:25153472

Website Sharing in Online Health Communities: A Descriptive Analysis.

PubMed

Nath, Chinmoy; Huh, Jina; Adupa, Abhishek Kalyan; Jonnalagadda, Siddhartha R

2016-01-13

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

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

PubMed Central

George, Asha S.; Mehra, Vrinda; Scott, Kerry; Sriram, Veena

2015-01-01

Background Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research. Objective To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries. Methodology We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation, we further examined 64 articles focused on service delivery and governance within health systems research. Results Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion interventions (78%, 202/260), even though they were less participatory than other health systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service

Teething myths among community health officers.

PubMed

Denloye, O; Bankole, O O; Aderinokun, G A

2005-03-01

Many symptoms are attributed to teething in infants as a result of myths and opinions of people in the community. These myths have given false security with the belief that these symptoms are part of the teething process. The purpose of the study was to investigate the beliefs and practices of Community health Officers about teething. 60% of the respondents whose responses were analyzed believed that children have systemic problems during teething periods. Fever and diarrhea were the most frequent symptoms associated with teething. As health care providers at the community level, there is a need for this cadre of health care providers to separate cultural beliefs from scientific and proven medical practices. This can be achieved by their attendance at regular refresher courses organized for them after their graduation.

The practice of certified community health CNSs.

PubMed

Logan, Leanne

2005-01-01

This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25

Relational coordination between community health nurses and other professionals in delivering care to community-dwelling frail people.

PubMed

Cramm, Jane Murray; Hoeijmakers, Marjan; Nieboer, Anna Petra

2014-03-01

The first aim of this study was to investigate whether relational coordination is higher between primary care professionals and community health nurses than among other professionals. The second aim of this study was to investigate the relationship between different levels of relational coordination and primary care professionals' satisfaction with the care delivery of community health nurses. Community health nursing is based on the notion that all activities should respond to frail people's needs in a coordinated way, together with other professionals. Relational coordination is therefore important for the effective health-care delivery by these nurses. This cross-sectional study was performed among 167 professionals (n = 323, response rate 52%) who regularly worked with community health nurses. The results showed a higher degree of relational coordination with community health nurses than with other primary care professionals. Multilevel analyses revealed that professionals' satisfaction with the care delivered by community health nurses was influenced positively by relational coordination. Enhancing relational coordination between community health nurses and other primary care professionals in the neighborhood may improve the delivery of care to community-dwelling frail people. Comprehensive care delivery to community-dwelling frail people requires strong connections between all health and social care professionals. Community health nurses may be an important factor in strengthening these connections. © 2013 John Wiley & Sons Ltd.

Food-group and nutrient-density intakes by Hispanic and Latino backgrounds in the Hispanic Community Health Study/Study of Latinos.

PubMed

Siega-Riz, Anna Maria; Sotres-Alvarez, Daniela; Ayala, Guadalupe X; Ginsberg, Mindy; Himes, John H; Liu, Kiang; Loria, Catherine M; Mossavar-Rahmani, Yasmin; Rock, Cheryl L; Rodriguez, Brendaly; Gellman, Marc D; Van Horn, Linda

2014-06-01

Hispanics are a heterogeneous group of individuals with a variation in dietary habits that is reflective of their cultural heritage and country of origin. It is important to identify differences in their dietary habits because it has been well established that nutrition contributes substantially to the burden of preventable diseases and early deaths in the United States. We estimated the distribution of usual intakes (of both food groups and nutrients) by Hispanic and Latino backgrounds by using National Cancer Institute methodology. The Hispanic Community Health Study/Study of Latinos is a population-based cohort study that recruited participants who were 18-74 y of age from 4 US cities in 2008-2011 (Miami, Bronx, Chicago, and San Diego). Participants who provided at least one 24-h dietary recall and completed a food propensity questionnaire (n = 13,285) were included in the analyses. Results were adjusted for age, sex, field center, weekend, sequencing, and typical amount of intake. Overall, Cubans (n = 2128) had higher intakes of total energy, macronutrients (including all subtypes of fat), and alcohol than those of other groups. Mexicans (n = 5371) had higher intakes of vitamin C, calcium, and fiber. Lowest intakes of total energy, macronutrients, folate, iron, and calcium were reported by Dominicans (n = 1217), whereas Puerto Ricans (n = 2176) had lowest intakes of vitamin C and fiber. Food-group servings reflected nutrient intakes, with Cubans having higher intakes of refined grains, vegetables, red meat, and fats and Dominicans having higher intakes of fruit and poultry, whereas Puerto Ricans had lowest intakes of fruit and vegetables. Central and South Americans (n = 1468 and 925, respectively) were characterized by being second in their reported intakes of fruit and poultry and the highest in fish intake in comparison with other groups. Variations in diet noted in this study, with additional analysis, may help explain diet-related differences in health

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.

Research on gender differences in online health communities.

PubMed

Liu, Xuan; Sun, Min; Li, Jia

2018-03-01

With the growing concern about health issues and the emergence of online communities based on user-generated content (UGC), more and more people are participating in online health communities (OHCs) to exchange opinions and health information. This paper aims to examine whether and how male and female users behave differently in OHCs. Using data from a leading diabetes community in China (Tianmijiayuan), we incorporate three different techniques: topic modeling analysis, sentiment analysis and friendship network analysis to investigate gender differences in chronic online health communities. The results indicated that (1) Male users' posting content was usually more professional and included more medical terms. Comparatively speaking, female users were more inclined to seek emotional support in the health communities. (2) Female users expressed more negative emotions than male users did, especially anxiety and sadness. (3) In addition, male users were more centered and influential in the friendship network than were women. Through these analyses, our research revealed the behavioral characteristics and needs for different gender users in online health communities. Gaining a deeper understanding of gender differences in OHCs can serve as guidance to better meet the information needs, emotional needs and relationship needs of male and female patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Ensuring Access to Quality Health Care in Vulnerable Communities.

PubMed

Bhatt, Jay; Bathija, Priya

2018-04-24

For millions of Americans living in vulnerable rural and urban communities, their hospital is an important, and often their only, source of health care. As transformation in the hospital and health care field continues, some communities may be at risk of losing access to health care services and the opportunities and resources they need to improve and maintain their health. Integrated, comprehensive strategies to reform health care delivery and payment, within which vulnerable communities can make individual choices based on their needs, support structures, and preferences, are needed.In this Invited Commentary, the authors outline characteristics and parameters of vulnerable communities as well as the essential health care services that hospitals should strive to maintain locally identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. They also describe four of nine emerging strategies-recommended by the task force-to reform health care delivery and payment and allow hospitals to provide the essential health care services, along with implementation barriers and how to address them. While this Invited Commentary focuses on vulnerable communities, the four highlighted strategies (addressing the social determinants of health, adopting new and innovative virtual care strategies, designing global budgets, and using inpatient/outpatient transformation strategy), as well as the other five strategies, may have broader applicability for all communities.

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

PubMed

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

2012-04-01

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

Training Mixtec Promotores to Assess Health Concerns in their Community: A CBPR Pilot Study

PubMed Central

Maxwell, Annette E.; Young, Sandra; Vega, Roena Rabelo; Herrmann, Alison K.; See, Cha; Glenn, Beth A.; Mistry, Ritesh; Bastani, Roshan

2012-01-01

Background An academic institution and a community organization partnered for one of the first studies assessing health needs of Mixtecs, indigenous immigrants from Southern Mexico, residing in Ventura County, California. Methods Ten bilingual Spanish- and Mixteco- speaking promotores received a one-day focus group training, participated in a focus group themselves and conducted 5 focus groups with 42 Mixtec community members. Results The focus group training is described. Health concerns discussed in the focus groups include outdoor exercise among women viewed as flirtatious; reluctance to ask for governmental assistance due to fear that children will have to pay back later; soda consumption perceived as a symbol of socio-economic status; and unwillingness to obtain mammograms or pap smears because private body parts are to be touched by husbands only. Discussion Training promotores to conduct focus groups can increase organizational capacity to identify pressing health needs in under-represented and hard-to-reach population groups. PMID:22940912

Health and sustainability of rural communities.

PubMed

Ryan-Nicholls, K D

2004-01-01

The challenges associated with rural and remote health have been widely acknowledged by rural communities and the health care community for some time now. However, it is only recently that any concerted effort has begun to address these difficulties. The aim of this paper was to examine the issue of rural health and sustainability internationally with a particular emphasis on the Canadian context. This paper used a framework to: articulate the nature of rural health and sustainability; examine the historical, socio-cultural, ethical, legal, economic and political aspects of rural health and sustainability; delineate the importance and significance of rural health and sustainability to Canadian citizens, and analyze progress made in relation to rural health and sustainability. This paper concludes by cautioning that rural health and sustainability can only be enhanced by innovative strategies that employ both capacity building partnerships with rural people that are supported overall, by adequate funding allocation.

Community Health Workers in Health-Related Missouri Agencies: Role, Professional Development and Health Information Needs

ERIC Educational Resources Information Center

Visker, Joseph; Rhodes, Darson; Cox, Carol

2017-01-01

Community Health Workers (CHWs) serve an indispensable but oftten misunderstood and unrecognized role in public health. These individuals constitute the frontline of health care in many communities and are relied upon to provide an assortment of services. Unfortunately, the full extent to which CHWs are utilized is unknown and there is little…

A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

PubMed

Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

2017-12-13

Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

Impact of dropout of female volunteer community health workers: An exploration in Dhaka urban slums

PubMed Central

2012-01-01

Background The model of volunteer community health workers (CHWs) is a common approach to serving the poor communities in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in this area, has been using female CHWs as core workers in its community-based health programs since 1977. After 25 years of implementing of the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through a community-based maternal health intervention. However, BRAC experiences high dropout rates among CHWs suggesting a need to better understand the impact of their dropout which would help to reduce dropout and increase program sustainability. The main objective of the study was to estimate impact of dropout of volunteer CHWs from both BRAC and community perspectives. Also, we estimated cost of possible strategies to reduce dropout and compared whether these costs were more or less than the costs borne by BRAC and the community. Methods We used the ‘ingredient approach’ to estimate the cost of recruiting and training of CHWs and the so-called ‘friction cost approach’ to estimate the cost of replacement of CHWs after adapting. Finally, we estimated forgone services in the community due to CHW dropout applying the concept of the friction period. Results In 2009, average cost per regular CHW was US$ 59.28 which was US$ 60.04 for an ad-hoc CHW if a CHW participated a three-week basic training, a one-day refresher training, one incentive day and worked for a month in the community after recruitment. One month absence of a CHW with standard performance in the community meant substantial forgone health services like health education, antenatal visits, deliveries, referrals of complicated cases, and distribution of drugs and health commodities. However, with an additional investment of US$ 121 yearly per CHW BRAC could save another US$ 60 invested an ad-hoc CHW plus forgone services in the community. Conclusion Although CHWs work as volunteers in Dhaka

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

Community health centers tackle rising demands and expectations.

PubMed

Hurley, Robert; Felland, Laurie; Lauer, Johanna

2007-12-01

As key providers of preventive and primary care for underserved people, including the uninsured, community health centers (CHCs) are the backbone of the U.S. health care safety net. Despite significant federal funding increases, community health centers are struggling to meet rising demand for care, particularly for specialty medical, dental and mental health services, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Health centers are responding to these pressures by expanding capacity and adding services but confront staffing, resource and other constraints. At the same time, CHCs are facing other demands, including increased quality reporting expectations, addressing racial and ethnic disparities, developing electronic medical records, and preparing for public health emergencies.

An Exploration of Costs of Community-Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Unwin, Gemma; Deb, Shoumitro; Deb, Tanya

2017-01-01

Background: In the UK, people with intellectual disabilities who exhibit aggressive behaviour often receive community-based specialist health services from a community learning disability team (CLDT). Our aim was to estimate costs associated with this provision and to identify predictors of higher costs. Method: Costs were estimated for 60 adults…

Ethics and Community Involvement in Syntheses Concerning American Indian, Alaska Native, or Native Hawaiian Health: A Systematic Review

PubMed Central

Around Him, Deana M.

2014-01-01

Background The objective of the research was to review reporting of ethical concerns and community involvement in peer-reviewed systematic reviews or meta-analyses concerning American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) health. Methods Text words and indexed vocabulary terms were used to query PubMed, Embase, Cochrane Library, and the Native Health Database for systematic reviews or meta-analyses concerning AI/AN/NH health published in peer-reviewed journals, followed by a search through reference lists. Each article was abstracted by two independent reviewers; results were discussed until consensus was reached. Results We identified 107 papers published from 1986–2012 that were primarily about AI/AN/NH health or presented findings separately for AI/AN/NH communities. Two reported seeking indigenous reviewer feedback; none reported seeking input from tribes and communities. Approximately 7% reported on institutional review board (IRB) approval of included studies, 5% reported on tribal approval, and 4% referenced the sovereignty of AI/AN tribes. Approximately 63% used evidence from more than one AI/AN/NH population study, and 28% discussed potential benefits to communities from the synthesis research. Conclusions Reporting of ethics and community involvement are not prominent. Systematic reviews and meta-analyses making community-level inferences may pose risks to communities. Future systematic reviews and meta-analyses should consider ethical and participatory dimensions of research. PMID:25089283

Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

PubMed

Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

2015-01-28

To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

A growing opportunity: Community gardens affiliated with US hospitals and academic health centers

PubMed Central

George, Daniel R.; Rovniak, Liza S.; Kraschnewski, Jennifer L.; Hanson, Ryan; Sciamanna, Christopher N.

2014-01-01

Background Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. Methods In 2013, national community garden databases, scientific abstracts, and public search engines (e.g., Google Scholar) were used to identify gardens. Outcomes included the prevalence of hospital-based community gardens by US regions, and demographic characteristics (age, race/ethnicity, education, household income, and obesity rates) of communities served by gardens. Results There were 110 healthcare-based gardens, with 39 in the Midwest, 25 in the South, 24 in the Northeast, and 22 in the West. Compared to US population averages, communities served by healthcare-based gardens had similar demographic characteristics, but significantly lower rates of obesity (27% versus 34%, P < .001). Conclusions Healthcare-based gardens are located in regions that are demographically representative of the US population, and are associated with lower rates of obesity in communities they serve. PMID:25599017

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.

Health promotores' perceptions of their communities' health needs, knowledge, and resource needs in rural Nicaragua.

PubMed

McDermott-Levy, Ruth; Weatherbie, Katherine

2013-03-01

This study was conducted to determine rural Nicaraguan health promotores' perceptions of their community's health problems, their self-identified learning needs, and resource needs. Despite the valuable contributions of promotores, there is limited research regarding unpaid volunteer promotores' perceptions of their needs in providing care to remote communities. A qualitative descriptive study of 13 unpaid, volunteer promotores in Waslala, Nicaragua, was conducted. Data were collected during individual interviews with seven promotores and two focus groups with 13 promotores. Data were analyzed by reading verbatim transcripts repeatedly and establishing general themes. Promotores confirmed the findings. Waslalan promotores described a synergy of traditional folk health beliefs and natural practices along with use of modern medications while working to meet the health needs of their communities. Without much formal training, the promotores used public health strategies to influence health behaviors and address health disparities in the communities they serve. Serving their communities and God were their motivation in their work. Recommendations include supporting efforts to meet promotores' needs regarding community health education with messages from community leaders and nurses, finding methods to financially compensate promotores, and including promotores in health program planning and evaluation. © 2012 Wiley Periodicals, Inc.

The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

PubMed

Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina

2011-10-01

One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Exploring community health through the Sustainable Livelihoods framework.

PubMed

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

2011-02-01

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

Community participation and mental health during retirement in community sample of Australians.

PubMed

Olesen, Sarah C; Berry, Helen L

2011-03-01

This study considered whether community participation during later adulthood is more strongly associated with mental health during retirement than it is while in employment; i.e. in the absence of paid work. Participants were 322 men and 311 women aged 45 years and older, who were part of a random sample of an Australian coastal community. The frequency of participation across 14 types of community-based activities was assessed. Overall mental health was measured on a 10-item Kessler Psychological Distress Scale. Linear regression models tested the multivariate associations between distress and community participation, and whether this association differed for retired and working people. Retirees did not participate in their communities more than working people. The association between community participation and psychological distress did not differ by retirement status when people of all ages were considered together; however, stronger associations between several activities and (less) distress were found for retirees compared to their working peers in a younger cohort (aged 45 to 54). This cohort coincides with the average age of transition to retirement in Australia. These findings offer some support for the view that community participation may assist in managing the mental health implications of the transition from work to retirement.

Assessing Opportunities to Enhance Comprehensive Health Promotion and Wellness Programming in a State Community College System.

PubMed

Linnan, Laura A; Arandia, Gabriela; Naseer, Carolyn; Li, Jiang; Pomerantz, Meg; Diehl, Sandra J

2017-01-01

BACKGROUND North Carolina has the third largest community college system in the nation and reaches residents in all 100 counties. Few studies have focused on the health of employees who work at these institutions. We assessed the current status of and interest in supporting health promotion efforts among North Carolina Community College System members. METHODS North Carolina Community College System presidents completed a brief 15-item survey assessing support for and interest in offering health promotion programs. Wellness coordinators completed a 60-item questionnaire assessing current health promotion programming and organizational, environmental, and policy supports for health promotion efforts. Onsite interviews with a sub-sample of Wellness coordinators offered insights into important implementation considerations. We examined differences by campus size with Fisher's exact test. RESULTS All 58 presidents (100%) and 51 wellness coordinators (88%) completed surveys. Ten percent of colleges offered comprehensive employee health promotion programming. Most offered physical activity (70.6%), tobacco cessation (51.0%), weight loss/management (49.0%), and/or nutrition counseling (47.1%). Larger colleges were more likely to offer programming and environmental support. Nearly all presidents (89.7%) believed it is "very" or "extremely" important to offer health promotion programs to employees, and most (84%) were interested in promoting health through a university partnership. LIMITATIONS Despite very high survey response rates from presidents and wellness coordinators at each community college, onsite interviews were only done at select campuses, limiting the generalizability and scope of conclusions derived from interview data. CONCLUSION Community colleges in North Carolina are promising settings for promoting employee health. Findings identify resources, barriers, and technical assistance that could facilitate greater adoption and implementation of programs. ©2017

Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review

PubMed Central

Cyril, Sheila; Smith, Ben J.; Possamai-Inesedy, Alphia; Renzaho, Andre M. N.

2015-01-01

Background Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. Design The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. Results Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. Conclusions The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way

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