Science.gov

Sample records for community health development

  1. Community participation in health and development.

    PubMed

    Sule, S S

    2004-01-01

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

  2. 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…

  3. 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…

  4. 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

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

    PubMed

    Roestam, K S

    1994-01-01

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

  6. 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.

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

    ERIC Educational Resources Information Center

    Bartoli, Claire; And Others

    1986-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

    Summary With the passage of the Patient Protection and Affordable Care Act, the requirements for hospitals to achieve tax-exempt status include performing a triennial community health needs assessment and developing a plan to address identified needs. To address community health needs, multisector collaborative efforts to improve both health care and non–health care determinants of health outcomes have been the most effective and sustainable. In 2015, CDC released the Community Health Improvement Navigator to facilitate the development of these efforts. This report describes the development of the database of interventions included in the Community Health Improvement Navigator. The database of interventions allows the user to easily search for multisector, collaborative, evidence-based interventions to address the underlying causes of the greatest morbidity and mortality in the United States: tobacco use and exposure, physical inactivity, unhealthy diet, high cholesterol, high blood pressure, diabetes, and obesity. PMID:26917110

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2003-01-01

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

  12. The Development of Educational Materials for Community College Health Services.

    ERIC Educational Resources Information Center

    Busky, Henry F.

    Guidelines are presented for the development of educational materials for the Health Services Program at Prince George's Community College. This program, as part of the Human Development Department, serves three kinds of functions: remediation--the correction of health problems after they have arisen; prevention--the prior identification and…

  13. Developing a community mental health nursing handover form.

    PubMed

    Burleton, Laurie

    While nursing handovers are predominantly used in ward settings, this essential form of communication is also used by community mental health teams to promote continuity of care. A community mental health nursing handover form was developed to overcome poor communication of patient information. It is expected that the form will increase efficiency and reduce handover time by focusing on pertinent and current patient information. Implementation of a community mental health nursing handover form requires the willingness of staff to be proactive and embrace change. The involvement of nurse leaders is essential to implement successful change, overcome barriers and motivate staff.

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

    PubMed

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-10-01

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

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

    PubMed Central

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

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

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

    PubMed

    Armstrong, D

    2000-12-01

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

  17. 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.

  18. Developing community partnerships in nursing education for children's health.

    PubMed

    Kushto-Reese, Kathryn; Maguire, Maureen C; Silbert-Flagg, Joanne; Immelt, Susan; Shaefer, Sarah J M

    2007-01-01

    Community partnerships are central to educating nurses and providing much-needed services to underserved children in Baltimore City. Johns Hopkins University School of Nursing (JHUSON) collaborates with Head Start programs and a local elementary school for faculty practice and child-health clinical Service Learning experiences. At local Head Start programs, undergraduate nursing students annually screen > 1000 children for height, weight, hearing, vision, and blood pressure. Results are sent to parents with referral information if indicated. In addition, graduate and baccalaureate nursing students implement skills and knowledge learned in the classroom in a nurse-run clinic in a local elementary school, a faculty practice site. The Service Learning community partnerships benefit nursing students because they can apply principles of growth and development while providing important health screening to children in underserved populations. All students gain from practicing in the community and applying their classroom instruction to the care of children.

  19. Developing health system surge capacity: community efforts in jeopardy.

    PubMed

    Felland, Laurie E; Katz, Aaron; Liebhaber, Allison; Cohen, Genna R

    2008-06-01

    Since Sept. 11, 2001, communities have responded to the federal call to enhance health care surge capacity--the space, supplies, staffing and management structure to care for many injured or ill people during a terrorist attack, natural disaster or infectious disease pandemic. Communities with varied experience handling emergencies are building broad surge capacity, including transportation, communication, hospital care and handling mass fatalities, according to a new study by the Center for Studying Health System Change (HSC). Communities rely on federal funding to help coordinate and plan across agencies and providers, conduct training and drills, recruit volunteers, and purchase equipment and stockpile supplies. The current federal focus on pandemic influenza has helped prepare for all types of emergencies, although at times communities struggle with fragmented and restrictive funding requirements. Despite progress, communities face an inherent tension in developing surge capacity. The need for surge capacity has increased at the same time that daily health care capacity has become strained, largely because of workforce shortages, reimbursement pressures and growing numbers of uninsured people. Payers do not subsidize hospitals to keep beds empty for an emergency, nor is it practical for trained staff to sit idle until a disaster hits. To compensate, communities are trying to develop surge capacity in a manner that supports day-to-day activities and stretches existing resources in an emergency. Many of these efforts--including integrating outpatient providers, expanding staff roles and adapting standards of care during a large-scale emergency--require greater coordination, guidance and policy support. As time passes since 9/11 and Hurricane Katrina, federal funding for surge capacity has waned, and communities are concerned about losing surge capacity they have built.

  20. Community Health

    EPA Pesticide Factsheets

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

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

    PubMed

    Lin, Pay-Fan

    2014-06-01

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

  2. Developing Learning Communities in Health and Human Performance

    ERIC Educational Resources Information Center

    Butler, Karen L.; Dawkins, Phyllis W.

    2007-01-01

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

  3. Developing Tomorrow's Integrated Community Health Systems: A Leadership Challenge for Public Health and Primary Care

    PubMed Central

    Welton, William E.; Kantner, Theodore A.; Katz, Sheila Moriber

    1997-01-01

    As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health. PMID:9184684

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

    PubMed

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

    2013-10-01

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

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

    PubMed Central

    Phillips, Susan

    1988-01-01

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

  6. Community health equipment loans: developing a clinical prioritization system.

    PubMed

    Oldman, Crystal; Brodie, David; Nmatsakanova, Naira

    2003-06-01

    This project aimed to develop an objective method for making equipment loans to home-based patients using a prioritisation system based on clinical need. An action research approach was selected as the most appropriate method because of the collaborative nature of the project. It involved working mainly with community nurses using questionnaires, focus groups, telephone and direct interviews. An important part of the process was a workshop with all stakeholders to involve them in decision-making. The resulting unique clinical referral form was implemented successfully. The research also highlighted existing attitudes and perceptions of the equipment loans service among health professionals. The new clinical referral form has improved service provision, is more equitable and now allows decisions to be made using agreed clinical criteria. The results of the research have been disseminated locally in the process of integration of NHS and social services equipment loans. This is a unique example of collaboration between community nursing practitioners, primary care trust managers and researchers producing a measurable difference to patient care.

  7. 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

  8. Community Wise: Development of a Model to Address Oppression in Order to Promote Individual and Community Health

    PubMed Central

    Windsor, Liliane; Pinto, Rogério M.; Benoit, Ellen; Jessell, Lauren; Jemal, Alexis

    2015-01-01

    Communities with histories of oppression have shown great resilience. Yet few health interventions focus on structural oppression as a contributor to health problems in these communities. This paper describes the development and active ingredients of Community Wise, a unique behavioral-health intervention designed to reduce substance use frequency, related health risk behaviors, and recidivism among individuals with a history of incarceration and substance abuse residing in distressed and predominantly African American communities. Community Wise, developed through the collaborative efforts of a board of service providers, researchers, consumers, and government officials, is a 12-week group intervention that aims to address behavioral-health problems by raising critical consciousness in distressed communities. PMID:26190947

  9. Mental health training and development needs of community agency staff.

    PubMed

    Secker, Jenny; Hill, Kathryn

    2002-09-01

    Emphasis has long been placed in UK national policy on providing 'seamless' mental health services to meet both the health and social care needs of service users. While attention has been paid to the training required by specialist mental health and primary care staff in order to achieve this, the needs of other community agency staff have received less attention. The present article describes a study designed to identify the training needs of staff working within a broad range of agencies. Focus group discussions were used to explore participants' experiences of mental health problems amongst clients, their confidence in dealing with these, current sources of support and perceived training needs. The results indicate that participants in all agencies routinely encountered a range of problems. Colleagues were the main source of support, followed by line managers, but supervision structures and wider organisational support were lacking in some cases. Joint working with specialist mental health services was almost universally problematic and all groups identified a range of training needs. On the basis of the results, the present authors put forward suggestions as to how these needs might be met.

  10. 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

  11. Implementing a Community Empowerment Center to Build Capacity for Developing, Implementing, and Sustaining Interventions to Promote Community Health.

    PubMed

    Smallwood, Stacy W; Freedman, Darcy A; Pitner, Ronald O; Sharpe, Patricia A; Cole, Jennie Ann; Hastie, Shanna; Hunter, Brittney

    2015-12-01

    The Community Empowerment Center used a community-engaged approach to build capacity among residents to develop and implement interventions focused on creating a healthier environment. The Center partnered with residents living in a public housing community and adjacent low-income neighborhood and provided support through a mini-grant program. A six-session training program guided community members in mini grant development; 25 individuals attended at least one session. Six grant proposals were submitted; three were awarded $12,000 each for intervention implementation. Findings offer a model for engaging residents from low-resource settings in intervention development, implementation, and sustainability for community health promotion.

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

    PubMed

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

    2009-01-01

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

  13. 76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... HUMAN SERVICES Centers for Disease Control and Prevention Development of Best Practices for Community... Human Services (HHS), will hold a public forum from July 11-13, 2011 on processes relating to community... accreditation standards, and by other entities who may wish to utilize them in their community health planning...

  14. The Development and Testing of a Community Health Nursing Clinical Evaluation Tool.

    ERIC Educational Resources Information Center

    Hawranik, Pamela

    2000-01-01

    Describes the development and testing of a clinical evaluation tool for a community health nursing course for registered nurses through review of the literature and focus groups with community health nurses and faculty. The article contains 22 references and an abbreviated form of the evaluation tool. (Author/JOW)

  15. Japanese development and testing of the network establishment practices scale for community and public health nurses.

    PubMed

    Koshida, Mihoko; Morita, Takae

    2013-03-01

    The practices required by community and public health nurses to establish community networks mainly involve communicative competencies. Assessment through development and testing of such competencies is necessary for community and public health nurse educators and practitioners around the world to create and maintain a mutual support network. The purpose of this study was to develop and test a scale for community and public health nurse practices to establish and maintain community networks, and to then determine construct validity in a factorial structure model. The participants were 3970 community and public health nurses in Japan. A 43-item list was developed from a literature review, individual interviews, and repeated examinations. The secondary structural model consisted of four factors with 21 items. The internal consistency of the 21 items was highly reliable (Cronbach's α = 0.915). Confirmatory factor analysis by structural equation modeling showed the fit criteria to be statistically significant. Attributes of the community and public health nurses (age, years of experience, work municipalities, work positions, and educational institutions) showed significant relationships with the scale scores. The findings validated the efficacy of the Network Establishment Practices Scale to assess community and public health nurse practices to establish community networks.

  16. Integrating public health and community development to tackle neighborhood distress and promote well-being.

    PubMed

    Pastor, Manuel; Morello-Frosch, Rachel

    2014-11-01

    Recently there have been calls for public health to reconnect to urban planning in ways that emphasize the impact of place on health and that address fundamental causes of poor health, such as poverty, social inequality, and discrimination. Community developers have realized that poor health limits individuals' and communities' economic potential and have begun to integrate into their work such neighborhood health issues as access to fresh food and open space. In this article we review recent shifts in the community development field and give examples of programs that operate at the intersection of community development, public health, and civic engagement. For example, in Sacramento, California, the Building Healthy Communities program successfully promoted the creation of community gardens and bike paths and the redevelopment of brownfields. A major housing revitalization initiative in San Francisco, California, known as Sunnydale-Velasco, is transforming the city's largest public housing site into a mixed-income community that provides existing residents with new housing, infrastructure, services, and amenities. These examples and others illustrate the need to identify and make use of interdisciplinary approaches to ensure that all places are strong platforms for economic mobility, full democratic participation, and community health.

  17. Partnerships among community development, public health, and health care could improve the well-being of low-income people.

    PubMed

    Erickson, David; Andrews, Nancy

    2011-11-01

    Safe, vibrant neighborhoods are vital to health. The community development "industry"-a network of nonprofit service providers, real estate developers, financial institutions, foundations, and government-draws on public subsidies and other financing to transform impoverished neighborhoods into better-functioning communities. Although such activity positively affects the "upstream" causes of poor health, the community development industry rarely collaborates with the health sector or even considers health effects in its work. Examples of initiatives-such as the creation of affordable housing that avoids nursing home placement-suggest a strong potential for cross-sector collaborations to reduce health disparities and slow the growth of health care spending, while at the same time improving economic and social well-being in America's most disadvantaged communities. We propose a four-point plan to help ensure that these collaborations achieve positive outcomes and sustainable progress for residents and investors alike.

  18. Evaluation of Diverse Community Asthma Interventions: Balancing Health Outcomes with Developing Community Capacity for Evidence-Based Program Measurement.

    PubMed

    Woodhouse, Lynn D; Livingood, William C; Toal, Russ; Keene, DeAnna; Hines, Robert B; Tedders, Stuart; Charles, Simone M; Lawrence, Raymona H; Gunn, Laura H; Williams, Natalie; Kellum, Andrea

    2015-10-01

    The challenge of evaluating community asthma management programs is complicated by balancing the emphasis on health outcomes with the need to build community process capacity for conducting and monitoring evidence-based programs. The evaluation of a Georgia Childhood Asthma Management Program, a Healthcare Georgia Foundation-supported initiative for multiple diverse programs and settings, provides an example of an approach and the results that address this challenge. A "developmental evaluation" approach was applied, using mixed methods of quantitative and qualitative data collection and analysis, to assess the progress of community asthma prevention programs in building community within the context of: where the community is starting, community-level systems changes, and the community's progress toward becoming more outcome measurement oriented and evidence based. Initial evaluation efforts revealed extensive mobilization of community assets to manage childhood asthma. However, there were minimal planned efforts to assess health outcomes and systems changes, and the lack of a logic model-based program design linking evidence-based practices to outcomes. Following developmental technical assistance within evaluation efforts, all programs developed logic models, linking practices to outcomes with data collection processes to assess progress toward achieving the selected outcomes. This developmental approach across diverse projects and communities, along with a quality improvement benchmarking approach to outcomes, created a focus on health status outcome improvement. Specifically, this approach complemented an emphasis on an improved community process capacity to identify, implement, and monitor evidence-based asthma practices that could be used within each community setting.

  19. Lessons learned in developing community mental health care in Latin American and Caribbean countries

    PubMed Central

    RAZZOUK, DENISE; GREGÓRIO, GUILHERME; ANTUNES, RENATO; MARI, JAIR DE JESUS

    2012-01-01

    This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. It presents an overview of the provision of mental health services in the region; describes key experiences in Argentina, Belize, Brazil, Chile, Cuba, Jamaica and Mexico; and discusses the lessons learned in developing community mental health care. PMID:23024680

  20. Public health and health services development in postconflict communities: a case study of a safe motherhood project in East Timor.

    PubMed

    Marlowe, Penny; Mahmood, Mohammad Afzal

    2009-10-01

    Armed conflict causes suffering in many countries; it contributes to poor health and hinders health services development. The effects of conflict are evidenced by weakened community structures and can make reconstruction efforts challenging. East Timor has a history of prolonged conflict and saw a resurgence of internal violence in 2006. This participant observation study discusses considerations for implementing public health and health systems development projects in postconflict settings using a case study of a maternal and child health project. It illustrates the importance of appreciating the historical context and community dynamics when implementing development projects. The sequelae of conflict are often characterized by reduced human resource development capacity, distrust of hierarchy, and limited capacity for resource mobilization. Working in such postconflict communities requires flexibility in program design, stronger efforts for community capacity building, and rebuilding trust between various stakeholders.

  1. Applying Indigenous Community-Based Participatory Research Principles to Partnership Development in Health Disparities Research

    PubMed Central

    Christopher, Suzanne; Saha, Robin; Lachapelle, Paul; Jennings, Derek; Colclough, Yoshiko; Cooper, Clarice; Cummins, Crescentia; Eggers, Margaret J.; FourStar, Kris; Harris, Kari; Kuntz, Sandra W.; LaFromboise, Victoria; LaVeaux, Deborah; McDonald, Tracie; Bird, James Real; Rink, Elizabeth; Webster, Lennie

    2017-01-01

    This case study of community and university research partnerships utilizes previously developed principles for conducting research in the context of Native American communities to consider how partners understand and apply the principles in developing community-based participatory research partnerships to reduce health disparities. The 7 partnership projects are coordinated through a National Institutes of Health-funded center and involve a variety of tribal members, including both health care professionals and lay persons and native and nonnative university researchers. This article provides detailed examples of how these principles are applied to the projects and discusses the overarching and interrelated emergent themes of sharing power and building trust. PMID:21633218

  2. An outline of the need for psychology knowledge in health professionals: implications for community development and breast cancer prevention.

    PubMed

    Ahmadian, Maryam; Samah, Asnarulkhadi Abu; Saidu, Mohammed Bashir

    2014-01-01

    Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

  3. Developing Research and Community Literacies to Recruit Latino Researchers and Practitioners to Address Health Disparities.

    PubMed

    Granberry, Phillip J; Torres, María Idalí; Allison, Jeroan J; Rosal, Milagros C; Rustan, Sarah; Colón, Melissa; Fontes, Mayara; Cruz, Ivettte

    2016-03-01

    Engaging community residents and undergraduate Latino students in developing research and community literacies can expose both groups to resources needed to address health disparities. The bidirectional learning process described in this article developed these literacies through an ethnographic mapping fieldwork activity that used a learning-by-doing method in combination with reflection on the research experience. The active efforts of research team members to promote reflection on the research activities were integral for developing research and community literacies. Our findings suggest that, through participating in this field research activity, undergraduate students and community residents developed a better understanding of resources for addressing health disparities. Our research approach assisted community residents and undergraduate students by demystifying research, translating scientific and community knowledge, providing exposure to multiple literacies, and generating increased awareness of research as a tool for change among community residents and their organizations. The commitment of the community and university leadership to this pedagogical method can bring out the full potential of mentoring, both to contribute to the development of the next generation of Latino researchers and to assist community members in their efforts to address health disparities.

  4. Developing public health competence among RN-to-BSN students in a rural community.

    PubMed

    Ouzts, Karen N; Brown, Julie Watson; Diaz Swearingen, Connie A

    2006-01-01

    A new RN/BSN nursing program offers rural students in a western state the opportunity to address significant health care needs on a local level by developing public health leadership competencies in their home communities. The innovative program, funded by a grant from the Health Resources and Services Administration, makes it possible for RNs to complete their BSN degrees without travel, as they position themselves to provide critically needed health care leadership in their local areas. Partnerships between the university, community colleges, and local health agencies allow students in the RN-to-BSN program to benefit from a streamlined BSN admission process, onsite mentoring, and newly developed courses that lead students to reflect on health needs in their home communities. On the basis of Public Health Nursing Competencies as defined by the Nursing Quad Council (2004), the re-designed curriculum prepares students for public health leadership by encouraging application of competencies while participating in the delivery of essential public health services in their communities. Initial response to this new opportunity indicates that students can develop as leaders by developing public health competencies, and facets of the program may encourage more students to commit to completing the BSN while increasing capacity among PHNs.

  5. Community development--improving patient safety by enhancing the use of health services.

    PubMed

    Baum, Fran; Freeman, Toby; Lawless, Angela; Jolley, Gwyneth

    2012-06-01

    Community development plays an important role in increasing the access of disadvantaged groups to resources and services. We examined how community development in primary healthcare services may improve patient safety by involving people in activities that lead to their enhanced use of services. Audits of service activity and 68 in-depth interviews at six primary healthcare services in South Australia and the Northern Territory. Managers, practitioners and administration staff, plus regional health service executives and departmental funders participated in the interviews. Each of the services undertook some community development. Reported benefits included engaging people in health promoting activity, providing people with social contacts and, crucially, encouraging people to use health services. Community development is a means of engaging people who, for a range of reasons, are reluctant to use services and therefore can increase patient safety.

  6. Unconventional natural gas development and public health: toward a community-informed research agenda.

    PubMed

    Korfmacher, Katrina Smith; Elam, Sarah; Gray, Kathleen M; Haynes, Erin; Hughes, Megan Hoert

    2014-01-01

    Unconventional natural gas development (UNGD) using high-volume horizontal hydraulic fracturing ("fracking") has vastly increased the potential for domestic natural gas production in recent years. However, the rapid expansion of UNGD has also raised concerns about its potential impacts on public health. Academics and government agencies are developing research programs to explore these concerns. Community involvement in activities such as planning, conducting, and communicating research is widely recognized as having an important role in promoting environmental health. Historically, however, communities most often engage in research after environmental health concerns have emerged. This community information needs assessment took a prospective approach to integrating community leaders' knowledge, perceptions, and concerns into the research agenda prior to initiation of local UNGD. We interviewed community leaders about their views on environmental health information needs in three states (New York, North Carolina, and Ohio) prior to widespread UNGD. Interviewees emphasized the cumulative, long-term, and indirect determinants of health, as opposed to specific disease outcomes. Responses focused not only on information needs, but also on communication and transparency with respect to research processes and funding. Interviewees also prioritized investigation of policy approaches to effectively protect human health over the long term. Although universities were most often cited as a credible source of information, interviewees emphasized the need for multiple strategies for disseminating information. By including community leaders' concerns, insights, and questions from the outset, the research agenda on UNGD is more likely to effectively inform decision making that ultimately protects public health.

  7. Unconventional natural gas development and public health: toward a community-informed research agenda

    PubMed Central

    Korfmacher, Katrina Smith; Elam, Sarah; Gray, Kathleen M.; Haynes, Erin; Hughes, Megan Hoert

    2015-01-01

    Unconventional natural gas development (UNGD) using high-volume horizontal hydraulic fracturing (“fracking”) has vastly increased the potential for domestic natural gas production in recent years. However, the rapid expansion of UNGD has also raised concerns about its potential impacts on public health. Academics and government agencies are developing research programs to explore these concerns. Community involvement in activities such as planning, conducting, and communicating research is widely recognized as having an important role in promoting environmental health. Historically, however, communities most often engage in research after environmental health concerns have emerged. This community information needs assessment took a prospective approach to integrating community leaders' knowledge, perceptions, and concerns into the research agenda prior to initiation of local UNGD. We interviewed community leaders about their views on environmental health information needs in three states (New York, North Carolina, and Ohio) prior to widespread UNGD. Interviewees emphasized the cumulative, long-term, and indirect determinants of health, as opposed to specific disease outcomes. Responses focused not only on information needs, but also on communication and transparency with respect to research processes and funding. Interviewees also prioritized investigation of policy approaches to effectively protect human health over the long term. Although universities were most often cited as a credible source of information, interviewees emphasized the need for multiple strategies for disseminating information. By including community leaders' concerns, insights, and questions from the outset, the research agenda on UNGD is more likely to effectively inform decision making that ultimately protects public health. PMID:25204212

  8. Lessons learned in developing community mental health care in East and South East Asia

    PubMed Central

    ITO, HIROTO; SETOYA, YUTARO; SUZUKI, YURIKO

    2012-01-01

    This paper summarizes the findings for the East and South East Asia Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Im-plementation of Community Mental Health Care. The paper presents a description of the region, an overview of mental health policies, a critical ap-praisal of community mental health services developed, and a discussion of the key obstacles and challenges. The main recommendations address the needs to campaign to reduce stigma, integrate care within the general health care system, prioritize target groups, strengthen leadership in policy mak-ing, and devise effective funding and economic incentives. PMID:23024679

  9. Development of Critically Reflective Dialogues in Communities of Health Professionals

    ERIC Educational Resources Information Center

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

    2013-01-01

    Critically reflective dialogues (CRD) are important for knowledge sharing and creating meaning in communities. CRD includes different aspects: being open about mistakes, critical opinion sharing, asking for and giving feedback, experimentation, challenging groupthink and research utilisation. In this article we explore whether CRD aspects change…

  10. Development of Critically Reflective Dialogues in Communities of Health Professionals

    ERIC Educational Resources Information Center

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

    2013-01-01

    Critically reflective dialogues (CRD) are important for knowledge sharing and creating meaning in communities. CRD includes different aspects: being open about mistakes, critical opinion sharing, asking for and giving feedback, experimentation, challenging groupthink and research utilisation. In this article we explore whether CRD aspects change…

  11. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    PubMed

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  12. REACH-Meharry community-campus partnership: developing culturally competent health care providers.

    PubMed

    Fort, Jane G; McClellan, Linda

    2006-05-01

    An important national health care effort is elimination of racial and ethnic disparities in six specific conditions: infant mortality, cancer screening and management, cardiovascular disease, diabetes, human immunodeficiency virus infection, and child and adult immunizations. To address this concern, several health entities in Nashville, Tennessee responded to a grant initiative from the Centers for Disease Control and Prevention to develop a Racial and Ethnic Approaches to Community Health (REACH) demonstration project. The resulting award is the Nashville REACH 2010 Project, charged to develop sustainable methods to reduce and, in time, eliminate racial and ethnic disparities in cardiovascular disease and diabetes in the North Nashville community, where mortality rates of these diseases are substantially higher than in other parts of the county. As one of its many interests, the project included potential health care providers to receive and disseminate messages about disease prevention and health education. The present paper describes the community-campus partnership between the Nashville REACH 2010 project and the post-baccalaureate program of Meharry Medical College, a partnership that enfolded Meharry's pre-professional health care students into the community-based participatory service research project to increase the awareness and sensitivity of future minority health care providers to issues in minority and poor, underserved populations and to increase potential providers' familiarity with the processes involved in community-based participatory research.

  13. Indian Health Service: Community Health

    MedlinePlus

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

  14. Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers with Primary Care

    PubMed Central

    Cherrington, Andrea L.; Agne, April A.; Lampkin, Yolanda; Birl, Annie; Shelton, Tanya C.; Guzman, Alfredo; Willig, James H.

    2016-01-01

    Community Health Worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the healthcare team and enhance care. We tested a model for the integration of a CHW delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using the mHealth tool. This project partnered an academic institution, a safety-net clinic, and African American churches. The integration of mHealth technology into CHW programs was successfully achieved and readily accepted. PMID:26353025

  15. Community Health Worker Handbook.

    ERIC Educational Resources Information Center

    Perales, Aurora Rodriguez

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

  16. Integration of environmental stewardship and local economic development to enhance community health.

    PubMed

    Levine, Jay F

    2011-01-01

    Environmental groups working to preserve natural ecosystems and groups working to enhance local economic development often find themselves on philosophically opposite sides of the negotiation table. Case histories of cooperative engagement are provided that serve as examples of how environmental stewardship is compatible with local economic development and community health.

  17. Developing a web-based data mining application to impact community health improvement initiatives: the Virginia Atlas of Community Health.

    PubMed

    Wilson, Jeffrey L

    2006-01-01

    This article describes how a team from the Virginia Department of Health (VDH) and the Virginia Center for Healthy Communities (VCHC) attended the UNC Management Academy for Public Health to learn skills to address Virginia's commitment to using technology to improve the public's health. After creating a business plan for a food-safety information Web site, team members used that experience as well as Management Academy training in information technology, the management of data and finances, and strategic partnering to create a comprehensive tool with which to place customizable population data in the hands of anyone interested in pursuing population health improvement. The Virginia Atlas of Community Health, launched through the VCHC in 2003, places clear, compelling data in the hands of those who can influence decisions at the local level and create the most impact for health. Since the program's inception, more than 2,000 individuals have registered as ongoing users of the Virginia Atlas. Initially funded by a Turning Point grant from the Robert Wood Johnson Foundation, the program is sustained through a series of smaller grants and funding from the VDH.

  18. 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

  19. Health inequalities: promoting policy changes in utilizing transformation development by empowering African American communities in reducing health disparities.

    PubMed

    Kennedy, Bernice Roberts

    2013-01-01

    Social inequalities in the United States resulted in negative health outcomes for the African Americans. Their stressful living conditions of poverty, discrimination, racism, abuse and rejection from American society contribute to their negative health outcomes. The lifestyles of African Americans have been influenced by poverty and prior injustices, which have molded their worldview of health and illness. Dr. Martin Luther King, national civil rights leader, brought about social change with much prayer; however, he went a step further with collective gatherings to include the power of non-violence massive public demonstrations. This paper is an analytical review of the literature addressing social inequalities impacting on health inequalities of African Americans resulting in health disparities. Policy changes are propose by implementing transformation development and community empowerment models as frameworks for community/public health nurses in guiding African American communities with addressing health disparities. These models empower members of the community to participate in a collaborative effort in making political and social changes to improve their overall health outcomes.

  20. Waste dumps in local communities in developing countries and hidden danger to health.

    PubMed

    Anetor, Gloria O

    2016-07-01

    The rapid industrialisation and urbanisation fuelled by a fast-growing population has led to the generation of a huge amount of waste in most communities in developing countries. The hidden disorders and health dangers in waste dumps are often ignored. The waste generated in local communities is usually of a mixed type consisting of domestic waste and waste from small-scale industrial activities. Among these wastes are toxic metals, lead (Pb), cadmium (Cd), arsenic (As), mercury (Hg), halogenated organic compounds, plastics, remnants of paints that are themselves mixtures of hazardous substances, hydrocarbons and petroleum product-contaminated devices. Therefore, there is the urgent need to create an awareness of the harmful health effect of toxic wastes in developing countries, especially Nigeria. This is a review aimed at creating awareness on the hidden dangers of waste dumps to health in local communities in developing countries. Many publications in standard outlets use the following keywords: cancer, chemical toxicity, modern environmental health hazards, waste management and waste speciation in PubMed, ISI, Toxbase environmental digest, related base journals, and some standard textbooks, as well as the observation of the researcher between 1959 and 2014. Studies revealed the preponderance of toxic chemicals such as Pb, Cd, As and Hg in dump sites that have the risk of entering food chain and groundwater supplies, and these can give rise to endemic malnutrition and may also increase susceptibility to mutagenic substances, thereby increasing the incidence of cancer in developing countries. Industrialisation and urbanisation have brought about a change in the waste that is generated in contemporary communities in developing countries. Therefore, there is the need to embrace speciation and sound management of waste, probably including bioremediation. The populations in the local communities need regulatory agencies who are health educators as positive change

  1. Community health workers leading the charge on workforce development: lessons from New Orleans.

    PubMed

    Wennerstrom, Ashley; Johnson, Liljana; Gibson, Kristina; Batta, Sarah E; Springgate, Benjamin F

    2014-12-01

    Academic institutions and community organizations engaged community health workers (CHWs) in creating a community-appropriate CHW workforce capacity-building program in an area without a previously established CHW professional group. From 2009 to 2010, we solicited New Orleans-based CHWs' opinions about CHW professional development through a survey, a community conference, and workgroup meetings. Throughout 2011 and 2012, we created and implemented a responsive 80-h workforce development program that used popular education techniques. We interviewed CHWs 6 months post-training to assess impressions of the course and application of skills and knowledge to practice. CHWs requested training to develop nationally-recognized core competencies including community advocacy, addresses issues unique to New Orleans, and mitigate common professional challenges. Thirty-five people completed the course. Among 25 interviewees, common themes included positive impressions of the course, application of skills and community-specific information to practice, understanding of CHWs' historical roles as community advocates, and ongoing professional challenges. Engaging CHW participation in workforce development programs is possible in areas lacking organized CHW groups. CHW insight supports development of training that addresses unique local concerns. Trained CHWs require ongoing professional support.

  2. 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…

  3. Activating Community Health Center Patients in Developing Question-Formulation Skills: A Qualitative Study

    ERIC Educational Resources Information Center

    Lu, Wei-Hsin; Deen, Darwin; Rothstein, Dan; Santana, Luz; Gold, Marthe R.

    2011-01-01

    The authors developed and delivered a brief patient activation intervention (PAI) that sought to facilitate physician-patient communication. The intervention was designed to assist low-income, racial/ethnic minority users of community health centers in building skills and confidence asking questions. The PAI takes 8 to 10 minutes to deliver and…

  4. Activating Community Health Center Patients in Developing Question-Formulation Skills: A Qualitative Study

    ERIC Educational Resources Information Center

    Lu, Wei-Hsin; Deen, Darwin; Rothstein, Dan; Santana, Luz; Gold, Marthe R.

    2011-01-01

    The authors developed and delivered a brief patient activation intervention (PAI) that sought to facilitate physician-patient communication. The intervention was designed to assist low-income, racial/ethnic minority users of community health centers in building skills and confidence asking questions. The PAI takes 8 to 10 minutes to deliver and…

  5. The Development of Community-Based Health Information Exchanges: A Comparative Assessment of Organizational Models

    ERIC Educational Resources Information Center

    Champagne, Tiffany

    2013-01-01

    The purpose of this dissertation research was to critically examine the development of community-based health information exchanges (HIEs) and to comparatively analyze the various models of exchanges in operation today nationally. Specifically this research sought to better understand several aspects of HIE: policy influences, organizational…

  6. 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…

  7. The Development of Community-Based Health Information Exchanges: A Comparative Assessment of Organizational Models

    ERIC Educational Resources Information Center

    Champagne, Tiffany

    2013-01-01

    The purpose of this dissertation research was to critically examine the development of community-based health information exchanges (HIEs) and to comparatively analyze the various models of exchanges in operation today nationally. Specifically this research sought to better understand several aspects of HIE: policy influences, organizational…

  8. Development of SOVAT: a numerical-spatial decision support system for community health assessment research.

    PubMed

    Scotch, Matthew; Parmanto, Bambang

    2006-01-01

    The development of numerical-spatial routines is frequently required to solve complex community health problems. Community health assessment (CHA) professionals who use information technology need a complete system that is capable of supporting the development of numerical-spatial routines. Currently, there is no decision support system (DSS) that is effectively able to accomplish this task as the majority of public health geospatial information systems (GIS) are based on traditional (relational) database architecture. On-Line Analytical Processing (OLAP) is a multidimensional data warehouse technique that is commonly used as a decision support system in standard industry. OLAP alone is not sufficient for solving numerical-spatial problems that frequently occur in CHA research. Coupling it with GIS technology offers the potential for a very powerful and useful system. A community health OLAP cube was created by integrating health and population data from various sources. OLAP and GIS technologies were then combined to develop the Spatial OLAP Visualization and Analysis Tool (SOVAT). The synergy of numerical and spatial environments within SOVAT is shown through an elaborate and easy-to-use drag and drop and direct manipulation graphical user interface (GUI). Community health problem-solving examples (routines) using SOVAT are shown through a series of screen shots. The impact of the difference between SOVAT and existing GIS public health applications can be seen by considering the numerical-spatial problem-solving examples. These examples are facilitated using OLAP-GIS functions. These functions can be mimicked in existing GIS public applications, but their performance and system response would be significantly worse since GIS is based on traditional (relational) backend. OLAP-GIS system offer great potential for powerful numerical-spatial decision support in community health analysis. The functionality of an OLAP-GIS system has been shown through a series of

  9. Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans.

    PubMed

    Wennerstrom, Ashley; Vannoy, Steven D; Allen, Charles E; Meyers, Diana; O'Toole, Elizabeth; Wells, Kenneth B; Springgate, Benjamin F

    2011-01-01

    The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment. Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program. A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation. CHW contributions resulted in a training program focused on community engagement, depression screening, education, referral assistance, collaboration with clinical teams, and self-care. CHWs reported use of screening tools, early client successes in spite of challenges with client engagement, increase in networking and collaboration with other community agencies and providers, and ongoing community hurricane recovery issues. This intervention development approach and model may be used to address post-disaster mental health disparities and as a complement to traditional implementation of collaborative care.

  10. Community-Based Participatory Development of a Community Health Worker Mental Health Outreach Role to Extend Collaborative Care in Post-Katrina New Orleans

    PubMed Central

    Wennerstrom, Ashley; Vannoy, Steven D.; Allen, Charles E.; Meyers, Diana; O'Toole, Elizabeth; Wells, Kenneth B.; Springgate, Benjamin F.

    2013-01-01

    Objectives The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment. Intervention Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program. Design A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation. Results CHW contributions resulted in a training program focused on community engagement, depression screening, education, referral assistance, collaboration with clinical teams, and self-care. CHWs reported use of screening tools, early client successes in spite of challenges with client engagement, increase in networking and collaboration with other community agencies and providers, and ongoing community hurricane recovery issues. Conclusions This intervention development approach and model may be used to address post-disaster mental health disparities and as a complement to traditional implementation of collaborative care. PMID:22352080

  11. Beyond the clinic: improving child health through evidence-based community development.

    PubMed

    Komro, Kelli A; Tobler, Amy L; Delisle, Alexis L; O'Mara, Ryan J; Wagenaar, Alexander C

    2013-10-21

    Promoting child wellbeing necessarily goes beyond the clinic as risks to child health and development are embedded in the social and physical environmental conditions in which children live. Pediatricians play a vital role in promoting the health of children in the communities they serve and can maximize their impact by advocating for and supporting efficacious, evidence-based strategies in their communities. To provide a succinct guide for community pediatric efforts to advance the wellbeing of all children and particularly disadvantaged children in a community, we conducted a theory-driven and structured narrative review to synthesize published systematic and meta-analytic reviews of policy-relevant, local-level strategies addressing potent and malleable influences on child health and development. An exhaustive list of policy-relevant, local-level strategies for improving child health was used to conduct a comprehensive search of recent (1990-2012), English language peer-reviewed published meta-analyses and systematic reviews in the 10 core databases of scientific literature. Our review of the literature encompassed six key conceptual domains of intervention foci, including distal influences of child health (i.e., income and resources, social cohesion, and physical environment) and proximal influences (i.e., family, school and peer). We examined intervention effects on four key domains of child health and development: cognitive development, social and emotional competence, psychological and behavioral wellbeing, and physical health. Published reviews were identified for 98 distinct policy-relevant community interventions, evaluated across 288 outcomes. We classified 46 strategies as meeting scientific criteria for efficacy by having consistent, positive outcomes from high-quality trials (e.g., tenant-based rental assistance, neighborhood watch programs, urban design and land use policies, access to quality childcare services, class size reductions, after

  12. Beyond the clinic: improving child health through evidence-based community development

    PubMed Central

    2013-01-01

    Background Promoting child wellbeing necessarily goes beyond the clinic as risks to child health and development are embedded in the social and physical environmental conditions in which children live. Pediatricians play a vital role in promoting the health of children in the communities they serve and can maximize their impact by advocating for and supporting efficacious, evidence-based strategies in their communities. Methods To provide a succinct guide for community pediatric efforts to advance the wellbeing of all children and particularly disadvantaged children in a community, we conducted a theory-driven and structured narrative review to synthesize published systematic and meta-analytic reviews of policy-relevant, local-level strategies addressing potent and malleable influences on child health and development. An exhaustive list of policy-relevant, local-level strategies for improving child health was used to conduct a comprehensive search of recent (1990–2012), English language peer-reviewed published meta-analyses and systematic reviews in the 10 core databases of scientific literature. Our review of the literature encompassed six key conceptual domains of intervention foci, including distal influences of child health (i.e., income and resources, social cohesion, and physical environment) and proximal influences (i.e., family, school and peer). We examined intervention effects on four key domains of child health and development: cognitive development, social and emotional competence, psychological and behavioral wellbeing, and physical health. Results Published reviews were identified for 98 distinct policy-relevant community interventions, evaluated across 288 outcomes. We classified 46 strategies as meeting scientific criteria for efficacy by having consistent, positive outcomes from high-quality trials (e.g., tenant-based rental assistance, neighborhood watch programs, urban design and land use policies, access to quality childcare services, class

  13. Community Health, Community Care, Community Support: Proceedings of the Invitational Conference on Innovative Childhood Care and Development Support Programs (Amsterdam, Netherlands, September 1996).

    ERIC Educational Resources Information Center

    Hanrahan, Marian, Ed.; Prinsen, Bert, Ed.

    The development of community-based programs to support inexperienced parents through home visits by experienced mothers, who are in turned facilitated by child health and development professionals, has become an increasingly common approach in Europe and the United States. This edited volume presents proceedings from an invitational conference on…

  14. Some implications of a community mental health model for developing countries.

    PubMed

    Mehryar, A; Khajavi, F

    The aim of this paper is to call attention to certain problems facing many developing countries which are bound to lead to further difficulties in psychosocial adjustment. Almost all these problems are inherent in the process of socioeconomic change, urbanization, and industrialization. These changes may not only lead to an increase in the rate of mental illness, but because of their impact on the basic family structure and living conditions, will result in a reduced tolerance of deviation on the part of the community. Moreover, the spread of public education and mass media is also likely to lead to a change in the expectations and attitudes of developing nations making it no longer possible to endure psychological suffering as part of one's destiny. Even the improvement of public health services leading to reduction of infant mortality and a rise in life expectancy may lead to a gross increase in demands for mental health services by the very young and the aged sections of the population. It is the contention of this paper that a community mental health model, with certain modifications to fit the local culture, will best serve the increasing mental health needs of developing nations. Of particular relevance are such aspects of the model as population and prevention orientation, community involvement, extension of prefessional resources through consultation, utilization of non-professional manpower, continuity and comprehensiveness of care as well as an open systems conceptualization of the whole process of the organization and delivery of mental health services. The latter approach will help bring about an integration of mental health services within the wider framework of human service agencies, e.g., public health, general and adult education, family planning, and community development.

  15. WALK Community Grants Scheme: lessons learned in developing and administering a health promotion microgrants program.

    PubMed

    Caperchione, Cristina; Mummery, W Kerry; Joyner, Kelly

    2010-09-01

    The Women's Active Living Kits (WALK) Community Grant Scheme was a key component of a federally funded Australian initiative aimed at increasing local capacity to promote and engage priority women's groups in health-related physical activity. Under the program, community groups and organizations were provided with the opportunity to apply and receive small grants to support the development of women's walking groups with the aim of increasing physical activity participation levels in women, supporting innovative community ideas for increasing women's physical activity by improving social structures and environments, or both. This article describes the development and administration of the WALK Community Grant Scheme, outlines challenges and barriers encountered throughout the grant program process, and provides practical insights for replicating this initiative.

  16. The Use of Health Impact Assessment for a Community Undergoing Natural Gas Development

    PubMed Central

    McKenzie, Lisa; Stinson, Kaylan E.; Scott, Kenneth; Newman, Lee S.; Adgate, John

    2013-01-01

    The development of natural gas wells is rapidly increasing, yet little is known about associated exposures and potential public health consequences. We used health impact assessment (HIA) to provide decision-makers with information to promote public health at a time of rapid decision making for natural gas development. We have reported that natural gas development may expose local residents to air and water contamination, industrial noise and traffic, and community changes. We have provided more than 90 recommendations for preventing or decreasing health impacts associated with these exposures. We also have reflected on the lessons learned from conducting an HIA in a politically charged environment. Finally, we have demonstrated that despite the challenges, HIA can successfully enhance public health policymaking. PMID:23597363

  17. The use of health impact assessment for a community undergoing natural gas development.

    PubMed

    Witter, Roxana Z; McKenzie, Lisa; Stinson, Kaylan E; Scott, Kenneth; Newman, Lee S; Adgate, John

    2013-06-01

    The development of natural gas wells is rapidly increasing, yet little is known about associated exposures and potential public health consequences. We used health impact assessment (HIA) to provide decision-makers with information to promote public health at a time of rapid decision making for natural gas development. We have reported that natural gas development may expose local residents to air and water contamination, industrial noise and traffic, and community changes. We have provided more than 90 recommendations for preventing or decreasing health impacts associated with these exposures. We also have reflected on the lessons learned from conducting an HIA in a politically charged environment. Finally, we have demonstrated that despite the challenges, HIA can successfully enhance public health policymaking.

  18. Connecting Communities to Health Research: Development of the Project CONNECT Minority Research Registry

    PubMed Central

    Green, Melissa A.; Kim, Mimi M.; Barber, Sharrelle; Odulana, Abedowale A.; Godley, Paul A.; Howard, Daniel L.; Corbie-Smith, Giselle M.

    2013-01-01

    Introduction Prevention and treatment standards are based on evidence obtained in behavioral and clinical research. However, racial and ethnic minorities remain relatively absent from the science that develops these standards. While investigators have successfully recruited participants for individual studies using tailored recruitment methods, these strategies require considerable time and resources. Research registries, typically developed around a disease or condition, serve as a promising model for a targeted recruitment method to increase minority participation in health research. This study assessed the tailored recruitment methods used to populate a health research registry targeting African-American community members. Methods We describe six recruitment methods applied between September 2004 and October 2008 to recruit members into a health research registry. Recruitment included direct (existing studies, public databases, community outreach) and indirect methods (radio, internet, and email) targeting the general population, local universities, and African American communities. We conducted retrospective analysis of the recruitment by method using descriptive statistics, frequencies, and chi-square statistics. Results During the recruitment period, 608 individuals enrolled in the research registry. The majority of enrollees were African American, female, and in good health. Direct and indirect methods were identified as successful strategies for subgroups. Findings suggest significant associations between recruitment methods and age, presence of existing health condition, prior research participation, and motivation to join the registry. Conclusions A health research registry can be a successful tool to increase minority awareness of research opportunities. Multi-pronged recruitment approaches are needed to reach diverse subpopulations. PMID:23340183

  19. Organizational capacity for community development in regional health authorities: a conceptual model.

    PubMed

    Germann, Kathy; Wilson, Doug

    2004-09-01

    The value of community development (CD) practices is well documented in the health promotion literature; it is a foundational strategy outlined in the Ottawa Charter for Health Promotion. Despite the importance of collaborative action with communities to enhance individual and community health and well-being, there exists a major gap between the evidence for CD and the actual extent to which CD is carried out by health organizations. In this paper it is argued that the gap exists because we have failed to turn the evaluative gaze inward-to examine the capacity of health organizations themselves to facilitate CD processes. This study was designed to explicate key elements that contribute to organizational capacity for community development (OC-CD). Twenty-two front-line CD workers and managers responsible for CD initiatives from five regional health authorities in Alberta, Canada, were interviewed. Based on the study findings, a multidimensional model for conceptualizing OC-CD is presented. Central to the model are four inter-related dimensions: (i) organizational commitment to CD, rooted in particular values and beliefs, leadership and shared understanding of CD; (ii) supportive structures and systems, such as job design, flexible planning processes, evaluation mechanisms and collaborative processes; (iii) allocation of resources for CD; and (iv) working relationships and processes that model CD within the health organization. These four dimensions contribute to successful CD practice in numerous ways, but perhaps most importantly by supporting the empowerment and autonomy of the pivotal organizational player in health promotion practice: the front-line worker.

  20. Annual Initiative Review: Report of Health Care Delivery Initiative. California Community Colleges Economic Development Program Annual Initiative Report.

    ERIC Educational Resources Information Center

    Comins, James L.; Krozek, Charles

    This 1999-2000 report addresses the objectives and impact of California's Health Care Delivery Initiative (HCDI), which is comprised of a network of Regional Health Occupations Resource Centers (RHORCs) and their community college and health care industry partners. The HCDI identifies needed workers, develops/modifies community college curricula,…

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

    PubMed Central

    2012-01-01

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

  2. Using strategic planning and organizational development principles for health promotion in an Alaska Native community

    PubMed Central

    Lardon, Cécile; Soule, Susan; Kernak, Douglas; Lupie, Henry

    2011-01-01

    SUMMARY Health promotion aims to support people in their efforts to increase control over factors that impact health and well-being. This emphasis on empowerment and contextual influences allows for a more holistic conceptualization of health and approaches to promoting health that are anchored in principles of community development and systems change. Piciryaratgun Calritllerkaq (Healthy Living Through A Healthy Lifestyle) is a collaboration between a Yup’ik village in rural Alaska and researchers from the University of Alaska Fairbanks. The goal was to improve nutrition, increase exercise and decrease stress. The project utilized elements of organization development and strategic planning to develop a local infrastructure and process and to promote local expertise. The project team developed goals, objectives, action and evaluation plans that integrated local traditions, Yup’ik culture, and research. PMID:21271433

  3. Using strategic planning and organizational development principles for health promotion in an Alaska native community.

    PubMed

    Lardon, Cecile; Soule, Susan; Kernak, Douglas; Lupie, Henry

    2011-01-01

    Health promotion aims to support people in their efforts to increase control over factors that impact health and well-being. This emphasis on empowerment and contextual influences allows for a more holistic conceptualization of health and approaches to promoting health that are anchored in principles of community development and systems change. Piciryaratgun Calritllerkaq (Healthy Living Through A Healthy Lifestyle) is a collaboration between a Yup'ik village in rural Alaska and researchers from the University of Alaska Fairbanks. The goal was to improve nutrition, increase exercise, and decrease stress. The project utilized elements of organization development and strategic planning to develop a local infrastructure and process and to promote local expertise. The project team developed goals, objectives, action, and evaluation plans that integrated local traditions, Yup'ik culture, and research.

  4. Cardiovascular Health in the Developing World: Community Perceptions from Carriacou, Grenada

    PubMed Central

    Dozier, Ann M.; Block, Robert; Levy, Deborah; Dye, Timothy D.; Pearson, Thomas A.

    2009-01-01

    Background As developing countries shift to increasing prevalence of cardiovascular risk factors and diseases (CVD), prevention efforts, both primary and secondary, become a public health priority. Designing effective methods requires a clear understanding of local beliefs and practices regarding health risks and behaviors. Methods A mixed gender and age team deployed a Rapid Assessment Protocol (participant observation; interviews) over three days. Interviews from 25 residents of Carriacou, Grenada included leaders and community members representing a range of demographic characteristics (gender, age, employment). Results Residents expressed general uncertainty about their actual health. While acknowledging that certain conditions (e.g. diabetes, hypertension) were prevalent, heredity was viewed as being more strongly associated with CVD. Not being able to work or carry out one’s daily activities often drove health care seeking behavior (evaluation, care or initiating lifestyle changes). Health improvement activities when practiced were fragmented, not an overall lifestyle change. Physical activity was implicitly valued but not universally practiced; it declined with age and increasing work and other commitments. Conclusions While public health programs benefit from understanding community attitudes and beliefs, research to inform program development is often not undertaken or if undertaken not effectively utilized to make needed program modifications. Key to our conclusions was their perspective on health as illness oriented and reactive, strongly associated with heredity rather than preventive and associated with behavior change. A preventive focus informed by local practices is fundamental to designing effective and sustainable primary and secondary prevention programs and particularly useful in developing countries. PMID:19730702

  5. Cardiovascular Health in the Developing World: Community Perceptions from Carriacou, Grenada.

    PubMed

    Dozier, Ann M; Block, Robert; Levy, Deborah; Dye, Timothy D; Pearson, Thomas A

    2008-09-01

    BACKGROUND: As developing countries shift to increasing prevalence of cardiovascular risk factors and diseases (CVD), prevention efforts, both primary and secondary, become a public health priority. Designing effective methods requires a clear understanding of local beliefs and practices regarding health risks and behaviors. METHODS: A mixed gender and age team deployed a Rapid Assessment Protocol (participant observation; interviews) over three days. Interviews from 25 residents of Carriacou, Grenada included leaders and community members representing a range of demographic characteristics (gender, age, employment). RESULTS: Residents expressed general uncertainty about their actual health. While acknowledging that certain conditions (e.g. diabetes, hypertension) were prevalent, heredity was viewed as being more strongly associated with CVD. Not being able to work or carry out one's daily activities often drove health care seeking behavior (evaluation, care or initiating lifestyle changes). Health improvement activities when practiced were fragmented, not an overall lifestyle change. Physical activity was implicitly valued but not universally practiced; it declined with age and increasing work and other commitments. CONCLUSIONS: While public health programs benefit from understanding community attitudes and beliefs, research to inform program development is often not undertaken or if undertaken not effectively utilized to make needed program modifications. Key to our conclusions was their perspective on health as illness oriented and reactive, strongly associated with heredity rather than preventive and associated with behavior change. A preventive focus informed by local practices is fundamental to designing effective and sustainable primary and secondary prevention programs and particularly useful in developing countries.

  6. Developing an inter-organizational community-based health network: an Australian investigation.

    PubMed

    Short, Alison; Phillips, Rebecca; Nugus, Peter; Dugdale, Paul; Greenfield, David

    2015-12-01

    Networks in health care typically involve services delivered by a defined set of organizations. However, networked associations between the healthcare system and consumers or consumer organizations tend to be open, fragmented and are fraught with difficulties. Understanding the role and activities of consumers and consumer groups in a formally initiated inter-organizational health network, and the impacts of the network, is a timely endeavour. This study addresses this aim in three ways. First, the Unbounded Network Inter-organizational Collaborative Impact Model, a purpose-designed framework developed from existing literature, is used to investigate the process and products of inter-organizational network development. Second, the impact of a network artefact is explored. Third, the lessons learned in inter-organizational network development are considered. Data collection methods were: 16 h of ethnographic observation; 10 h of document analysis; six interviews with key informants and a survey (n = 60). Findings suggested that in developing the network, members used common aims, inter-professional collaboration, the power and trust engendered by their participation, and their leadership and management structures in a positive manner. These elements and activities underpinned the inter-organizational network to collaboratively produce the Health Expo network artefact. This event brought together healthcare providers, community groups and consumers to share information. The Health Expo demonstrated and reinforced inter-organizational working and community outreach, providing consumers with community-based information and linkages. Support and resources need to be offered for developing community inter-organizational networks, thereby building consumer capacity for self-management in the community.

  7. 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

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

    PubMed

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

    2013-07-20

    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. 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. 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. This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the fact that actors' power or position in the

  9. Development and implementation of a culturally sensitive cervical health survey: a community-based participatory approach.

    PubMed

    Smith, Adina; Christopher, Suzanne; McCormick, Alma Knows His Gun

    2004-01-01

    Cervical cancer mortality rates are higher for Great Plains Native American women than for Caucasian women and other Native women. Messengers for Health, a project based on the Apsáalooke (Crow Indian) reservation, utilizes a lay health advisor approach to decrease cervical cancer screening barriers, increase knowledge regarding screening and prevention, and increase the proportion of women receiving Pap tests among Apsáalooke women aged 18 and older. This project utilizes a community-based participatory research model, which emphasizes community member involvement in all phases of the project. The initial phase of this project was the development and implementation of a culturally sensitive survey used to guide the program and benefit the community. The process and preliminary results are presented.

  10. Capacity development for community health nurses in Pakistan: the assistant manager role.

    PubMed

    Gulzar, S A; Mistry, R; Upvall, M J

    2011-09-01

    Community health nurses (CHNs), as leaders in developing countries, can promote successful outcomes in meeting the targets of the Millennium Development Goals. A community-based organization in Pakistan is striving to achieve the goals of maternal and child health through the development of the assistant manager role for community health nursing. The purpose of this study was to assess the perception of the role of the CHN assistant manager, with the goal of strengthening that role. This interpretive, qualitative study included 13 participants already familiar with CHNs in Pakistan. Interviewing was utilized to explore perceptions of the assistant manager role and to uncover challenges currently existing within this new role. Content analysis revealed the following themes: 'role perceptions', 'expectations of the role' and 'collaboration with other community healthcare providers'. Changes to the role are necessary including increased education of the assistant manager CHNs and preparing administration to work with the assistant mangers for effective leadership. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  11. DEVELOPMENT OF A RURAL COMMUNITY HEALTH CARE MODEL BASED ON INDIAN INDIGENOUS SYSTEM OF MEDICINE

    PubMed Central

    Hyma, B.; Ramesh, A.; Subhadra, N.L.

    1988-01-01

    Based on the principles of primary health care as outlined by WHO at the Alma Ata Conference in 1978, many voluntary organizations in India have been formulating, organizing and experimenting with the comprehensive rural community health Schemes. The goal is to indentify the felt needs at both individual and community levels and facilitate direct participation in decision making, develop suitable alternative, ecologically Sound indigenous models for socioeconomic well-being. In this context the Indian system of medicine has a useful and complementary role to play in the preventive and curative aspects of primary health care programmes. With the above objectives in mind the investigators undertook a brief survey of a “comprehensive rural health” project. The primary aim of this project is to develop a community health care model using innovative alternative methods using Indian indigenous system of medicine and participatory research techniques to improve rural health services of the surrounding under privileged villages. Many gaps exist in the assessment, however, a birds eye-view is presented here. PMID:22557645

  12. Community health nursing in Australia: a critical literature review and implications for professional development.

    PubMed

    Brookes, Kim; Davidson, Patricia; Daly, John; Hancock, Karen

    2004-01-01

    Increasing emphasis on community-based mandates an examination of the community health nurse (CHN). A critical literature review of the CHN role internationally, with an emphasis on Australia, was undertaken in order to understand historical precedents and inform policy and strategic directions for the CHN. A search of the CINAHL, EMBASE, and COCHRANE electronic data-bases from 1982 to June 2002 using community' and 'nursing' as key words and hand searching of books and government reports was undertaken. This search strategy revealed a lack of literature compared with other areas of nursing. Key themes emerging from this review are: (1) an absence of clear role definitions and lack of clarity of roles; (2) variability in educational requirements for CHNs; (3) diminished CHN power in policy decision making; (3) conflicting role expectations between different facets of the health care system; (4) underutilisation and untapped potential of the role of the CHN in the contemporary health care system; (5) the emerging influence of specialist nurses in community based-care; (6) uptake of traditional nursing roles by non-nurses and (7) an absence of a cohesive model of professional development of CHN that is able to articulate with contemporary social, political and economic trends in health care delivery. Community health nursing in Australia has a low professional profile when compared to other nursing specialties. An emerging issue, gleaned from the literature review is the tension and debate between specialist and generalist services. It is apparent from this review that CHN have to more actively participate in research and peer reviewed debate in order to have their voice heard and promote their unique and valuable contribution to the nursing profession and the health care system.

  13. How the health and community development sectors are combining forces to improve health and well-being.

    PubMed

    Braunstein, Sandra; Lavizzo-Mourey, Risa

    2011-11-01

    The root causes of poor health experienced by many who live in low-income neighborhoods-such as the lack of access to health care, limited food choices, and exposure to environmental hazards-are well documented, but often go beyond the scope of the health care delivery system. But that is beginning to change. The health sector has begun to collaborate with the community development sector, which for decades has been working in low-income neighborhoods. Encouraging local and national examples of these new partnerships abound. They include an effort in Seattle, Washington, to reduce exposure to allergens and irritants among low-income asthmatic children, and a $500 million federal program to finance the operation of grocery stores in what have previously been urban "food deserts." To nurture such efforts, the Robert Wood Johnson Foundation, the Federal Reserve System, and others have sponsored a series of "healthy community" forums in US cities. In this article we explore the growing partnerships between the health and community development sectors as well as the challenges they face, and we offer policy recommendations that might help them succeed.

  14. Bringing Researchers and Community Developers Together to Revitalize a Public Housing Project and Improve Health

    PubMed Central

    LeWinn, Kaja Z.; Hutson, Malo A.; Dare, Ramie; Falk, Janet

    2014-01-01

    Billions of dollars are invested annually to improve low-income neighborhoods, the health impacts of which are rarely studied prospectively. University of California researchers and Mercy Housing/The Related Companies formed a “Learning Community” with the dual goals of examining the health impacts of a large-scale San Francisco redevelopment project and informing the development team of best public health practices. Early experiences highlight challenges and opportunities, including differences in stakeholders, incentives, and funding, the strengths of local partnerships, and fresh insights from new analytic tools and perspectives. Research suggests interventions that ameliorate upstream causes of poor health would save health care dollars, but policy makers must incentivize collaboration in order to spread a Learning Community model. PMID:22068398

  15. Engaging Student Health Organizations in Reducing Health Disparities in Underserved Communities through Volunteerism: Developing a Student Health Corps

    PubMed Central

    Mays, Vickie M.; Ly, Lichin; Allen, Erica; Young, Sophia

    2013-01-01

    One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable trainings in preventive health screenings and help in understanding target populations’ needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers. PMID:19648716

  16. Issues in the Development of an All-Digital Public Health Library in Michigan: The Michigan Community Health Electronic Library

    ERIC Educational Resources Information Center

    Brenneise, Harvey R.

    2005-01-01

    The Michigan Community Health Electronic Library (MCHEL) serves the public health and other community health workers in Michigan. It is committed to desktop delivery of the best health information to its primary clientele, with as much as possible in digital full-text form. It collaborates with other libraries in the state to make this possible.…

  17. A model for common ground development to support collaborative health communities.

    PubMed

    Kuziemsky, Craig E; O'Sullivan, Tracey L

    2015-03-01

    Common ground is necessary for developing collaboration as part of building resilience for public health preparedness. While the importance of common ground as an essential component of collaboration has been well described, there is a need for studies to identify how common ground develops over time, across individual and group dimensions, and the contexts that influence its development. This paper studied common ground development in three Canadian communities between October 2010 and March 2011 through a project on capacity building for disaster management. Disaster management requires the integration of paid and volunteer participants across public and private sectors and is therefore a good domain to study common ground development. We used directed qualitative content analysis to develop a model of common ground development over time that describes its progression through coordinative, cooperative and collaborative common ground. We also identified how common ground develops at micro (individual) and macro (group) levels, as well as how agency, technology and geographical contexts influence its development. We then use the four phases of disaster management to illustrate how our model can support longitudinal common ground development. Our findings provide useful insight to enable proactive development of common ground in collaborative health communities.

  18. The Ramathibodi Community Health Program

    ERIC Educational Resources Information Center

    Buri, Prem; And Others

    1974-01-01

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

  19. Community development and livestock promotion in rural Nepal: effects on child growth and health.

    PubMed

    Miller, Laurie C; Joshi, Neena; Lohani, Mahendra; Rogers, Beatrice; Loraditch, Meghan; Houser, Robert; Singh, Padma; Mahato, Shubh

    2014-09-01

    More than 50% of children in Nepal are malnourished. Economic growth and poverty reduction are not always sufficient to improve the health and nutritional status of children. Heifer Nepal uses livestock training as a tool for community development and poverty alleviation but does not directly address child health and nutrition. To systematically assess the effects of Heifer activities on child health and nutrition. The study was a 2-year, longitudinal, randomized, controlled trial in six communities in Nepal (both Terai and hills), pair-matched for specific characteristics, randomly assigned to receive Heifer community development activities at baseline (intervention) or 1 year (control). At 6-month intervals over a period of 2 years, child anthropometric and comprehensive household surveys were performed. Four hundred fifteen households were enrolled containing 607 children 6 months to 5 years of age. The intervention and control communities were equivalent for baseline socioeconomic status, household size, ownership of land and animals, and child nutrition and health. At 12 months (prior to animal donations), the Terai intervention group had improved child weight (p = .04), improved child height (p = .05), and reduced sick days (p = .03), as well as increased household income (p = .004), increased ownership of animals (p = .04) and land (p = .04), and improved sanitation practices (p < .01). In all districts, longer participation in Heifer activities corresponded to more improvement in child height-for-age z-scores. Heifer interventions resulted in improved socioeconomic status and household income per family member. Children under 60 months of age in the intervention group had greater incremental improvement in height-for-age and weight-for-age z-scores than children in the control group, and longer participation in Heifer activities was associated with better growth. Poverty alleviation programs, such as Heifer, may indirectly benefit child growth.

  20. Community health impacts from oil and gas development in Texas: The perspective of Sharon Wilson.

    PubMed

    Vera, Lourdes

    2016-08-30

    Sharon Wilson is a community organizer for the nonprofit organization Earthworks. After leaving her office job managing data for the oil and gas industry, she started organizing in response to negative impacts from unconventional oil and gas extraction methods near her Texas home and throughout the state. She describes the environmental health impacts of oil and gas development aided by new technologies and regulatory exemptions set forth by the 2005 Energy Policy Act. Production has spread to previously unexplored regions over the last decade, including her property on the Barnett Shale in North Texas, where she has interacted with energy corporations and observed the intensification of residents' health issues. I structured the questions in this interview to highlight her unique perspective on organizing in relation to current regulatory loopholes, health impacts of oil and gas development, and the experiences individuals have had with representatives from the industry.

  1. Developing a performance measurement framework and indicators for community health service facilities in urban China.

    PubMed

    Wong, Sabrina T; Yin, Delu; Bhattacharyya, Onil; Wang, Bin; Liu, Liqun; Chen, Bowen

    2010-11-18

    China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC.

  2. Developing Effective Interuniversity Partnerships and Community-Based Research to Address Health Disparities

    PubMed Central

    Carey, Timothy S.; Howard, Daniel L.; Goldmon, Moses; Roberson, James T.; Godley, Paul A.; Ammerman, Alice

    2009-01-01

    Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date. PMID:16249303

  3. Strengthening population health interventions: developing the CollaboraKTion Framework for Community-Based Knowledge Translation.

    PubMed

    Jenkins, Emily K; Kothari, Anita; Bungay, Vicky; Johnson, Joy L; Oliffe, John L

    2016-08-30

    Much of the research and theorising in the knowledge translation (KT) field has focused on clinical settings, providing little guidance to those working in community settings. In this study, we build on previous research in community-based KT by detailing the theory driven and empirically-informed CollaboraKTion framework. A case study design and ethnographic methods were utilised to gain an in-depth understanding of the processes for conducting a community-based KT study as a means to distilling the CollaboraKTion framework. Drawing on extensive field notes describing fieldwork observations and interactions as well as evidence from the participatory research and KT literature, we detail the processes and steps undertaken in this community-based KT study as well as their rationale and the challenges encountered. In an effort to build upon existing knowledge, Kitson and colleagues' co-KT framework, which provides guidance for conducting KT aimed at addressing population-level health, was applied as a coding structure to inform the current analysis. This approach was selected because it (1) supported the application of an existing community-based KT framework to empirical data and (2) provided an opportunity to contribute to the theory and practice gaps in the community-based KT literature through an inductively derived empirical example. Analysis revealed that community-based KT is an iterative process that can be viewed as comprising five overarching processes: (1) contacting and connecting; (2) deepening understandings; (3) adapting and applying the knowledge base; (4) supporting and evaluating continued action; and (5) transitioning and embedding as well as several key elements within each of these processes (e.g. building on existing knowledge, establishing partnerships). These empirically informed theory advancements in KT and participatory research traditions are summarised in the CollaboraKTion framework. We suggest that community-based KT researchers place

  4. Development of radio dramas for health communication pilot intervention in Canadian Inuit communities

    PubMed Central

    Racicot-Matta, Cassandra; Wilcke, Markus; Egeland, Grace M.

    2016-01-01

    A mixed-methods approach was used to develop a culturally appropriate health intervention over radio within the Inuit community of Pangnirtung, Nunavut (NU), Canada. The radio dramas were developed, recorded and tested pre-intervention through the use of Participatory Process and informed by the extended elaboration likelihood model (EELM) for education–communication. The radio messages were tested in two focus groups (n = 4 and n = 5) to determine fidelity of the radio dramas to the EELM theory. Focus group feedback identified that revisions needed to be made to two characteristics required of educational programmes by the EELM theorem: first, the quality of the production was improved by adding Inuit youth recorded music and second, the homophily (relatability of characters) of radio dramas was improved by re-recording the dramas with voices of local youth who had been trained in media communication studies. These adjustments would not have been implemented had pre-intervention testing of the radio dramas not taken place and could have reduced effectiveness of the overall intervention. Therefore, it is highly recommended that media tools for health communication/education be tested with the intended target audience before commencement of programmes. Participatory Process was identified to be a powerful tool in the development and sustainability of culturally appropriate community health programming. PMID:24957329

  5. Development of radio dramas for health communication pilot intervention in Canadian Inuit communities.

    PubMed

    Racicot-Matta, Cassandra; Wilcke, Markus; Egeland, Grace M

    2016-03-01

    A mixed-methods approach was used to develop a culturally appropriate health intervention over radio within the Inuit community of Pangnirtung, Nunavut (NU), Canada. The radio dramas were developed, recorded and tested pre-intervention through the use of Participatory Process and informed by the extended elaboration likelihood model (EELM) for education-communication. The radio messages were tested in two focus groups (n = 4 and n = 5) to determine fidelity of the radio dramas to the EELM theory. Focus group feedback identified that revisions needed to be made to two characteristics required of educational programmes by the EELM theorem: first, the quality of the production was improved by adding Inuit youth recorded music and second, the homophily (relatability of characters) of radio dramas was improved by re-recording the dramas with voices of local youth who had been trained in media communication studies. These adjustments would not have been implemented had pre-intervention testing of the radio dramas not taken place and could have reduced effectiveness of the overall intervention. Therefore, it is highly recommended that media tools for health communication/education be tested with the intended target audience before commencement of programmes. Participatory Process was identified to be a powerful tool in the development and sustainability of culturally appropriate community health programming. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    ERIC Educational Resources Information Center

    Platz-Wiechert, Lynn Marie

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Platz-Wiechert, Lynn Marie

    2010-01-01

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

  8. Development and community-based validation of eight item banks to assess mental health.

    PubMed

    Batterham, Philip J; Sunderland, Matthew; Carragher, Natacha; Calear, Alison L

    2016-09-30

    There is a need for precise but brief screening of mental health problems in a range of settings. The development of item banks to assess depression and anxiety has resulted in new adaptive and static screeners that accurately assess severity of symptoms. However, expansion to a wider array of mental health problems is required. The current study developed item banks for eight mental health problems: social anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder, adult attention-deficit hyperactivity disorder, drug use, psychosis and suicidality. The item banks were calibrated in a population-based Australian adult sample (N=3175) by administering large item pools (45-75 items) and excluding items on the basis of local dependence or measurement non-invariance. Item Response Theory parameters were estimated for each item bank using a two-parameter graded response model. Each bank consisted of 19-47 items, demonstrating excellent fit and precision across a range of -1 to 3 standard deviations from the mean. No previous study has developed such a broad range of mental health item banks. The calibrated item banks will form the basis of a new system of static and adaptive measures to screen for a broad array of mental health problems in the community.

  9. Human resource development for a community-based health extension program: a case study from Ethiopia

    PubMed Central

    2013-01-01

    Introduction Ethiopia is one of the sub-Saharan countries most affected by high disease burden, aggravated by a shortage and imbalance of human resources, geographical distance, and socioeconomic factors. In 2004, the government introduced the Health Extension Program (HEP), a primary care delivery strategy, to address the challenges and achieve the World Health Organization Millennium Development Goals (MDGs) within a context of limited resources. Case description The health system was reformed to create a platform for integration and institutionalization of the HEP with appropriate human capacity, infrastructure, and management structures. Human resources were developed through training of female health workers recruited from their prospective villages, designed to limit the high staff turnover and address gender, social and cultural factors in order to provide services acceptable to each community. The service delivery modalities include household, community and health facility care. Thus, the most basic health post infrastructure, designed to rapidly and cost-effectively scale up HEP, was built in each village. In line with the country’s decentralized management system, the HEP service delivery is under the jurisdiction of the district authorities. Discussion and evaluation The nationwide implementation of HEP progressed in line with its target goals. In all, 40 training institutions were established, and over 30,000 Health Extension Workers have been trained and deployed to approximately 15,000 villages. The potential health service coverage reached 92.1% in 2011, up from 64% in 2004. While most health indicators have improved, performance in skilled delivery and postnatal care has not been satisfactory. While HEP is considered the most important institutional framework for achieving the health MDGs in Ethiopia, quality of service, utilization rate, access and referral linkage to emergency obstetric care, management, and evaluation of the program are the key

  10. Human resource development for a community-based health extension program: a case study from Ethiopia.

    PubMed

    Teklehaimanot, Hailay D; Teklehaimanot, Awash

    2013-08-20

    Ethiopia is one of the sub-Saharan countries most affected by high disease burden, aggravated by a shortage and imbalance of human resources, geographical distance, and socioeconomic factors. In 2004, the government introduced the Health Extension Program (HEP), a primary care delivery strategy, to address the challenges and achieve the World Health Organization Millennium Development Goals (MDGs) within a context of limited resources. The health system was reformed to create a platform for integration and institutionalization of the HEP with appropriate human capacity, infrastructure, and management structures. Human resources were developed through training of female health workers recruited from their prospective villages, designed to limit the high staff turnover and address gender, social and cultural factors in order to provide services acceptable to each community. The service delivery modalities include household, community and health facility care. Thus, the most basic health post infrastructure, designed to rapidly and cost-effectively scale up HEP, was built in each village. In line with the country's decentralized management system, the HEP service delivery is under the jurisdiction of the district authorities. The nationwide implementation of HEP progressed in line with its target goals. In all, 40 training institutions were established, and over 30,000 Health Extension Workers have been trained and deployed to approximately 15,000 villages. The potential health service coverage reached 92.1% in 2011, up from 64% in 2004. While most health indicators have improved, performance in skilled delivery and postnatal care has not been satisfactory. While HEP is considered the most important institutional framework for achieving the health MDGs in Ethiopia, quality of service, utilization rate, access and referral linkage to emergency obstetric care, management, and evaluation of the program are the key challenges that need immediate attention. This article

  11. Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

    PubMed

    Cohen, Benita E; Gregory, David

    2009-01-01

    Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

  12. Mitigation of non-communicable diseases in developing countries with community health workers.

    PubMed

    Mishra, Shiva Raj; Neupane, Dinesh; Preen, David; Kallestrup, Per; Perry, Henry B

    2015-11-10

    Non-communicable diseases (NCDs) are rapidly becoming priorities in developing countries. While developed countries are more prepared in terms of skilled human resources for NCD management, developing the required human resources is still a challenge in developing countries. In this context, mobilizing community health workers (CHWs) for control of NCDs seems promising. With proper training, supervision and logistical support, CHWs can participate in the detection and treatment of hypertension, diabetes, and other priority chronic diseases. Furthermore, advice and support that CHWs can provide about diet, physical activity, and other healthy lifestyle habits (such as avoidance of smoking and excessive alcohol intake) have the potential for contributing importantly to NCD programs. This paper explores the possibility of involving CHWs in developing countries for addressing NCDs.

  13. Therapeutic friendliness and the development of therapeutic leverage by mental health nurses in community rehabilitation settings.

    PubMed

    Gardner, Andrew

    2010-01-01

    In a world dominated by technology and driven by fiscal policy emphasis, the therapeutic relationship as a healing modality is still a central theme to mental health nurses (MHN) in their everyday work. This research, as part of a PhD program, used a constructivist grounded theory approach to explore the process of therapeutic relationships and professional boundaries. The current paper outlines how therapeutic friendliness provides a connection for the therapeutic relationship to develop but in doing so requires a balancing of the therapeutic relationship and constant maintenance of the professional boundary. The authors also discuss how community mental health nurses (CMHN) invest in the therapeutic relationship in order to develop a therapeutic alliance and how the alliance between the CMHN and the client facilitates the use of therapeutic leverage applied by the CMHN as part of the therapeutic process.

  14. Development and evaluation of a youth mental health community awareness campaign - The Compass Strategy.

    PubMed

    Wright, Annemarie; McGorry, Patrick D; Harris, Meredith G; Jorm, Anthony F; Pennell, Kerryn

    2006-08-22

    Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12-25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects (p < 0.05): awareness of mental health campaigns, self-identified depression, help for depression sought in the previous year, correct estimate of prevalence of mental health problems, increased awareness of suicide risk, and a reduction in perceived

  15. Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool

    PubMed Central

    2013-01-01

    Introduction The residents of many Australian rural and remote communities do not have the essential infrastructure and services required to support healthy living conditions and community members choosing healthy lifestyle options. Improving these social determinants of health is seen to offer real opportunities to improve health among such disadvantaged populations. In this paper, we describe the development and trialling of a tool to measure, monitor and evaluate key social determinants of health at community level. Methods The tool was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders and trialling the tool in remote Indigenous communities in the Northern Territory of Australia. Results The indicators were found to be robust, and by testing the tool on a number of different levels, face validity was confirmed. The scoring system was well understood and easily followed by Indigenous and non-Indigenous study participants. A facilitated small group process was found to reduce bias in scoring of indicators. Conclusion The Healthy Community Assessment Tool offers a useful vehicle and process to help those involved in planning, service provision and more generally promoting improvements in community social determinants of health. The tool offers many potential uses and benefits for those seeking to address inequities in the social determinants of health in remote communities. Maximum benefits in using the tool are likely to be gained with cross-sector involvement and when assessments are part of a continuous quality improvement program. PMID:23442804

  16. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    SciTech Connect

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; Anderson, Kim A.; Scaffidi, Christopher; Sudakin, Daniel; Peterson, Elena S.; Waters, Katrina M.; Haynes, Erin; Arkin, Lisa; Feezel, Paul; Kincl, Laurel

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototype and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.

  17. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    DOE PAGES

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; ...

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototypemore » and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.« less

  18. Community Participation in Mental Health Training. Developing Self-Reliance to Meet the Current and Future Mental Health Needs in the Pacific.

    ERIC Educational Resources Information Center

    Trotter, Charlotte M. F.

    1985-01-01

    A context is developed for viewing mental health problems and needs in Micronesia and American Samoa. The article highlights the process the trainer encounters in preparing the community for the training. The concept of community participation is developed and operationalized. A two-phased training model suggests one way to implement this concept.…

  19. The Development of the Milwaukee Consortium for Hmong Health: Capacity Building Through Direct Community Engagement.

    PubMed

    Sparks, Shannon M; Vang, Pang C

    2015-01-01

    Hmong women experience increased incidence and mortality rates for cervical cancer, yet their cancer risk is often masked by their inclusion within the comparatively low-risk Asian American and Pacific Islander (AAPI) category. Key to this disparity is late stage at diagnosis, a consequence of low rates of screening. This article describes the establishment and community engagement efforts of the Milwaukee Consortium for Hmong Health, established in 2008 to build capacity to investigate and address barriers to screening and cancer care. The Consortium facilitated a series of three community dialogues to explore with community members effective ways to overcome barriers to accessing screening and cancer care. The community dialogues produced a series of six recommendations for action, detailed herein, supported and prioritized by the community. We posit that the integral involvement of the Hmong community from the outset promoted buy-in of ensuing Consortium education and outreach efforts, and helped to ensure fit with community perspectives, needs, and priorities.

  20. Developing an Evidence-Based Fall Prevention Curriculum for Community Health Workers

    PubMed Central

    St. John, Julie A.; Shubert, Tiffany E.; Smith, Matthew Lee; Rosemond, Cherie A.; Howell, Doris A.; Beaudoin, Christopher E.; Ory, Marcia G.

    2015-01-01

    This perspective paper describes processes in the development of an evidence-based fall prevention curriculum for community health workers/promotores (CHW/P) that highlights the development of the curriculum and addresses: (1) the need and rationale for involving CHW/P in fall prevention; (2) involvement of CHW/P and content experts in the curriculum development; (3) best practices utilized in the curriculum development and training implementation; and (4) next steps for dissemination and utilization of the CHW/P fall prevention curriculum. The project team of CHW/P and content experts developed, pilot tested, and revised bilingual in-person training modules about fall prevention among older adults. The curriculum incorporated the following major themes: (1) fall risk factors and strategies to reduce/prevent falls; (2) communication strategies to reduce risk of falling and strategies for developing fall prevention plans; and (3) health behavior change theories utilized to prevent and reduce falls. Three separate fall prevention modules were developed for CHW/P and CHW/P Instructors to be used during in-person trainings. Module development incorporated a five-step process: (1) conduct informal focus groups with CHW/P to inform content development; (2) develop three in-person modules in English and Spanish with input from content experts; (3) pilot-test the modules with CHW/P; (4) refine and finalize modules based on pilot-test feedback; and (5) submit modules for approval of continuing education units. This project contributes to the existing evidence-based literature by examining the role of CHW/P in fall prevention among older adults. By including evidence-based communication strategies such as message tailoring, the curriculum design allows CHW/P to personalize the information for individuals, which can result in an effective dissemination of a curriculum that is evidence-based and culturally appropriate. PMID:25964920

  1. Coalicion de Salud Comunitaria (COSACO): using a Healthy Community Partnership framework to integrate short-term global health experiences into broader community development.

    PubMed

    Loh, Lawrence C; Valdman, Olga; Dacso, Matthew M

    2016-05-02

    There is growing concern that short-term experiences in global health experiences (STEGH), undertaken by healthcare providers, trainees, and volunteers from high income countries in lower and middle income countries, risk harming the community by creating a parallel system of care separate from established community development efforts. At the same time, the inclusion of non-traditional actors in health planning has been the basis of the development of many Healthy Community Partnerships (HCP) being rolled out in Canada and the United States. These partnerships aim to bring all stakeholders with a role to play in health to the table to align efforts, goals and programs towards broad community health goals. This methodology paper reports on the process used in La Romana, Dominican Republic, in applying a modified HCP framework. This project succeeded at bringing visiting STEGH organizations into a coalition with key community partners and supported attempts to embed the work of STEGH within longer-term, established development plans. In presenting the work and process and lessons learned, the hope is that other communities that encounter significant investment from STEGH groups, and will gain the same benefits that were seen in La Romana with regards to improved information exchange, increased cross-communication between silos, and the integration of STEGH into the work of community partners.

  2. The Effect of a Multicomponent Professional Development Training on the Beliefs and Behaviors of Community Health Educators Concerning Food Irradiation

    ERIC Educational Resources Information Center

    Thompson, Britta M.; Knight, Stephanie L.

    2006-01-01

    Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponent professional development training on food…

  3. The Effect of a Multicomponent Professional Development Training on the Beliefs and Behaviors of Community Health Educators Concerning Food Irradiation

    ERIC Educational Resources Information Center

    Thompson, Britta M.; Knight, Stephanie L.

    2006-01-01

    Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponent professional development training on food…

  4. Developing Teachers' Health-Related Fitness Knowledge through a Community of Practice: Impact on Student Learning

    ERIC Educational Resources Information Center

    Hunuk, Deniz; Ince, Mustafa Levent; Tannehill, Deborah

    2013-01-01

    The purposes of this study were twofold: to examine the effects of a community of practice (CoP) on (1) physical educators' and their students' health-related fitness content knowledge and (2) the physical educators' health-related fitness pedagogical content knowledge construction process. Twelve experienced physical education teachers (six in…

  5. Chasing the dragon: Developing indicators for the assessment of community participation in health programmes.

    PubMed

    Draper, Alizon Katharine; Hewitt, Gillian; Rifkin, Susan

    2010-09-01

    Community participation was identified as one of the key components of Primary Health Care as articulated in the Alma Ata declaration of 1978 and is enjoying a renewal of interest in both low and high income countries. There remains, however, an on-going challenge in how to assess its role in achieving health improvements. This is largely due to the multiplicity of definitions of community participation, which has made it difficult to evaluate its impact on desired programme outcomes, such as uptake and sustainability, as well as broader health improvements. This paper addresses this challenge by first defining a continuum of community participation that captures its many forms, and then incorporates this into an evaluation framework that enables an analysis of the process of participation and links this with health and programme outcomes. The continuum of participation and framework is based upon the spidergram of Rifkin, Muller, and Bichmann (1988), but modified in the light of the growing literature on community participation and also in relation to our original requirements to evaluate the role of community participation in nutrition-related child survival programmes. A case-study is presented to provide a worked example of the evaluation framework and its utility in the evaluation of community participation. While this is a literature-based and retrospective analysis, it demonstrates how the evaluation tool enables a nuanced analysis of the different ways in which communities can participate in the delivery of health-related interventions. It could be used prospectively by those involved in programme design and implementation to further our understanding of community participation and its relationship with health outcomes, as well as key programme outcomes, such as sustainability. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. Innovations in Community Development.

    ERIC Educational Resources Information Center

    Flora, Cornelia Butler

    1997-01-01

    Decentralization and budget reduction in the public sector, and globalization and downsizing in the private sector have placed more responsibility on localities to address challenges to the health of their economies, ecosystems, and people. Community development theory and practice are also changing, evidenced by changes in vocabulary. Community…

  7. Addressing asthma and obesity in children with community health workers: proof-of-concept intervention development.

    PubMed

    Martin, Molly A; Rothschild, Steven K; Lynch, Elizabeth; Christoffel, Katherine Kaufer; Pagán, Militza M; Rodriguez, Jose Luis; Barnes, Anna; Karavolos, Kelly; Diaz, Antonieta; Hoffman, Lucretia M; Plata, Diana; Villalpando, Sandra

    2016-12-01

    The objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity. Using a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5-12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%. Families were offered 12 home visits from CHWs that integrated asthma and obesity core curriculums. The primary asthma outcome was asthma control, measured via the Childhood Asthma Control Test (cACT). The primary obesity outcome was child body mass index (BMI). Families received a median of 10 out of the 12 home visits over 1 year. At 1 year, there was a significant improvement in the number of children with controlled asthma as measured via cACT (85.7% at 1 year compared to 61.9% at baseline, p = 0.01). Activity limitations and emergency utilization were reduced while inhaler technique improved (p < 0.01 for all). Child BMI z-score was reduced: mean = 1.97 (SD 0.79) at 1 year compared to mean = 2.13 (SD 0.40) at baseline, p < 0.01. No association was seen between change in child BMI and change in asthma control. Worse baseline child depression scores were associated with less improvement in asthma control (p = 0.003) and higher baseline caregiver post-traumatic stress disorder scores were associated with increased child BMI (p = 0.012). The CHW intervention has promise for improving asthma and weight outcomes in high-risk children with comorbid asthma and obesity; this model warrants further development and investigation.

  8. Community health and foot health.

    PubMed

    Brodie, B S

    1989-01-01

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

  9. Developing a Pipeline for the Community-Based Primary Care Workforce and Its Leadership: The Kraft Center for Community Health Leadership's Fellowship and Practitioner Programs.

    PubMed

    Shtasel, Derri; Hobbs-Knutson, Katherine; Tolpin, Harriet; Weinstein, Debra; Gottlieb, Gary L

    2015-09-01

    Community health centers (CHCs) face challenges recruiting and retaining primary care clinicians. Providing advanced training that enhances clinical skills within a public health framework, teaches leadership, protects time for scholarly activities, and focuses on the social mission may be a successful career development strategy. In July 2012, the Kraft Center for Community Health Leadership developed and implemented two 2-year programs to develop physician and nursing leaders with blended academic-community career paths and identities. The fellowship program for physicians and the practitioner program for early-career physicians and advanced practice nurses include mentored practice in a CHC; monthly learning days; completion of a community-based research project; and, for fellows, matriculation in an MPH program and engagement in a bimonthly leadership seminar. The first classes of 5 fellows and 14 practitioners graduated in June 2014. All 5 fellowship graduates were offered full-time positions at the CHCs where they practiced, and 2 have accepted leadership positions at their CHCs. All 14 practitioner graduates remain in community health, 5 have accepted leadership positions, and 2 have obtained grants to support ongoing projects. The authors are tracking graduates' career paths and the programs' impact on CHCs while modifying the programs on the basis of feedback; identifying elements of the programs that may be amenable to more cost-effective delivery; and exploring the potential for federal funding to support expansion of the practitioner program, and for the practitioner program to increase the return on investment provided by the National Health Service Corps.

  10. 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)

  11. 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)

  12. Developing a Framework for Conducting Economic Evaluations of Community-Based Health Information Technology Interventions

    PubMed Central

    Eisenstein, Eric L.; Anstrom, Kevin J.; Macri, Jennifer M.; Crosslin, David R.; Johnson, Frederick S.; Kawamoto, Kensaku; Lobach, David F.

    2005-01-01

    This study describes a framework for conducting economic analyses for health information technology (HIT) interventions, in the context of three interventions that are currently being implemented in a community-based health network caring for 17,779 Medicaid beneficiaries in Durham County, North Carolina. We show that if the HIT interventions were to redirect only 10% of low-severity emergency room encounters to outpatient care, it will result in $12,523 of monthly savings. PMID:16779235

  13. Community health outreach program of the Chad-Cameroon petroleum development and pipeline project.

    PubMed

    Utzinger, Jürg; Wyss, Kaspar; Moto, Daugla D; Tanner, Marcel; Singer, Burton H

    2004-02-01

    A critical appraisal has been presented of the CHOP for a large-scale energy infrastructure development project that was implemented in two of the world's poorest countries. The project is under close scrutiny from various independent monitoring groups, civil society organizations, and human rights groups. Reviewing the achievements and shortcomings permits the extraction of important lessons that will be critical for the future adoption of the CHOP in the current setting and for the implementation of additional CHOPs elsewhere in the developing world. The authors believe that the design must be flexible, efficient, and innovative so that a CHOP promptly can address pressing public health issues as they arise (eg, epidemic outbreak) and include the needs and demands of the concerned communities. An innovative feature of the current project is the high degree and mix of public-private partnerships. The project's CHOP also relies on partnerships. As elaborated elsewhere, public-private partnerships should be seen as a social experiment--they reveal promise but are not the solution for every problem. For this CHOP, the focus is on partnerships between a multinational consortium, government agencies, and international organizations. The partnerships also include civil society organizations for monitoring and evaluation and local NGOs designated for the implementation of the selected public health interventions within the CHOP. The governments and their respective health policies often form the umbrella under which the partnerships operate. With the increase in globalization, however, the importance and capacities of governments have diminished, and there is growing private-sector involvement. Private enterprise is seen as an efficient, innovative, pragmatic, and powerful means to achieve environmental and social sustainability. Experiences with the partnership configurations in the current CHOP are of importance for tackling grand challenges in global health by

  14. Developing a Network of Community Health Centers with a Common Electronic Health Record: Description of the Safety Net West Practice-based Research Network (SNW-PBRN)

    PubMed Central

    DeVoe, Jennifer E.; Gold, Rachel; Spofford, Mark; Chauvie, Susan; Muench, John; Turner, Ann; Likumahuwa, Sonja; Nelson, Christine

    2012-01-01

    In 2001, community health center (CHC) leaders in Oregon established an organization to facilitate the integration of health information technology, including a shared electronic health record (EHR), into safety net clinics. The Oregon Community Health Information Network (shortened to OCHIN as other states joined) became a CHC information technology hub, supporting a network-wide EHR with one master patient index, now linked across >40 safety net organizations serving >900,000 patients with nearly 8,000,000 distinct CHC visits. Recognizing the potential of OCHIN’s multi-clinic network and comprehensive EHR database for conducting safety net-based research, OCHIN leaders and local researchers formed the Safety Net West practice-based research network (PBRN). The Safety Net West “community-based laboratory,” based at OCHIN, is positioned to become an important resource for many studies including: evaluation of the real-time impact of health care reform on uninsured populations; development of new models of primary care delivery; dissemination and translation of interventions from other EHR-based systems (e.g., Kaiser Permanente) into the community health setting; and analyses of factors influencing disparities in health and health care access. We describe the founding of Safety Net West, its infrastructure development, current projects, and the future goals of this community-based PBRN with a common EHR. PMID:21900444

  15. Development of Community-Based Health Services for Adolescents at Risk for Sociomedical Problems.

    ERIC Educational Resources Information Center

    Lear, Julia Graham; And Others

    1985-01-01

    In 1981 the Robert Wood Johnson Foundation provided funds to 20 teaching hospitals to support health services to high-risk adolescents (young people living in communities with high rates of pregnancy, drug abuse, alcohol abuse, accidents, homicide, suicide, and depression). The experiences of these institutions are described. (Author/MLW)

  16. Brentwood Community Health Care Assessment

    PubMed Central

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

    2015-01-01

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

  17. Supporting community-based prevention and health promotion initiatives: developing effective technical assistance systems.

    PubMed

    Mitchell, Roger E; Florin, Paul; Stevenson, John F

    2002-10-01

    As research evidence for the effectiveness of community-based prevention has mounted, so has recognition of the gap between research and community practice. As a result, state and local governments are taking a more active role in building the capacity of community-based organizations to deliver evidence-based prevention interventions. Innovations are taking place in the establishment of technical assistance or support systems to influence the prevention and health education activities of community-based organizations. Several challenges for technical assistance systems are described: (1) setting prevention priorities and allocating limited technical assistance resources, (2) balancing capacity-building versus program dissemination efforts, (3) collaborating across categorical problem areas, (4) designing technical assistance initiatives with enough "dose strength" to have an effect, (5) balancing fidelity versus adaptation in program implementation, (6) building organizational cultures that support innovation, and (7) building local evaluative capacity versus generalizable evaluation findings.

  18. Community health insurance in sub-Saharan Africa: what operational difficulties hamper its successful development?

    PubMed

    De Allegri, Manuela; Sauerborn, Rainer; Kouyaté, Bocar; Flessa, Steffen

    2009-05-01

    In recent years, a number of reviews have generated evidence on the potential of community health insurance (CHI) to increase access to care and offer financial protection against the cost of illness for poor people excluded from formal insurance systems. Field experience, however, shows that in sub-Saharan Africa (SSA), a series of operational difficulties still hampers the successful development of CHI, yielding negative effects on potential progress towards increased access to care and improved financial protection. Through a careful assessment of the existing literature, including peer-reviewed articles, books, consultancy reports, and manuscripts from international organizations, we produce an analytical review of such difficulties. Our aim is to provide policy makers with the necessary knowledge on the problems at stake and with policy propositions to offset such problems, strengthening CHI and enhancing its role within SSA health systems. Our review of the literature reveals that the major difficulties currently faced by CHI in SSA are operational in nature and cluster around five areas: (i) lack of clear legislative and regulatory framework; (ii) low enrolment rates; (iii) insufficient risk management measures; (iv) weak managerial capacity; and (v) high overhead costs. Consequently, our review calls for appropriate policy interventions, specifically: (i) greater commitment towards the development of adequate legislation in support of CHI; (ii) increasing uptake of measures to expand equitable enrolment; (iii) the adoption of adequate risk management measures in all schemes; (iv) substantial investments from host countries as well as from sponsoring agencies to improve managerial capacity; and (v) collective efforts to contain overhead costs.

  19. Developing community mental health services for indigenous people of northern Ontario.

    PubMed

    Ward, J A

    1991-01-01

    Inadequacies of three common models of mental health service delivery have been presented but each of these can contribute to an adequate system if the approach aims at the totality of mental health care. The key to service delivery and the provision of services in the local community by adequately trained and supervised mental health workers familiar with the culture and language and who are involved with other community workers in an inter-agency process. A major and the most important part of the work occurs in this level. This front line work must have the back-up and support of the system which has three roots. The clinical root is that of a support team of professionals, the local nursing station, hospital and the tertiary institutions. The second root is in training and education by recognized courses and other resources and the third in an adequate administration in which the indigenous population has been put in control.

  20. 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…

  1. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

    PubMed

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

    2016-01-01

    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Development and testing of a community audit tool to assess rural built environments: Inventories for Community Health Assessment in Rural Towns.

    PubMed

    Seguin, Rebecca A; Lo, Brian K; Sriram, Urshila; Connor, Leah M; Totta, Alison

    2017-09-01

    Rural populations face unique challenges to physical activity that are largely driven by environmental conditions. However, research on rural built environments and physical activity is limited by a paucity of rural-specific environmental assessment tools. The aim of this paper is to describe the development and testing of a rural assessment tool: Inventories for Community Health Assessment in Rural Towns (iCHART). The iCHART tool was developed in 2013 through a multistep process consisting of an extensive literature search to identify existing tools, an expert panel review, and pilot testing in five rural US communities. Tool items represent rural built environment features that influence active living and physical activity: community design, transportation infrastructure, safety, aesthetics, and recreational facilities. To assess reliability, field testing was performed in 26 rural communities across five states between July and November of 2014. Reliability between the research team and community testers was high among all testing communities (average percent agreement = 77%). Agreement was also high for intra-rater reliability (average kappa = 0.72) and inter-rater reliability (average percent agreement = 84%) among community testers. Findings suggest that the iCHART tool provides a reliable assessment of rural built environment features and can be used to inform the development of contextually-appropriate physical activity opportunities in rural communities.

  3. Developing an academic and American Indian tribal partnership in education: a model of community health nursing clinical education.

    PubMed

    Strickland, C June; Logsdon, Rebecca G; Hoffman, Barbara; Hill, Teresa Garrett

    2014-01-01

    American Indian tribes shoulder a heavy burden in health inequities and recognize the value of partnerships with academic institutions. This article describes a unique education model developed through a partnership between a school of nursing and 2 Pacific Northwest tribes to provide clinical education for students. Over 3 years, students and faculty worked with 2 tribal communities to design research and implement education programs.

  4. The effect of a multicomponent professional development training on the beliefs and behaviors of community health educators concerning food irradiation.

    PubMed

    Thompson, Britta M; Knight, Stephanie L

    2006-10-01

    Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponent professional development training on food irradiation could change their beliefs and behaviors. This study compared the food irradiation beliefs and educational programming of educators who participated in a professional development training with those who did not. Results indicated that the training significantly improved the food irradiation beliefs of participants. In addition, the number of participants who provided food irradiation education significantly improved compared with educators who had not attended the training. These results suggest that this type of professional development training format can significantly affect beliefs and could increase the amount of food irradiation information available to consumers through community health educators.

  5. Health Promotion Outcomes of a Newly Developed Elastic Band Exercise Program for Older Adults in the Community: A Pilot Test.

    PubMed

    Chan, Shu-Ya; Kuo, Chang-Chih; Chen, Kuei-Min; Tseng, Wei-Shyuan; Huang, Hsin-Ting; Li, Chun-Huw

    2016-06-01

    Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps < .05). No significant differences were identified for the other indicators. The SEB exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.

  6. The Partnered Research Center for Quality Care: Developing Infrastructure to Support Community-partnered Participatory Research in Mental Health

    PubMed Central

    Lizaola, Elizabeth; Schraiber, Ron; Braslow, Joel; Kataoka, Sheryl; Springgate, Benjamin F.; Wells, Kenneth B.; Jones, Loretta

    2013-01-01

    Evidence-based programs have been shown to improve functioning and mental health outcomes, especially for vulnerable populations. However, these populations face numerous barriers to accessing care including lack of resources and stigma surrounding mental health issues. In order to improve mental health outcomes and reduce health disparities, it is essential to identify methods for reaching such populations with unmet need. A promising strategy for reducing barriers and improving access to care is Community Partnered Participatory Research (CPPR). Given the power of this methodology to transform the impact of research in resource-poor communities, we developed an NIMH-funded Center, the Partnered Research Center for Quality Care, to support partnerships in developing, implementing, and evaluating mental health services research and programs. Guided by a CPPR framework, center investigators, both community and academic, collaborated in all phases of research with the goal of establishing trust, building capacity, increasing buy-in, and improving the sustainability of interventions and programs. They engaged in two-way capacity-building, which afforded the opportunity for practical problems to be raised and innovative solutions to be developed. This article discusses the development and design of the Partnered Research Center for Quality Care and provides examples of partnerships that have been formed and the work that has been conducted as a result. PMID:22352082

  7. 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…

  8. 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…

  9. Sustaining health in faith community nursing practice: emerging processes that support the development of a middle-range theory.

    PubMed

    Dyess, Susan MacLeod; Chase, Susan K

    2012-01-01

    This article reveals processes that support theoretical development for holistic nursing in the context of a faith community. The emerging processes enhance the articulation of the holistically focused practice, add clarity to faith community nursing activities and outcomes, and contribute to theoretical clarification and development. Theoretical clarity is essential to guide faith community nursing practice, research, and education because there is tremendous potential for the specialty practice to contribute to the health of a community across the continuum of caring and because to date there has been no unifying model for this practice proposed. A lack of a theoretical basis can result in disparate and disconnected approaches to studying, testing, and promoting the practice.

  10. Development of Community Based Learning and Education system within Undergraduate Medical Curriculum of Patan Academy of Health Sciences.

    PubMed

    Baral, K P; Upadhyay, S K; Bhandary, S; Gongal, R N; Karki, A

    2016-01-01

    In response to continuing health disparities between rural and urban population, Patan Academy of Health Sciences (PAHS) was established in 2008. It aimed to produce physicians who would be able and willing to serve in the rural areas. In order to empower them with understanding and tools to address health issues of rural population, an innovative curriculum was developed. This paper aims to describe the community based learning and education (CBLE) system within the overall framework of PAHS undergraduate medical curriculum. A Medical School Steering Committee (MSSC) comprising of a group of committed medical educators led the curriculum development process. The committee reviewed different medical curricula, relevant literatures, and held a series of consultative meetings with the stakeholders and experts within and outside Nepal. This process resulted in defining the desirable attributes, terminal competencies of the graduates, and then the actual development of the entire curriculum including CBLE. Given the critical importance of population health, 25% of the curricular weightage was allocated to the Community Health Sciences (CHS). CBLE system was developed as the primary means of delivering CHS curriculum. The details of CBLE system was finalized for implementation with the first cohort of medical students commencing their studies from June 2010. The CBLE, a key educational strategy of PAHS curriculum, is envisaged to improve retention and performance of PAHS graduates and, thereby, health status of rural population. However, whether or not that goal will be achieved needs to be verified after the graduates join the health system.

  11. Community bioethics: the health decisions community council.

    PubMed

    Gallegos, T; Mrgudic, K

    1993-08-01

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

  12. Developing a Community-Based Participatory Research Model to Engage Transition Age Youth Using Mental Health Service in Research

    PubMed Central

    Lincoln, Alisa K.; Borg, Ryan; Delman, Jonathan

    2014-01-01

    We present a model for the development and conduct of a Community-Based Participatory Research (CBPR) project with transition age youth (TAY) mental health service users. CBPR frameworks can facilitate equitable partnerships and meaningful inclusion, but have not been fully drawn-upon in mental health research. The model included TAY as trained research associates involved in every aspect of the research process. We describe the development of the project, creation of the research team, training, the design and conduct of the study, and challenges faced. The methods developed successfully provided support for the meaningful participation of TAY in the project. PMID:25423247

  13. "I Love Ballet": Arts Incentives for Adolescent Health and Community Development

    ERIC Educational Resources Information Center

    Fliegel, Lisa S.

    2005-01-01

    In this article, the author discusses the United South End Settlements' (USES) Arts Incentives Program (AIP), a clinically informed, arts-based, youth and community development program working with high-risk girls ages 11 to 19. These girls face a convergence of risk factors, such as trauma, abuse, neglect, poverty, substance abuse, and…

  14. 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.

  15. Community Public Health Fact Sheet

    EPA Pesticide Factsheets

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

  16. Beyond the Biomedical Paradigm: The Formation and Development of Indigenous Community-Controlled Health Organizations in Australia.

    PubMed

    Khoury, Peter

    2015-01-01

    This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health.

  17. Health and special education: a study of new developments for handicapped children in five metropolitan communities.

    PubMed Central

    Palfrey, J S; Singer, J D; Walker, D K; Butler, J A

    1986-01-01

    Since the implementation in 1977 of the Education for All Handicapped Children Act (Public Law 94-142), public school systems have provided special education and related services to students with a wide range of handicapping conditions, including some children served previously in hospitals or other institutions. Although the Federal law does not require physician participation in the special education process, it does imply an active new role for the medical care community, both public and private, in helping schools to identify and diagnose children with disabilities and in ensuring that those children have adequate access to health services. This study explores the experience of five nationally dispersed urban school systems in implementing P.L. 94-142, with particular reference to the interaction of physicians and the schools. The findings highlight continued problems with early identification of certain types of childhood handicaps, classification of children's functional disorders, and adequate participation of practicing physicians in the program, especially with regard to developmental and behavioral issues. In addition, inequities in community health services are documented for a substantial number of the children studied. Improved collaboration between the health and education sectors is needed to address these concerns in order to fulfill the intent of national special education policy and to maximize the potentialities of these children and their families. PMID:2942962

  18. Successful Community Development Strategies.

    ERIC Educational Resources Information Center

    Johnson, Thomas G.

    This paper sketches several successful community economic development programs that have implications for rural education. Case studies are used to discuss community characteristics that contribute to development success. In Virginia, a Community Certification Program offers statewide business recruitment services to communities that meet program…

  19. [Health education for major parasitic diseases in rural community of China: current status and future development].

    PubMed

    Zhang, Jing; Lin, Dan-dan

    2013-08-01

    Owing to human parasitic diseases being related to behavior, the health education as an important measure to prevent parasite infections through human behavior intervention, has played an important role in the process of parasitic disease prevention and control in rural area of China. This paper comments on the development history of the health education for parasitic disease prevention and control, current intervention modes and the effect of the health education for parasitic diseases in rural area. This paper also summarizes the role and impact of different modes of the health education for parasitic disease prevention and control and gives some suggestions to future development of the health education in rural area under current prevalent situation of parasitic diseases.

  20. Community participation in formulating the post-2015 health and development goal agenda: reflections of a multi-country research collaboration.

    PubMed

    Brolan, Claire E; Hussain, Sameera; Friedman, Eric A; Ruano, Ana Lorena; Mulumba, Moses; Rusike, Itai; Beiersmann, Claudia; Hill, Peter S

    2014-10-10

    Global discussion on the post-2015 development goals, to replace the Millennium Development Goals when they expire on 31 December 2015, is well underway. While the Millennium Development Goals focused on redressing extreme poverty and its antecedents for people living in developing countries, the post-2015 agenda seeks to redress inequity worldwide, regardless of a country's development status. Furthermore, to rectify the UN's top-down approach toward the Millennium Development Goals' formulation, widespread negotiations are underway that seek to include the voices of people and communities from around the globe to ground each post-2015 development goal. This reflexive commentary, therefore, reports on the early methodological challenges the Go4Health research project experienced in its engagement with communities in nine countries in 2013. Led by four research hubs in Uganda, Bangladesh, Australia and Guatemala, the purpose of this engagement has been to ascertain a 'snapshot' of the health needs and priorities of socially excluded populations particularly from the Global South. This is to inform Go4Health's advice to the European Commission on the post-2015 global goals for health and new governance frameworks. Five methodological challenges were subsequently identified from reflecting on the multidisciplinary, multiregional team's research practices so far: meanings and parameters around qualitative participatory research; representation of marginalization; generalizability of research findings; ethical research in project time frames; and issues related to informed consent. Strategies to overcome these methodological hurdles are also examined. The findings from the consultations represent the extraordinary diversity of marginal human experience requiring contextual analysis for universal framing of the post-2015 agenda. Unsurprisingly, methodological challenges will, and did, arise. We conclude by advocating for a discourse to emerge not only critically

  1. Partnership Selection and Formation: A Case Study of Developing Adolescent Health Community-Researcher Partnerships in 15 U.S. Communities

    PubMed Central

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

    2007-01-01

    Purpose This study describes the partner selection process in 15 U.S. communities developing community-researcher partnerships for the Connect to Protect® (C2P): Partnerships for Youth Prevention Interventions, an initiative of the Adolescent Trials Network for HIV/AIDS Interventions. Methods Each site generated an epidemiological profile of urban youth in their community, selected a focus population and geographic area of youth at risk for HIV, conducted a series of successive structured interviews, and engaged in a process of relationship-building efforts culminating in a collaborative network of community agencies. Results Sites chose as their primary target population young women who have sex with men (n=8 sites), young men who have sex with men (n=6), and intravenous drug users (n=1). Of 1,162 agencies initially interviewed, 281 of 335 approached (84%) agreed to join the partnership (average 19/site). A diverse array of community agencies were represented in the final collaborative network; specific characteristics included: 93% served the sites' target population, 54% were predominantly youth-oriented, 59% were located in the geographical area of focus, and 39% reported provision of HIV/STI prevention services. Relationship-building activities, development of collaborative relationships, and lessons learned, including barriers and facilitators to partnership, are also described. Conclusions Study findings address a major gap in the community partner research literature. Health researchers and policy makers need an effective partner selection framework whereby community-researcher partnerships can develop a solid foundation to address public health concerns. PMID:17531754

  2. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications.

    PubMed

    Jeet, Gursimer; Thakur, J S; Prinja, Shankar; Singh, Meenu

    2017-01-01

    factors to 19 months, and primary responsibilities of health workers included health promotion, treatment adherence and follow ups. Only a single trial reported all-cause mortality. The pooled effect computed indicated an increase in tobacco cessation (RR: 2.0, 95%CI: 1.11, 3.58, moderate-quality evidence) and a decrease in systolic blood pressure ((MD: -4.80, 95% CI: -8.12, -1.49, I2 = 93%, very low-quality evidence), diastolic blood pressure ((MD: -2.88, 95% CI: -5.65, -0.10, I2 = 96%, very low-quality evidence)) and blood sugar levels (glycated haemoglobin MD: -0.83%, 95%CI: -1.25,-0.41). None of the included trials reported on adverse events. Evidence on the implementation of primary prevention strategies using community health workers is still developing. Existing evidence suggests that, compared with standard care, using CHWs in health programmes have the potential to be effective in LMICs, particularly for tobacco cessation, blood pressure and diabetes control.

  3. Oral Health in Rural Communities

    MedlinePlus

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

  4. Community health for Rwandan refugees.

    PubMed

    Plummer, M

    1995-12-01

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

  5. [Processes and strategies for developing public health nurse directed community health projects in municipalities of Japan--focusing on setting agendas and making project alternatives].

    PubMed

    Yoshioka, Kyoko; Asahara, Kiyomi; Murashima, Sachiyo

    2004-04-01

    The purpose of this study was to explore processes and strategies for developing community health projects directed by public health nurses (PHNs) in municipalities of Japan. Yin's case study design was adopted into the 5-step Policy Making Process Model as the theoretical framework. The first two steps involving agenda setting and project planning were the focus of this study. PHNs who had developed new community health projects in municipalities were interviewed as study participants. In order to maintain the quality of projects at a certain level, only these approved officially by municipalities with a program and budget were selected. Common strategies emerged for developing community health projects in the cases presented by the 5 PHNs. Out of 891 codes, twenty-six sub-categories were identified and integrated into 9 categories. When categories were analyzed in a time series, the following common processes were found: integration of related data, identification of the health problems in the community and recognition of project needs (Phase 1); refining the concept and characteristics of the project plan (Phase 2); and assuring that resources were available for the optimal implementation of the project by consolidating ideas (Phase 3). In Phase 1, PHNs integrated the information about previous experimental cases or social circumstances to identify community health problems needing solution. PHNs' thoughts were given to problems of existing projects and daily practices were grouped to make comprehensive plans for improvement. In Phase 2, PHNs discussed ideas for the project plans and considered resources and strategies that were necessary for putting new projects into place. In Phase 3, PHNs were attentive to the factors reviewed in Phase 2, kept account of necessary resources, and made certain of timing for immediate implementation of plans. The dual roles of PHNs, both as nurses and public servants, helped to clarify and solve the community health problems

  6. Long-Term Development of a “Whole Community” Best Practice Model to Address Health Disparities in the Cambodian Refugee and Immigrant Community of Lowell, Massachusetts

    PubMed Central

    Toof, Robin; Silka, Linda; Liang, Sidney; Sou, Linda; Najarian, Lisa; Peou, Sonith; Och, Sheila

    2010-01-01

    Cambodians in Lowell, Massachusetts, experience significant health disparities. Understanding the trauma they have experienced in Cambodia and as refugees has been the starting point for Lowell Community Health Center's whole community approach to developing community-based interventions. This approach places physical-psychosocial-spiritual needs at the center of focus and is attentive to individual and institutional barriers to care. Interventions are multilevel. The effect of the overall program comes from the results of each smaller program, the collaborations and coordination with the Cambodian community and community-based organizations, and the range and levels of services available through the health center. PMID:20864723

  7. Community Capacity and Resource Mapping: Model Development.

    ERIC Educational Resources Information Center

    Dedrick, Angie; Mitchell, Graham

    This document explains the use of a model for mapping community capacity and resources that was developed by the community development office of a health group in Edmonton, Alberta, and applied in a collaborative pilot project in preparation for development of a community health plan. A brief discussion of the factors leading to development of the…

  8. The development of urban community health centres for strengthening primary care in China: a systematic literature review.

    PubMed

    Wang, Harry H X; Wang, Jia Ji; Wong, Samuel Y S; Wong, Martin C S; Mercer, Stewart W; Griffiths, Sian M

    2015-01-01

    This review outlines the development of China's primary care system, with implications for improving equitable health care. Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed. Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging. The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration. Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established. Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

    PubMed Central

    2012-01-01

    Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion) to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge

  10. Community accountability at peripheral health facilities: a review of the empirical literature and development of a conceptual framework

    PubMed Central

    Molyneux, Sassy; Atela, Martin; Angwenyi, Vibian; Goodman, Catherine

    2012-01-01

    Public accountability has re-emerged as a top priority for health systems all over the world, and particularly in developing countries where governments have often failed to provide adequate public sector services for their citizens. One approach to strengthening public accountability is through direct involvement of clients, users or the general public in health delivery, here termed ‘community accountability’. The potential benefits of community accountability, both as an end in itself and as a means of improving health services, have led to significant resources being invested by governments and non-governmental organizations. Data are now needed on the implementation and impact of these initiatives on the ground. A search of PubMed using a systematic approach, supplemented by a hand search of key websites, identified 21 papers from low- or middle-income countries describing at least one measure to enhance community accountability that was linked with peripheral facilities. Mechanisms covered included committees and groups (n = 19), public report cards (n = 1) and patients’ rights charters (n = 1). In this paper we summarize the data presented in these papers, including impact, and factors influencing impact, and conclude by commenting on the methods used, and the issues they raise. We highlight that the international interest in community accountability mechanisms linked to peripheral facilities has not been matched by empirical data, and present a conceptual framework and a set of ideas that might contribute to future studies. PMID:22279082

  11. Challenges to achieving sustainable community health development within a donor aid business model.

    PubMed

    Ashwell, Helen; Barclay, Lesley

    2010-06-01

    This paper explores the paradox of donor aid being delivered through a business model through a case study in Papua New Guinea. A retrospective review of project implementation and an outcome evaluation provided an opportunity to examine the long-term results and sustainability of a large project. Analysis was informed by data collected from 175 interviews (national, provincial, district and village), 93 community discussions and observations across 10 provinces. Problems with the business model of delivering aid were evident from implementation data and in an evaluation conducted two years after project completion (2006). Compounding the business model effect were challenges of over-ambitious project goals with limited flexibility to adapt to changing circumstances, a donor payment system requiring short-term productivity and excessive reporting requirements. An overly ambitious project design, donor dominance within the business model and limited local counterpart capacity created problems in the community initiatives component of the project. Contractual pressures can negatively influence long-term outcomes that require development of local leadership and capacity. Future planning for donor project designs needs to be flexible, smaller in scope and have a longer timeframe of seven to 10 years. Donor-funded projects need to be sufficiently flexible to apply proven principles of community development, build local ownership and allow adequate time to build counterpart knowledge and skills.

  12. Problem posing and cultural tailoring: developing an HIV/AIDS health literacy toolkit with the African American community.

    PubMed

    Rikard, R V; Thompson, Maxine S; Head, Rachel; McNeil, Carlotta; White, Caressa

    2012-09-01

    The rate of HIV infection among African Americans is disproportionately higher than for other racial groups in the United States. Previous research suggests that low level of health literacy (HL) is an underlying factor to explain racial disparities in the prevalence and incidence of HIV/AIDS. The present research describes a community and university project to develop a culturally tailored HIV/AIDS HL toolkit in the African American community. Paulo Freire's pedagogical philosophy and problem-posing methodology served as the guiding framework throughout the development process. Developing the HIV/AIDS HL toolkit occurred in a two-stage process. In Stage 1, a nonprofit organization and research team established a collaborative partnership to develop a culturally tailored HIV/AIDS HL toolkit. In Stage 2, African American community members participated in focus groups conducted as Freirian cultural circles to further refine the HIV/AIDS HL toolkit. In both stages, problem posing engaged participants' knowledge, experiences, and concerns to evaluate a working draft toolkit. The discussion and implications highlight how Freire's pedagogical philosophy and methodology enhances the development of culturally tailored health information.

  13. Emergency contraceptive pills: Exploring the knowledge and attitudes of community health workers in a developing Muslim country.

    PubMed

    Mir, Azeem Sultan; Malik, Raees

    2010-08-01

    Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to 'evil' practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force.

  14. Emergency contraceptive pills: Exploring the knowledge and attitudes of community health workers in a developing Muslim country

    PubMed Central

    Mir, Azeem Sultan; Malik, Raees

    2010-01-01

    Background: Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. Aims: This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. Materials and Methods: The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Results: Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to ‘evil’ practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). Conclusion: The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force. PMID:22737673

  15. Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project.

    PubMed

    Saito, Masashige; Kondo, Naoki; Aida, Jun; Kawachi, Ichiro; Koyama, Shihoko; Ojima, Toshiyuki; Kondo, Katsunori

    2017-05-01

    We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan. We used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes. From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94-0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93-0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96-1.00). Social cohesion score was not consistently associated with individual health indicators. Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers. Copyright © 2016 The Authors. Production and

  16. Ethnographic Approach to Community Organization and Health Empowerment.

    ERIC Educational Resources Information Center

    Braithwaite, Ronald L.; And Others

    1994-01-01

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

  17. Development of an electronic breast pathology database in a community health system

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Martel, Maritza; Bifulco, Carlo; Assur, Ted; Elmore, Joann G.; Weaver, Donald L.

    2014-01-01

    Background: Health care systems rely on electronic patient data, yet access to breast tissue pathology results continues to depend on interpreting dictated free-text reports. Objective: The objective was to develop a method to electronically search and categorize pathologic diagnoses of patients’ breast tissue specimens from dictated free-text pathology reports in a large health system for multiple users including clinicians. Design: A database integrating existing patient-level administrative and clinical information for breast cancer screening and diagnostic services and a web-based application for comprehensive searching of pathology reports were developed by a health system team led by pathologists. The Breast Pathology Assessment Tool and Hierarchy for Diagnosis (BPATH-Dx) provided search terms and guided electronic transcription of diagnoses from text fields on breast pathology clinical reports to standardized categories. Approach: Breast pathology encounters in the pathology database were matched with administrative data for 7332 women with breast tissue specimens obtained from an initial procedure in the health system from January 1, 2008 to December 31, 2011. Sequential queries of the pathology text based on BPATH-Dx categorized biopsies according to their worst pathological diagnosis, as is standard practice. Diagnoses ranged from invasive breast cancer (23.3%), carcinoma in situ (7.8%), atypical lesions (6.39%), proliferative lesions without atypia (27.9%), and nonproliferative lesions (34.7%), and were further classified into subcategories. A random sample of 5% of reports that were manually reviewed indicated 97.5% agreement. Conclusions: Sequential queries of free-text pathology reports guided by a standardized assessment tool in conjunction with a web-based search application provide an efficient and reproducible approach to accessing nonmalignant breast pathology diagnoses. This method advances the use of pathology data and electronic health

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

    PubMed

    Abdullatif, A

    2000-07-01

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

  19. The importance of health literacy in the development of 'Self Care’' cards for community pharmacies in Ireland

    PubMed Central

    Coughlan, Diarmuid; Sahm, Laura; Byrne, Stephen

    Objective 'Self Care’'cards play a significant role in delivering health education via community pharmacies in Australia and New Zealand. The primary objective of this study was to evaluate whether such an initiative could have a similar impact in an Irish context. The secondary objective was to understand the importance of health literacy to this initiative. Methods Ten cards were developed for the Irish healthcare setting and trialed as a proof of concept study. The pilot study ran in ten community pharmacies in the greater Cork area for a six-month period. Using a mixed methods approach (Questionnaires & focus group) staff and patient reactions to the initiative were obtained. Concurrent to the pilot study, readability scores of cards (Flesch-Kincaid, Fry, SMOG methods) and the Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy screening tool was administered to a sample of patients. Results 88.7% of patient respondents (n=53) liked the concept of the 'Self Care’' cards and 83% of respondents agreed that the use of the card was beneficial to their understanding of their ailment. Focus groups with Pharmacy staff highlighted the importance of appropriate training for the future development of this initiative. An emerging theme from designing the cards was health literacy. The pilot 'Self Care’'cards were pitched at too high a literacy level for the general Irish public to understand as determined by readability score methods. It was found that 19.1% of a sample population (n=199) was deemed to have low health literacy skills. Conclusions The 'Self Care’'initiative has the potential to be Pharmacy’s contribution to health education in Ireland. The initiative needs to be cognizant of the health literacy framework that equates the skills of individuals to the demands placed upon them. PMID:24155830

  20. GetHealthyHarlem.org: Developing a Web Platform for Health Promotion and Wellness Driven by and for the Harlem Community

    PubMed Central

    Khan, Sharib A.; Ancker, Jessica S.; Li, Jianhua; Kaufman, David; Hutchinson, Carly; Cohall, Alwyn; Kukafka, Rita

    2009-01-01

    GetHealthyHarlem.org is a community website developed on an open-source platform to facilitate collaborative development of health content through participatory action research (PAR) principles. The website was developed to enable the Harlem community to create a shared health and wellness knowledgebase, to enable discourse about local and culturally relevant health information, and to foster social connections between community members and health promotion organizations. The site is gaining active use with more than 9,500 unique site visits in the six months since going live in November, 2008. In ongoing research studies, we are using the website to explore how the PAR model can be applied to the development of a community health website. PMID:20351872

  1. Development of a group model of clinical supervision to meet the needs of a community mental health nursing team.

    PubMed

    Walsh, Ken; Nicholson, Jennifer; Keough, Colleen; Pridham, Robert; Kramer, Myra; Jeffrey, Jennifer

    2003-02-01

    Clinical supervision is an important tool in the development of quality nursing care. It involves a process of reflection upon practice, the aim of which is to improve clinical practices and hence improve patient outcomes. The term 'clinical supervision' is itself problematic in that it implies an hierarchical, rather than a nurse-centred and reflective, process. In addition there are a variety of models of supervision which range from the purely managerial to the clinical. This gives rise to confusion and in some cases suspicion, in clinicians. This paper reports on the development, implementation and evaluation of a group model of clinical supervision developed by a small team of mental health nurses in a community mental health setting. This team recognised the need for a formal clinical supervision model but was unsure as to the model which best suited their practice situation and needs. Through collaboration with a university department of nursing, this group developed its own model of group clinical supervision. This paper reports on the development of the model and its evaluation. The model was developed with a small team of community nurses and hence may not be applicable to other teams and other settings. However, the methods described may be useful as a guide to other nurses who wish to plan, implement and evaluate a model of clinical supervision in their workplace.

  2. Lessons learned from a community-academic initiative: the development of a core competency-based training for community-academic initiative community health workers.

    PubMed

    Ruiz, Yumary; Matos, Sergio; Kapadia, Smiti; Islam, Nadia; Cusack, Arthur; Kwong, Sylvia; Trinh-Shevrin, Chau

    2012-12-01

    Despite the importance of community health workers (CHWs) in strategies to reduce health disparities and the call to enhance their roles in research, little information exists on how to prepare CHWs involved in community-academic initiatives (CAIs). Therefore, the New York University Prevention Research Center piloted a CAI-CHW training program. We applied a core competency framework to an existing CHW curriculum and bolstered the curriculum to include research-specific sessions. We employed diverse training methods, guided by adult learning principles and popular education philosophy. Evaluation instruments assessed changes related to confidence, intention to use learned skills, usefulness of sessions, and satisfaction with the training. Results demonstrated that a core competency-based training can successfully affect CHWs' perceived confidence and intentions to apply learned content, and can provide a larger social justice context of their role and work. This program demonstrates that a core competency-based framework coupled with CAI-research-specific skill sessions (1) provides skills that CAI-CHWs intend to use, (2) builds confidence, and (3) provides participants with a more contextualized view of client needs and CHW roles.

  3. Community Development in Ireland.

    ERIC Educational Resources Information Center

    Lee, Anna

    2003-01-01

    In the last decade, community development in Ireland has emphasized social and economic inclusion, regeneration, and civic participation. Continuing challenges include designation of diverse community representatives, demand for increased administrative efficiency, and management of mandates and accountability. There are more community development…

  4. Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process.

    PubMed

    Kwak, Lydia; Wåhlin, Charlotte; Stigmar, Kjerstin; Jensen, Irene

    2017-01-18

    One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process. A multidisciplinary community of practice group (n = 16) consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012-December 2013) to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data. Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group). Fidelity was rated as fairly high. The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future guideline development; it provides valuable information on how

  5. An Ecological Approach to a University Course that Develops Partnerships Impacting Health and Wellness in K-12 Schools and Communities

    ERIC Educational Resources Information Center

    Shields, Sharon L.; Gilchrist, Leigh Z.; Nixon, Carol T.; Holland, Barbara A.; Thompson, Elizabeth A.

    2013-01-01

    Over the past several decades, there has been an increased focus on health promotion as opposed to individual health determinants and disease prevention. Given the association between health and academic success, health promotion is a vastly overlooked lever for establishing effective K-12 schools. Student, organizational, and community well-being…

  6. An Ecological Approach to a University Course that Develops Partnerships Impacting Health and Wellness in K-12 Schools and Communities

    ERIC Educational Resources Information Center

    Shields, Sharon L.; Gilchrist, Leigh Z.; Nixon, Carol T.; Holland, Barbara A.; Thompson, Elizabeth A.

    2013-01-01

    Over the past several decades, there has been an increased focus on health promotion as opposed to individual health determinants and disease prevention. Given the association between health and academic success, health promotion is a vastly overlooked lever for establishing effective K-12 schools. Student, organizational, and community well-being…

  7. Understanding the benefits and challenges of community engagement in the development of community mental health services for common mental disorders: lessons from a case study in a rural South African subdistrict site.

    PubMed

    Petersen, Inge; Baillie, Kim; Bhana, Arvin

    2012-07-01

    Against the backdrop of a large treatment gap for mental disorders in low- to middle-income countries (LMICs), the 2007 Lancet series on global mental health calls for a scaling up of mental health services. Community participation is largely harnessed as one strategy to facilitate this call. Using a participatory implementation framework for the development of mental health services for common mental disorders (CMDs) in a rural subdistrict in South Africa as a case study, this study sought to understand the benefits and challenges of community participation beyond that of scaling up. Qualitative process evaluation involving interviews with service providers and users was employed. The results suggest that in addition to promoting mobilization of resources and actions for scaling up mental health services, community participation can potentially contribute to more culturally competent services and personal empowerment of recipients of care. In addition, community participation holds promise for engendering community-led public health actions to ameliorate some of the social determinants of mental ill health. Challenges include that community members involved in these activities are mainly marginalized women, who have limited power to achieve structural change, including cultural practices that may be harmful to the mental health of women and children. We conclude that in addition to contributing to scaling up mental health services, community participation can potentially promote the development of culturally competent mental health services and greater community control of mental health.

  8. Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities.

    PubMed

    Lawless, Angela; Freeman, Toby; Bentley, Michael; Baum, Fran; Jolley, Gwyn

    2014-05-15

    This paper describes the development of a model of Comprehensive Primary Health Care (CPHC) applicable to the Australian context. CPHC holds promise as an effective model of health system organization able to improve population health and increase health equity. However, there is little literature that describes and evaluates CPHC as a whole, with most evaluation focusing on specific programs. The lack of a consensus on what constitutes CPHC, and the complex and context-sensitive nature of CPHC are all barriers to evaluation. The research was undertaken in partnership with six Australian primary health care services: four state government funded and managed services, one sexual health non-government organization, and one Aboriginal community controlled health service. A draft model was crafted combining program logic and theory-based approaches, drawing on relevant literature, 68 interviews with primary health care service staff, and researcher experience. The model was then refined through an iterative process involving two to three workshops at each of the six participating primary health care services, engaging health service staff, regional health executives and central health department staff. The resultant Southgate Model of CPHC in Australia model articulates the theory of change of how and why CPHC service components and activities, based on the theory, evidence and values which underpin a CPHC approach, are likely to lead to individual and population health outcomes and increased health equity. The model captures the importance of context, the mechanisms of CPHC, and the space for action services have to work within. The process of development engendered and supported collaborative relationships between researchers and stakeholders and the product provided a description of CPHC as a whole and a framework for evaluation. The model was endorsed at a research symposium involving investigators, service staff, and key stakeholders. The development of a theory

  9. Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico.

    PubMed

    Sarti, E; Flisser, A; Schantz, P M; Gleizer, M; Loya, M; Plancarte, A; Avila, G; Allan, J; Craig, P; Bronfman, M; Wijeyaratne, P

    1997-02-01

    A comprehensive study was undertaken in a rural community in the state of Morelos, Mexico to evaluate health education as an intervention measure against Taenia solium. An educational program was developed to promote recognition and knowledge of the transmission of the parasite and to improve hygienic behavior and sanitary conditions that foster transmission. The effects of educational intervention were evaluated by measuring changes in knowledge and practices and prevalence of human taeniasis and swine cysticercosis before and after the campaign. The health education strategy was implemented with the active participation of the population based on the information obtained from a sociologic study. A questionnaire was designed and used before, immediately after the intervention, and six months later. Statistically significant improvements occurred in knowledge of the parasite, its life cycle, and how it is acquired by humans; however, changes in behavior related to transmission were less dramatic and persistent. The prevalences of cysticercosis in pigs at the start of the education intervention were 2.6% and 5.2% by lingual examination and antibody detection (immunoblot assay), respectively, and approximately one year after the intervention they were 0% and 1.2% (P < 0.05). These changes were accompanied by significant reductions in the reported access of pigs to sources of infection and freedom to roam. We conclude that health education, developed along with community involvement, reduced opportunities for transmission of T. solium in the human-pig cycle.

  10. Scenario planning for community development in Vietnam: a new tool for integrated health approaches?

    PubMed

    Nguyen, Vi; Nguyen-Viet, Hung; Pham-Duc, Phuc; Wiese, Martin

    2014-01-01

    Like many countries in Southeast Asia, Vietnam's rapid population and economic growth has met challenges in infrastructure development, especially sanitation in rural areas. As an entry point, we developed scenario planning as an action-research tool in a peri-urban community to identify first steps towards improving their complex sanitation problem and to, systemically, address emerging/re-emerging infectious diseases, as these are commonly linked to unsafe water and inadequate sanitation conditions. As an integrated approach, the process of constructing scenarios allowed us to work across sectors and stakeholders to incorporate this knowledge into a common vision. We conducted focus group discussions to identify and rank driving forces, orally constructed scenarios for the most uncertain drivers, discussed scenario implications and options, and examined the overall process for usefulness and sustainability. During a one-month scoping phase and in between focus group meetings, we carried out household visits which helped us understand the context of data and gather feedback from participants outside of the formal data collection process. Recorded results from these activities were used to develop subsequent tools. The research process gave us insights into how to adapt the scenario planning tool to identify alternative options. This involved choosing boundary partners, negotiating priorities, drawing out participant learning through self-assessment of our process (a prerequisite for changing mental models and thus achieving outcomes), and understanding how conveyed messages may reinforce the status quo. These insights showed the importance of examining research results beyond outputs and outcomes, namely through process.

  11. CenteringPregnancy Smiles: A Community Engagement to Develop and Implement a New Oral Health and Prenatal Care Model in Rural Kentucky

    ERIC Educational Resources Information Center

    Kovarik, Robert E.; Skelton, Judith; Mullins, M. Raynor; Langston, LeAnn; Womack, Sara; Morris, Jack; Martin, Dan; Brooks, Robert; Ebersole, Jeffrey L.

    2009-01-01

    CenteringPregnancy Smiles[TM] (CPS) is a partnership between the University of Kentucky, Trover Health System, and Hopkins County Health Department. The purpose of the partnership is to: (1) establish an infrastructure to address health problems requiring research-based solutions, (2) develop a model for community partnership formation, and (3)…

  12. Developing Evidence-Based Practice questionnaire for community health nurses: reliability and validity of a Spanish adaptation.

    PubMed

    Zabaleta-del-Olmo, Edurne; Subirana-Casacuberta, Mireia; Ara-Pérez, Ana; Escuredo-Rodríguez, Bibiana; Ríos-Rodríguez, María Ángeles; Carrés-Esteve, Lourdes; Jodar-Solà, Glòria; Lejardi-Estevez, Yolanda; Nuix-Baqué, Núria; Aguas-Lluch, Asunción; Ondiviela-Cariteu, Àngels; Blanco-Sánchez, Rafaela; Rosa García-Cerdán, María; Contel-Segura, Juan Carlos; Jurado-Campos, Jeroni; Juvinyà-Canal, Dolors

    2016-02-01

    This study aimed to translate the community nursing version of the Developing Evidence-Based Practice questionnaire, adapt the Spanish translation to the primary care context in Spain, and evaluate its reliability and validity. Instruments available in Spanish to date are not designed to rigorously evaluate barriers and incentives associated with evidence-based practice implementation in community health nursing. Classical Test Theory approach. The 49-item Developing Evidence-Based Practice questionnaire was translated, back-translated and pilot-tested. Two items were added to assess respondents' ability to read and understand the English language. During the first six months of 2010, 513 nurses from 255 primary health care centres in Catalunya (Spain) voluntarily participated in the study. Internal consistency and test-retest reliability were evaluated. Internal structure was analysed by principal component analysis. A randomized, controlled, parallel-design study was carried out to test scores' sensitivity to change with two groups, intervention and control. The intervention consisted of eight hours of in-person training, provided by experts in evidence-based practice. Of 513 nurses, 445 (86·7%) nurses responded to all 51 items. Factor analysis showed six components that explained 51% of the total variance. Internal consistency and test-retest reliability were satisfactory (Cronbach α and intraclass correlation coefficients >0·70). A total of 93 nurses participated in the sensitivity-to-change tests (42 in the intervention group, 51 controls). After the training session, overall score and the 'skills for evidence-based practice' component score showed a medium (Cohen d = 0·69) and large effect (Cohen d = 0·86), respectively. The Developing Evidence-Based Practice questionnaire adapted to community health nursing in the primary care setting in Spain has satisfactory psychometric properties. The Developing Evidence-Based Practice questionnaire is a useful

  13. Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process

    PubMed Central

    2014-01-01

    Background A substantial literature suggests that mobile phones have great potential to improve management and survival of acutely ill children in rural Africa. The national strategy of the Ugandan Ministry of Health calls for employment of volunteer community health workers (CHWs) in implementation of Integrated Community Case Management (iCCM) of common illnesses (diarrhea, acute respiratory infection, pneumonia, fever/malaria) affecting children under five years of age. A mobile phone enabled system was developed within iCCM aiming to improve access by CHWs to medical advice and to strengthen reporting of data on danger signs and symptoms for acutely ill children under five years of age. Herein critical steps in development, implementation, and integration of mobile phone technology within iCCM are described. Methods Mechanisms to improve diagnosis, treatment and referral of sick children under five were defined. Treatment algorithms were developed by the project technical team and mounted and piloted on the mobile phones, using an iterative process involving technical support personnel, health care providers, and academic support. Using a purposefully developed mobile phone training manual, CHWs were trained over an intensive five-day course to make timely diagnoses, recognize clinical danger signs, communicate about referrals and initiate treatment with appropriate essential drugs. Performance by CHWs and the accuracy and completeness of their submitted data was closely monitored post training test period and during the subsequent nine month community trial. In the full trial, the number of referrals and correctly treated children, based on the agreed treatment algorithms, was recorded. Births, deaths, and medication stocks were also tracked. Results and Discussion Seven distinct phases were required to develop a robust mobile phone enabled system in support of the iCCM program. Over a nine month period, 96 CHWs were trained to use mobile phones and their

  14. Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process.

    PubMed

    Tumusiime, David Katuruba; Agaba, Gad; Kyomuhangi, Teddy; Finch, Jan; Kabakyenga, Jerome; MacLeod, Stuart

    2014-01-01

    A substantial literature suggests that mobile phones have great potential to improve management and survival of acutely ill children in rural Africa. The national strategy of the Ugandan Ministry of Health calls for employment of volunteer community health workers (CHWs) in implementation of Integrated Community Case Management (iCCM) of common illnesses (diarrhea, acute respiratory infection, pneumonia, fever/malaria) affecting children under five years of age. A mobile phone enabled system was developed within iCCM aiming to improve access by CHWs to medical advice and to strengthen reporting of data on danger signs and symptoms for acutely ill children under five years of age. Herein critical steps in development, implementation, and integration of mobile phone technology within iCCM are described. Mechanisms to improve diagnosis, treatment and referral of sick children under five were defined. Treatment algorithms were developed by the project technical team and mounted and piloted on the mobile phones, using an iterative process involving technical support personnel, health care providers, and academic support. Using a purposefully developed mobile phone training manual, CHWs were trained over an intensive five-day course to make timely diagnoses, recognize clinical danger signs, communicate about referrals and initiate treatment with appropriate essential drugs. Performance by CHWs and the accuracy and completeness of their submitted data was closely monitored post training test period and during the subsequent nine month community trial. In the full trial, the number of referrals and correctly treated children, based on the agreed treatment algorithms, was recorded. Births, deaths, and medication stocks were also tracked. Seven distinct phases were required to develop a robust mobile phone enabled system in support of the iCCM program. Over a nine month period, 96 CHWs were trained to use mobile phones and their competence to initiate a community trial was

  15. Epistemic communities in global health and the development of child survival policy: a case study of iCCM.

    PubMed

    Dalglish, Sarah L; George, Asha; Shearer, Jessica C; Bennett, Sara

    2015-12-01

    Nearly all African countries have recently implemented some form of integrated community case management of childhood illness (iCCM), a strategy aimed at reducing child mortality by providing curative care for common yet fatal childhood illnesses. This case study describes the evolution of iCCM at the global level using the theory of epistemic communities first outlined by Haas, which explains how international policy coordination on technical issues takes place via transnational expert networks. We draw from in-depth interviews with global policy-makers (n = 25), a document review (n = 72) and co-authorship network analysis of scientific articles on iCCM. We find that members of the iCCM epistemic community were mainly mid- to upper-level technical officers working in the headquarters of large norm-setting bodies, implementing partners, funders and academic/research groups in global health. Already linked by pre-existing relationships, the epistemic community was consolidated as conflicts were overcome through structural changes in the network (including or excluding some members), changes in the state of technology or scientific evidence, shifting funding considerations, and the development of consensus through argument, legitimation and other means. Next, the epistemic community positioned iCCM as a preferred solution via three causal dynamics outlined by Haas: (1) responding to decision-makers' uncertainty about how to reduce child mortality after previous policies proved insufficient, (2) using sophisticated analytic tools to link the problem of child mortality to iCCM as a solution and (3) gaining buy-in from major norm-setting bodies and financial and institutional support from large implementing agencies. Applying the epistemic communities framework to the iCCM case study reveals the strengths and weaknesses of a focused policy enterprise with highly specialized and homogenous disciplinary origins, allowing for efficient sharing of complex, high

  16. Developing model-based public health policy through knowledge translation: the need for a 'Communities of Practice'.

    PubMed

    Driedger, S M; Cooper, E J; Moghadas, S M

    2014-06-01

    The 2009 influenza A (H1N1) pandemic prompted public health agencies worldwide to respond in a context of substantial uncertainty. While many lessons around successful management strategies were learned during the influenza A (H1N1) pandemic, the usefulness and impact of mathematical models to optimize policy decisions in protecting public health were poorly realized. The authors explored the experiences of modellers and public health practitioners in trying to develop model-based public health policies in the management of the 2009 influenza A (H1N1) pandemic in Canada. A qualitative case study design based on interviews and other textual data was used. Individual interviews were conducted with mathematical modellers and public health professionals from academia and government health departments during the second wave of the 2009 influenza A (H1N1) pandemic (both prior to and following the vaccine roll-out), using a convergent interviewing process. Interviews were supplemented with discussions held during three separate workshops involving representatives from these groups on the role of modelling in pandemic preparedness and responses. NVivo9™ was used to analyse interview data and associated notes. Mathematical models were underutilized during the response phase of the 2009 influenza A (H1N1) pandemic, largely because many public health professionals were unaware of modelling infrastructure in Canada. Challenges were reflected in three ways: 1) the relevance of models to public health priorities; 2) the need for clear communication and plain language around modelling and its contributions and limitations; and 3) the need for increased trust and collaboration to develop strong working relationships. Developing a 'Communities of Practice' between public health professionals and mathematical modellers during inter-pandemic periods based on common targeted goals, using plain language, and where relationships between individuals and organizations are developed

  17. Scenario planning for community development in Vietnam: a new tool for integrated health approaches?

    PubMed Central

    Nguyen, Vi; Nguyen-Viet, Hung; Pham-Duc, Phuc; Wiese, Martin

    2014-01-01

    Background Like many countries in Southeast Asia, Vietnam's rapid population and economic growth has met challenges in infrastructure development, especially sanitation in rural areas. Objective As an entry point, we developed scenario planning as an action–research tool in a peri-urban community to identify first steps towards improving their complex sanitation problem and to, systemically, address emerging/re-emerging infectious diseases, as these are commonly linked to unsafe water and inadequate sanitation conditions. As an integrated approach, the process of constructing scenarios allowed us to work across sectors and stakeholders to incorporate this knowledge into a common vision. Design We conducted focus group discussions to identify and rank driving forces, orally constructed scenarios for the most uncertain drivers, discussed scenario implications and options, and examined the overall process for usefulness and sustainability. During a one-month scoping phase and in between focus group meetings, we carried out household visits which helped us understand the context of data and gather feedback from participants outside of the formal data collection process. Recorded results from these activities were used to develop subsequent tools. Results and Conclusions The research process gave us insights into how to adapt the scenario planning tool to identify alternative options. This involved choosing boundary partners, negotiating priorities, drawing out participant learning through self-assessment of our process (a prerequisite for changing mental models and thus achieving outcomes), and understanding how conveyed messages may reinforce the status quo. These insights showed the importance of examining research results beyond outputs and outcomes, namely through process. PMID:25138530

  18. Scenario planning for community development in Vietnam: a new tool for integrated health approaches?

    PubMed

    Nguyen, Vi; Nguyen-Viet, Hung; Pham-Duc, Phuc; Wiese, Martin

    2014-12-01

    Background Like many countries in Southeast Asia, Vietnam's rapid population and economic growth has met challenges in infrastructure development, especially sanitation in rural areas. Objective As an entry point, we developed scenario planning as an action-research tool in a peri-urban community to identify first steps towards improving their complex sanitation problem and to, systemically, address emerging/re-emerging infectious diseases, as these are commonly linked to unsafe water and inadequate sanitation conditions. As an integrated approach, the process of constructing scenarios allowed us to work across sectors and stakeholders to incorporate this knowledge into a common vision. Design We conducted focus group discussions to identify and rank driving forces, orally constructed scenarios for the most uncertain drivers, discussed scenario implications and options, and examined the overall process for usefulness and sustainability. During a one-month scoping phase and in between focus group meetings, we carried out household visits which helped us understand the context of data and gather feedback from participants outside of the formal data collection process. Recorded results from these activities were used to develop subsequent tools. Results and Conclusions The research process gave us insights into how to adapt the scenario planning tool to identify alternative options. This involved choosing boundary partners, negotiating priorities, drawing out participant learning through self-assessment of our process (a prerequisite for changing mental models and thus achieving outcomes), and understanding how conveyed messages may reinforce the status quo. These insights showed the importance of examining research results beyond outputs and outcomes, namely through process.

  19. The individual, the government and the global community: sharing responsibility for health post-2015 in Vanuatu, a small island developing state.

    PubMed

    Ibell, Claire; Sheridan, Simon A; Hill, Peter S; Tasserei, John; Maleb, Marie-France; Rory, Jean-Jacques

    2015-10-24

    The end of 2015 will see the creation of the sustainable development goals - the new global framework for development. The process of creating universally relevant goals has involved community consultation throughout the world. Within this process it is vital that Pacific Island countries are included as they face particular development challenges due to their size and geographical location. As small island developing states, many Pacific Island countries struggle to overcome high rates of poverty and poor health outcomes. In order to include Pacific voices in the new health related sustainable development goals, Vanuatu was selected as a representative of the Pacific for this qualitative study. This paper presents the perspectives of communities throughout Vanuatu on their essential health needs and how best to meet them. This paper examines the perspectives of 102 individuals from throughout Vanuatu. Ten focus group discussions and 2 individual interviews were conducted within communities in September 2013. Discussions focused on community perceptions of health, essential health needs, and responsibility in achieving health needs. Discussions were audio recorded and transcribed. The transcripts were then analysed using a theoretical thematic approach in order to identify central themes and subthemes. Individuals in this study demonstrated a comprehensive understanding of health, defining health in a holistic manner. Participants identified clear environmental and societal factors that impact upon health, and emphasized failures within the current health system as important barriers to attaining good health. Participants described the challenges faced in taking responsibility for one's health, and pointed to both the government and the international community as key players in meeting the essential health needs of communities. As a small island developing state, Vanuatu faces accentuated development challenges - particularly as globalisation and climate change

  20. The Native Telehealth Outreach and Technical Assistance Program: a community-based approach to the development of multimedia-focused health care information.

    PubMed

    Dick, Rhonda Wiegman; Manson, Spero M; Hansen, Amy L; Huggins, Annie; Trullinger, Lori

    2007-01-01

    The development and dissemination of culturally relevant health care information has traditionally taken a "top-down" approach. Governmental funding agencies and research institutions have too often dictated the importance and focus of health-related research and information dissemination. In addition, the digital divide has affected rural communities in such a way that their members often do not possess the knowledge or experience necessary to use technological resources. And, even when they do, their skills may be limited, adequate only for implementing applications and programs designed by others who live and work outside of these communities. This need became the driving force in the creation of the Native Telehealth Outreach and Technical Assistance Program. The goal of the program is to equip Native community members, at both the lay and professional levels, with the means to use technology to address tribal health care needs. The transfer of relevant technical knowledge and skills enables participants to develop projects which enhance the community-wide dissemination of health care information. Nine community health advocates and professionals participated in the initial cohort. Eight of the participants successfully developed multimedia-based projects including Web sites, interactive CD-ROMs, and video focusing on a variety of health concerns. At the conclusion of the 18-month program period, projects were disseminated throughout rural communities. The NTOTAP staff continues to evaluate the use of these projects and their benefits within the rural communities.

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

    PubMed

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

    2011-01-01

    Community health worker programs have emerged as one of the most effective strategies to address human resources for health shortages while improving access to and quality of primary healthcare. Many developing countries have succeeded in deploying community health worker programs in recognition of the potential of community health workers to identify, refer, and in many cases treat illnesses at the household level. However, challenges in program design and sustainability are expanded when such programs are expanded at scale, particularly with regard to systems management and integration with primary health facilities. Several nongovernmental organizations provide cases of innovation on management of community health worker programs that could support a sustainable system that is capable of being expanded without being stressed in its functionality nor effectiveness--therefore, providing for stronger scalability. This paper explores community health worker programs that have been deployed at national scale, as well as scalable innovations found in successful nongovernmental organization-run community health worker programs. In exploration of strategies to ensure sustainable community health worker programs at scale, we reconcile scaling constraints and scalable innovations by mapping strengths of nongovernmental organizations' community health worker programs to the challenges faced by programs currently deployed at national scale. © 2011 Mount Sinai School of Medicine.

  2. 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…

  3. Curriculum for Community Health Workers.

    ERIC Educational Resources Information Center

    Southwick, Paula S.

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

  4. Development of the Health Atlas of Jalisco: A New Web-Based Service for the Ministry of Health and the Community in Mexico.

    PubMed

    Ramos Herrera, Igor Martin; Gonzalez Castañeda, Miguel; Robles, Juan; Fonseca León, Joel

    2016-01-01

    Maps have been widely used to provide a visual representation of information of a geographic area. Health atlases are collections of maps related to conditions, infrastructure or services provided. Various countries have put resources towards producing health atlases that support health decision makers to enhance their services to the communities. Latin America, as well as Spain, have produced several atlases of importance such as the interactive mortality atlas of Andalucía, which is very similar to the one that is presented in this paper. In Mexico, the National Institute of Public Health produced the only health atlas found that is of relevance. It was published online in 2003 and is currently still active. The objective of this work is to describe the methods used to develop the Health Atlas of Jalisco (HAJ), and show its characteristics and how it interactively works with the user as a Web-based service. This work has an ecological design in which the analysis units are the 125 municipalities (counties) of the state of Jalisco, Mexico. We created and published online a geographic health atlas displaying a system based on input from official health database of the Health Ministry of Jalisco (HMJ), and some databases from the National Institute of Statistics and Geography (NISGI). The atlas displays 256 different variables as health-direct or health-related indicators. Instant Atlas software was used to generate the online application. The atlas was developed using these procedures: (1) datasheet processing and base maps generation, (2) software arrangements, and (3) website creation. The HAJ is a Web-based service that allows users to interact with health and general data, regions, and categories according to their information needs and generates thematic maps (eg, the total population of the state or of a single municipality grouped by age or sex). The atlas is capable of displaying more than 32,000 different maps by combining categories, indicators

  5. Development of the Health Atlas of Jalisco: A New Web-Based Service for the Ministry of Health and the Community in Mexico

    PubMed Central

    Robles, Juan; Fonseca León, Joel

    2016-01-01

    Background Maps have been widely used to provide a visual representation of information of a geographic area. Health atlases are collections of maps related to conditions, infrastructure or services provided. Various countries have put resources towards producing health atlases that support health decision makers to enhance their services to the communities. Latin America, as well as Spain, have produced several atlases of importance such as the interactive mortality atlas of Andalucía, which is very similar to the one that is presented in this paper. In Mexico, the National Institute of Public Health produced the only health atlas found that is of relevance. It was published online in 2003 and is currently still active. Objective The objective of this work is to describe the methods used to develop the Health Atlas of Jalisco (HAJ), and show its characteristics and how it interactively works with the user as a Web-based service. Methods This work has an ecological design in which the analysis units are the 125 municipalities (counties) of the state of Jalisco, Mexico. We created and published online a geographic health atlas displaying a system based on input from official health database of the Health Ministry of Jalisco (HMJ), and some databases from the National Institute of Statistics and Geography (NISGI). The atlas displays 256 different variables as health-direct or health-related indicators. Instant Atlas software was used to generate the online application. The atlas was developed using these procedures: (1) datasheet processing and base maps generation, (2) software arrangements, and (3) website creation. Results The HAJ is a Web-based service that allows users to interact with health and general data, regions, and categories according to their information needs and generates thematic maps (eg, the total population of the state or of a single municipality grouped by age or sex). The atlas is capable of displaying more than 32,000 different maps by

  6. 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.

  7. Health Action Theatre by Seniors: Community Development and Education with Groups of Diverse Languages and Cultures.

    ERIC Educational Resources Information Center

    Palmar, Isabel; Nascimento, Odete

    2002-01-01

    Describes St. Christopher House Health Action Theatre by Seniors in Toronto, which uses interactive theater to address such issues as elder abuse, mental health, substance abuse, and other health care issues. Includes information about the lack of appropriate culturally sensitive healthcare and home care support services. (JOW)

  8. Health Action Theatre by Seniors: Community Development and Education with Groups of Diverse Languages and Cultures.

    ERIC Educational Resources Information Center

    Palmar, Isabel; Nascimento, Odete

    2002-01-01

    Describes St. Christopher House Health Action Theatre by Seniors in Toronto, which uses interactive theater to address such issues as elder abuse, mental health, substance abuse, and other health care issues. Includes information about the lack of appropriate culturally sensitive healthcare and home care support services. (JOW)

  9. Health development in Djibouti.

    PubMed

    Hatem, M M

    1996-01-01

    When the government of Djibouti established its national health development plan for 1991-95, it took into account traditional medicine, services founded in the colonial era, and the need for primary care. Djibouti needs more physicians. As such, students should be encouraged to pursue medical studies. Efforts to train paramedical staff, the need to integrate the traditional sector into the health system, disease prevention programs, the need to modernize the General Peltier Hospital, maternal and child health, measures being taken to increase the level of community participation in health care, and the adverse effect upon service quality of providing free medical care are discussed. Drug supplies have dwindled as population size has grown. In general, the country's health facilities are overburdened and their equipment is breaking down. In this context, the community must assume part of the financial responsibility for health care.

  10. The role of "Theatre for Development" in mobilising rural communities for primary health care: the case of Liwonde PHC Unit in southern Malawi.

    PubMed

    Kalipeni, E; Kamlongera, C

    1996-01-01

    The improved health conditions that are essential for development may depend more upon the self-help motivation of local people than upon the provision of Western-style health facilities. Such motivation can be created by the culturally-appropriate dissemination of health education at the community level. This article describes an effective health improvement strategy implemented in three villages in southern Malawi during the late 1980s. After an introduction, the paper presents an overview of current strategies used in Malawi for the dissemination of primary health care information and notes that these strategies have failed to reach the rural population. Next, the paper describes the health status of two of the villages, Mbela and Mwima, before the introduction of the Liwonde Agricultural Development Division Primary Health Care Program. None of the three village involved had access to modern health care facilities. This program involved the joint efforts of the community, a primary health care team, and the Chancellor College Theatre for Development. The paper continues by presenting a conceptual model of the process. Community involvement was assured by the election of the members of village health committees and the delivery of health training to two members of each committee. The Theatre for Development used interactive dramatic techniques and participatory research activities in Mwima and Mbela to help the communities assess their health needs and possible solutions in conjunction with the introduction of primary health care activities. The article also contrasts the Theatre for Development technique with the focus group approach and notes that the latter may not be successful in motivating self-help efforts. Finally, the relative success of the Theatre for Development methodology used in the two villages is described by comparing health indicators with those before the intervention and with those in the third village where this approach was not used in

  11. Computer Simulation of Community Mental Health Centers.

    ERIC Educational Resources Information Center

    Cox, Gary B.; And Others

    1985-01-01

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

  12. A COMMUNITY MENTAL HEALTH PROFESSIONAL DEVELOPMENT MODEL FOR THE EXPANSION OF REFLECTIVE PRACTICE AND SUPERVISION: EVALUATION OF A PILOT TRAINING SERIES FOR INFANT MENTAL HEALTH PROFESSIONALS.

    PubMed

    Shea, Sarah E; Goldberg, Sheryl; Weatherston, Deborah J

    2016-11-01

    The Michigan Association for Infant Mental Health identified a need for reflective supervision training for infant mental health (IMH) specialists providing home-based services to highly vulnerable infants and their families. Findings indicate that this pilot of an IMH community mental health professional development model was successful, as measured by the participants' increased capacity to apply reflective practice and supervisory knowledge and skills. Furthermore, IMH clinicians demonstrated an increase in the frequency of their use of reflective practice skills, and their supervisors demonstrated an increase in their sense of self-efficacy regarding reflective supervisory tasks. Finally, the evaluation included a successful pilot of new measures designed to measure reflective practice, contributing to the growing body of research in the area of reflective supervision.

  13. Issues faced by community health centers.

    PubMed

    Grover, Jane

    2009-05-01

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

  14. 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.

  15. Effectiveness of the Rural Trauma Team Development Course for Educating Nurses and Other Health Care Providers at Rural Community Hospitals.

    PubMed

    Zhu, Thein Hlaing; Hollister, Lisa; Scheumann, Christopher; Konger, Jennifer; Opoku, Dazar

    2016-01-01

    The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). ED and trauma registry data were queried to achieve objective (3) for assessing reduction in ED time (EDT), from patient arrival to decision to transfer and ED length of stay (LOS). The RTTDC was positively perceived by health care providers (96.3% of them completed the program). Significant improvement in 13 of the 19 knowledge items was observed in nurses. Education intervention was an independent predictor in reducing EDT by 28 minutes and 95% confidence interval (CI) [-57, -0.1] at 6 months post-RTTDC, and 29 minutes and 95% CI [-53, -6] at 12 months post-RTTDC. Similar results were observed with ED LOS. The RTTDC is well-perceived as an education program. It improves acute trauma emergency care knowledge in rural health care providers. It promotes early transfer of severely injured patients to a higher level of care.

  16. Animal bite management practices: a survey of health care providers in a community development block of Haryana.

    PubMed

    Prasad, V S; Duggal, M; Aggarwal, A K; Kumar, R

    2001-12-01

    It is seen that outcome of animal bites is influenced by various factors including the treatment procedures practiced by health care providers (HCPs). A cross sectional study of health care providers was conducted during May 2000 in PHC Kurali and Naraingarh town of community development block Naraingarh in district Ambala, Haryana. A total of forty-four HCPs were interviewed at their health facility. They were asked about the qualification and number of years in practice. Health care providers were assessed for their knowledge regarding history taking, immediate management of animal bite, post bite anti-rabies treatment, follow up advice and availability of vaccines. Pre-exposure prophylaxis was known to 18.8% of HCPs. Fifty-nine per cent of HCPs were confident in managing dog bites and 93.1% knew about tissue culture vaccine. Vaccine cost was the commonest barrier (38.8%) in the management of animal bites. This study shows a gross difference between awareness and actual practice of management of animal bites.

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

    PubMed

    Pai, Lu

    2011-02-01

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

  18. Collaboration between traditional practitioners and primary health care staff in South Africa: developing a workable partnership for community mental health services.

    PubMed

    Campbell-Hall, Vicky; Petersen, Inge; Bhana, Arvin; Mjadu, Sithembile; Hosegood, Victoria; Flisher, Alan J

    2010-09-01

    The majority of the black African population in South Africa utilize both traditional and public sector Western systems of healing for mental health care. There is a need to develop models of collaboration that promote a workable relationship between the two healing systems. The aim of this study was to explore perceptions of service users and providers of current interactions between the two systems of care and ways in which collaboration could be improved in the provision of community mental health services. Qualitative individual and focus group interviews were conducted with key health care providers and service users in one typical rural South African health sub-district. The majority of service users held traditional explanatory models of illness and used dual systems of care, with shifting between treatment modalities reportedly causing problems with treatment adherence. Traditional healers expressed a lack of appreciation from Western health care practitioners but were open to training in Western biomedical approaches and establishing a collaborative relationship in the interests of improving patient care. Western biomedically trained practitioners were less interested in such an arrangement. Interventions to acquaint traditional practitioners with Western approaches to the treatment of mental illness, orientation of Western practitioners towards a culture-centred approach to mental health care, as well as the establishment of fora to facilitate the negotiation of respectful collaborative relationships between the two systems of healing are required at district level to promote an equitable collaboration in the interests of improved patient care.

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

    PubMed

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

    2013-01-01

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

  20. Development of a health information technology-based data system in community-based hospice and palliative care.

    PubMed

    Abernethy, Amy P; Wheeler, Jane L; Bull, Janet

    2011-05-01

    Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear. To develop a HIT-based data infrastructure that serves multiple hospice and palliative care sites, meeting clinical and administrative needs with data, technical, and analytic support. Through a multi-site academic/community partnership, a data infrastructure was collaboratively developed, pilot-tested at a community-based site, refined, and demonstrated for data collection and preliminary analysis. Additional sites, which participated in system development, became prepared to contribute data to the growing aggregate database. Electronic data collection proved feasible in community-based hospice and palliative care. The project highlighted "success factors" for implementing HIT in this field: engagement of site-based project "champions" to promote the system from within; involvement of stakeholders at all levels of the organization, to promote culture change and buy-in; attention to local needs (e.g., data for quality reporting) and requirements (e.g., affordable cost, efficiency); consideration of practical factors (e.g., potential to interfere with clinical flow); provision of adequate software, technical, analytic, and statistical support; availability of flexible HIT options (e.g., different data-collection platforms); and adoption of a consortium approach in which sites can support one another, learn from each others' experiences, pool data, and benefit from economies of scale. In hospice and palliative care, HIT-based data collection/management has potential to generate better understanding of populations and outcomes, support quality assessment/quality improvement, and prepare sites to participate in research. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Using Needs Assessment to Develop Curricula for Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Academic and Community Health Settings

    ERIC Educational Resources Information Center

    Satre, Derek D.; McCance-Katz, Elinore F.; Moreno-John, Gina; Julian, Katherine A.; O'Sullivan, Patricia S.; Satterfield, Jason M.

    2012-01-01

    This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social…

  2. Using Needs Assessment to Develop Curricula for Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Academic and Community Health Settings

    ERIC Educational Resources Information Center

    Satre, Derek D.; McCance-Katz, Elinore F.; Moreno-John, Gina; Julian, Katherine A.; O'Sullivan, Patricia S.; Satterfield, Jason M.

    2012-01-01

    This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social…

  3. Developing Capacities of Community Health Workers in Sexual and Reproductive, Maternal, Newborn, Child, and Adolescent Health: A Mapping and Review of Training Resources

    PubMed Central

    Tran, Nguyen Toan; Portela, Anayda; de Bernis, Luc; Beek, Kristen

    2014-01-01

    Background Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. Methods A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. Results We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. Conclusions There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be

  4. Developing capacities of community health workers in sexual and reproductive, maternal, newborn, child, and adolescent health: a mapping and review of training resources.

    PubMed

    Tran, Nguyen Toan; Portela, Anayda; de Bernis, Luc; Beek, Kristen

    2014-01-01

    Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs. A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation. We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems. There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be delivered by CHWs. Packages with defined

  5. Health, hope, and human development: building capacity in public housing communities on the U.S.-Mexico border.

    PubMed

    Mata, Holly; Flores, Maria; Castañeda, Ernesto; Medina-Jerez, William; Lachica, Josue; Smith, Curtis; Olvera, Hector

    2013-11-01

    In this paper we highlight results from our recent survey of public housing residents living in the U.S.-Mexico border region. Our data inform our interdisciplinary (public health, education, environmental engineering, sociology) efforts to improve health and educational equity in our community, and provide ripe opportunities for policy advocacy.

  6. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

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

  7. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

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

  8. Promoting community health resources: preferred communication strategies.

    PubMed

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

    2011-03-01

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

  9. Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case-control studies.

    PubMed

    March, Sebastià; Ripoll, Joana; Jordan Martin, Matilde; Zabaleta-Del-Olmo, Edurne; Benedé Azagra, Carmen Belén; Elizalde Soto, Lázaro; Vidal, Mª Clara; Bauzà Amengual, María de Lluc; Planas Juan, Trinidad; Pérez Mariano, Damiana Maria; Llull Sarralde, Micaela; Ruiz-Giménez, Juan Luís; Bajo Viñas, Rosa; Solano Villarubia, Carmen; Rodriguez Bajo, Maria; Cordoba Victoria, Manuela; Badia Capdevila, Marta; Serrano Ferrandez, Elena; Bosom Diumenjo, Maria; Montaner-Gomis, Isabel; Bolibar-Ribas, Buenaventura; Antoñanzas Lombarte, Angel; Bregel Cotaina, Samantha; Calvo Tocado, Ana; Olivan Blázquez, Barbara; Magallon Botaya, Rosa; Marín Palacios, Pilar; Echauri Ozcoidi, Margarita; Perez-Arauta, María Jose; Llobera, Joan; Ramos, Maria

    2017-10-08

    Spanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities. Two case-control studies. Performed in primary care of five Spanish regions. In the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not. Team, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources. The first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1). Professional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

  10. Development of the community midwifery education initiative and its influence on women's health and empowerment in Afghanistan: a case study.

    PubMed

    Speakman, Elizabeth M; Shafi, Ahmad; Sondorp, Egbert; Atta, Nooria; Howard, Natasha

    2014-09-15

    Political transition in Afghanistan enabled reconstruction of the destroyed health system. Maternal health was prioritised due to political will and historically high mortality. However, severe shortages of skilled birth attendants--particularly in rural areas--hampered safe motherhood initiatives. The Community Midwifery Education (CME) programme began training rural midwives in 2002, scaling-up nationally in 2005. This case study analyses CME development and implementation to help determine successes and challenges. Data were collected through documentary review and key informant interviews. Content analysis was informed by Walt and Gilson's policy triangle framework. The CME programme has contributed to consistently positive indicators, including up to a 1273/100,000 reduction in maternal mortality ratios, up to a 28% increase in skilled deliveries, and a six-fold increase in qualified midwives since 2002. Begun as a small pilot, CME has gained support of international donors, the Afghan government, and civil society. CME is considered by stakeholders to be a positive model for promoting women's education, employment, and health. However, its future is threatened by insecurity, corruption, lack of regulation, and funding uncertainties. Strategic planning and resource mobilisation are required for it to achieve its potential of transforming maternal healthcare in Afghanistan.

  11. Economics, health and development: some ethical dilemmas facing the World Bank and the international community

    PubMed Central

    Wagstaff, A.

    2001-01-01

    The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility".1 Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues—which are often not acknowledged by commentators—that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor). Key Words: World Bank • poverty • health • population • health economics • global ethics PMID:11479358

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

    PubMed

    Neufer, L

    1994-06-01

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

  13. Economics, health and development: some ethical dilemmas facing the World Bank and the international community.

    PubMed

    Wagstaff, A

    2001-08-01

    The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility".(1) Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues--which are often not acknowledged by commentators--that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor).

  14. The Development of Health Programs for Junior and Community Colleges: An Interpretation of Recommended Standards and Practices for a College Health Program.

    ERIC Educational Resources Information Center

    American Coll. Health Association, Evanston, IL.

    The basic premise of this document is that every community college should have a plan through which the health needs of students, faculty and staff can be met by health services which are available, accessible and of high quality. Services should be available in each of the following program areas: personal medical, mental health, and other direct…

  15. Faculty Growth through Community Development.

    ERIC Educational Resources Information Center

    Rohfeld, Rae

    1984-01-01

    Enumerates ways institutions can benefit from faculty involvement in community development. Sees community involvement as one way to meet faculty members' need for job enrichment. Identifies possible community development activities, requisite skills, and ways instructors can develop these skills. (DMM)

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

    PubMed

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

    1996-02-01

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

  17. Learning about Urban Congregations and HIV/AIDS: Community-Based Foundations for Developing Congregational Health Interventions

    PubMed Central

    Mendel, Peter J.; Kanouse, David E.; Bluthenthal, Ricky N.; Castaneda, Laura Werber; Hawes-Dawson, Jennifer; Mata, Michael; Oden, Clyde W.

    2010-01-01

    Religious congregations are important community institutions that could help fight HIV/AIDS; however, barriers exist, particularly in the area of prevention. Formative, participatory research is needed to understand the capacity of congregations to address HIV/AIDS. This article describes a study that used community-based participatory research (CBPR) approaches to learn about congregation-sponsored HIV activities. CBPR strategies were used throughout the study, including proposal development, community expert interviews, Community Advisory Board, congregational telephone survey, congregational case studies, and congregational feedback sessions. Involving community consultants, experts, and advisory board members in all stages of the study helped the researchers to conceptualize congregational involvement in HIV, be more sensitive to potential congregational concerns about the research, achieve high response rates, and interpret and disseminate findings. Providing preliminary case findings to congregational participants in an interactive feedback session improved data quality and relationships with the community. Methods to engage community stakeholders can lay the foundation for future collaborative interventions. PMID:20361357

  18. Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England.

    PubMed

    Gillard, Steve; Adams, Katie; Edwards, Christine; Lucock, Mike; Miller, Stephen; Simons, Lucy; Turner, Kati; White, Rachel; White, Sarah

    2012-07-07

    Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting

  19. Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

    PubMed Central

    2012-01-01

    Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are

  20. Bridging community intervention and mental health services research.

    PubMed

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

    2004-06-01

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

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

    PubMed Central

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

    2014-01-01

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

  2. Developing a Sustainable Model of Oral Health Care for Disadvantaged Aboriginal People Living in Rural and Remote Communities in NSW, Using Collective Impact Methodology.

    PubMed

    Gwynne, Kylie; Irving, Michelle J; McCowen, Debbie; Rambaldini, Boe; Skinner, John; Naoum, Steve; Blinkhorn, Anthony

    2016-02-01

    A sustainable model of oral health care for disadvantaged Aboriginal people living in rural and remote communities in New South Wales was developed using collective impact methodology. Collective impact is a structured process which draws together organizations to develop a shared agenda and design solutions which are jointly resourced, measured and reported upon.

  3. Developing a Sustainable Model of Oral Health Care for Disadvantaged Aboriginal People Living in Rural and Remote Communities in NSW, Using Collective Impact Methodology.

    PubMed

    Gwynne, Kylie; Irving, Michelle J; McCowen, Debbie; Rambaldini, Boe; Skinner, John; Naoum, Steve; Blinkhorn, Anthony

    2016-01-01

    A sustainable model of oral health care for disadvantaged Aboriginal people living in rural and remote communities in New South Wales was developed using collective impact methodology. Collective impact is a structured process which draws together organizations to develop a shared agenda and design solutions which are jointly resourced, measured and reported upon.

  4. Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: development of priority concerns and potential health, nutrition and education interventions.

    PubMed

    Casapia, Martin; Joseph, Serene A; Gyorkos, Theresa W

    2007-07-10

    Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus. Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits. The top ten priority problems in Belen were identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3) diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low level of education; 8) sexually transmitted diseases; 9) domestic violence; and 10) delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues. The two workshops provided valuable insight into the main health and health-related problems facing the community of Belen. The participatory focus of the workshops ensured the

  5. Multidisciplinary and participatory workshops with stakeholders in a community of extreme poverty in the Peruvian Amazon: Development of priority concerns and potential health, nutrition and education interventions

    PubMed Central

    Casapia, Martin; Joseph, Serene A; Gyorkos, Theresa W

    2007-01-01

    Background Communities of extreme poverty suffer disproportionately from a wide range of adverse outcomes, but are often neglected or underserved by organized services and research attention. In order to target the first Millennium Development Goal of eradicating extreme poverty, thereby reducing health inequalities, participatory research in these communities is needed. Therefore, the purpose of this study was to determine the priority problems and respective potential cost-effective interventions in Belen, a community of extreme poverty in the Peruvian Amazon, using a multidisciplinary and participatory focus. Methods Two multidisciplinary and participatory workshops were conducted with important stakeholders from government, non-government and community organizations, national institutes and academic institutions. In Workshop 1, participants prioritized the main health and health-related problems in the community of Belen. Problem trees were developed to show perceived causes and effects for the top six problems. In Workshop 2, following presentations describing data from recently completed field research in school and household populations of Belen, participants listed potential interventions for the priority problems, including associated barriers, enabling factors, costs and benefits. Results The top ten priority problems in Belen were identified as: 1) infant malnutrition; 2) adolescent pregnancy; 3) diarrhoea; 4) anaemia; 5) parasites; 6) lack of basic sanitation; 7) low level of education; 8) sexually transmitted diseases; 9) domestic violence; and 10) delayed school entry. Causes and effects for the top six problems, proposed interventions, and factors relating to the implementation of interventions were multidisciplinary in nature and included health, nutrition, education, social and environmental issues. Conclusion The two workshops provided valuable insight into the main health and health-related problems facing the community of Belen. The

  6. Personas in online health communities.

    PubMed

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

    2016-10-01

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

  7. Use of the Persuasive Health Message framework in the development of a community-based mammography promotion campaign.

    PubMed

    Hall, Ingrid J; Johnson-Turbes, Ashani

    2015-05-01

    We describe how the Persuasive Health Message (PHM) framework was used to guide the formative evaluation informing development of messages and materials used in a community-based multi-media campaign intended to motivate low-income African American women to obtain low- or no-cost mammograms through the CDC's National Breast and Cervical Cancer Early Detection Program. Seventy-eight African American women were recruited for eight focus groups that discussed breast cancer screening. The moderator guide was developed in accordance with the PHM framework and solicited information on perceived threat and efficacy, cues, salient beliefs and referents, and barriers to self-efficacy. We created persuasive messages to emphasize that African American women are susceptible to the threat of breast cancer, but that their personal action in obtaining regular mammograms may lead to early detection, subsequent treatment, and reduced cancer mortality. The messages addressed concerns of self-efficacy by emphasizing that uninsured women can also obtain high-quality low- or no-cost mammograms. In an attempt to combat the sentiment that breast cancer is a death sentence, the messages indicated that breast cancer can be successfully treated, especially when detected early. The PHM framework consists of three steps: (1) determine information about threat and efficacy; (2) develop an audience profile; and (3) construct a persuasive message. It offered our team easy-to-follow, flexible steps to create a persuasive and effective campaign promoting awareness and use of mammogram screening among low-income African American women.

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

    ERIC Educational Resources Information Center

    Christeson, Elisabeth P.

    2003-01-01

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

  9. Meeting the Health Promotion Needs of Hispanic Communities.

    ERIC Educational Resources Information Center

    American Journal of Health Promotion, 1995

    1995-01-01

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

  10. Meeting the Health Promotion Needs of Hispanic Communities.

    ERIC Educational Resources Information Center

    American Journal of Health Promotion, 1995

    1995-01-01

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

  11. Community forums promote health awareness.

    PubMed

    Woodrow, M; Wheat, R P

    1978-01-01

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

  12. Promotion of oral health by community nurses.

    PubMed

    Garry, Brendan; Boran, Sue

    2017-10-02

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

  13. 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.

  14. 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

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

    ERIC Educational Resources Information Center

    National Commission on Community Health Services, Washington, DC.

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

  16. [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.

  17. Evaluation of community health assessment in Kansas.

    PubMed

    Curtis, Denice C

    2002-07-01

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

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

    ERIC Educational Resources Information Center

    Mayfield-Johnson, Susan

    2011-01-01

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

  19. Evaluating the ecological association of casino industry economic development on community health status: a natural experiment in the Mississippi delta region.

    PubMed

    Honoré, Peggy A; Simoes, Eduardo J; Moonesinghe, Ramal; Wang, Xueyuan; Brown, Lovetta

    2007-01-01

    Objectives of this study were to examine for associations of casino industry economic development on improving community health status and funding for public health services in two counties in the Mississippi Delta Region of the United States. An ecological approach was used to evaluate whether two counties with casino gaming had improved health status and public health funding in comparison with two noncasino counties in the same region with similar social, racial, and ethic backgrounds. Variables readily available from state health department records were used to develop a logic model for guiding analytical work. A linear regression model was built using a stepwise approach and hierarchical regression principles with many dependent variables and a set of fixed and nonfixed independent variables. County-level data for 23 variables over an 11-year period were used. Overall, this study found a lack of association between the presence of a casino and desirable health outcomes or funding for public health services. Changes in the environment were made to promote health by utilizing gaming revenues to build state-of-the-art community health and wellness centers and sports facilities. However, significant increases in funding for local public health services were not found in either of the counties with casinos. These findings are relevant for policy makers when debating economic development strategies. Analysis similar to this should be combined with other routine public health assessments after implementation of development strategies to increase knowledge of health outcome trends and shifts in socioeconomic position that may be expected to accrue from economic development projects.

  20. Developing the future Indigenous health workforce: The feasibility and impact of a student-led placement programme in remote Indigenous communities.

    PubMed

    Warren, Johanna M; Irish, Georgina L; Purbrick, Brydie; Li, Joule J; Li, Xi; Fitzpatrick, Danielle J; Faull, Randall J

    2016-10-01

    To describe and evaluate a programme where medical students designed and implemented Indigenous health placements for students with an interest in rural/Indigenous health. In 2011, a student-led programme at the University of Adelaide was set up to give medical students the opportunity to undertake outreach trips and clinical placements in remote Indigenous communities. Twenty-four medical students attended trips to remote communities between 2012 and 2014. Here we evaluate our programme using a single-arm experimental design. Responses to questionnaire items before and after attending an outreach placement, scored on 6-point Likert scales. Following their remote Indigenous health placement, participants expressed a significantly higher mean likelihood of working in an Indigenous community in the future (3.17 (2.69-3.64) versus 4.00 (3.65-4.35); P < 0.007). Furthermore, after their placement participants felt better prepared to work in Indigenous communities (mean 1.79 (1.44-2.14) versus 3.21 (2.88-3.54); P < 0.001). A placement programme initiated and run by medical students can provide meaningful exposure to Indigenous health. Implementation of this student-led model in other medical schools may encourage nationwide development of the Indigenous health workforce. © 2016 National Rural Health Alliance Inc.

  1. Developing a communitywide electronic health record disease registry in primary care practices: lessons learned from the Western new york beacon community.

    PubMed

    Heider, Arvela R; Maloney, Nancy A; Satchidanand, Nikhil; Allen, Geoffrey M; Mueller, Raymond; Gangloff, Steven; Singh, Ranjit

    2014-01-01

    Disease registries, as part of electronic health records (EHRs), have shown promise in improving care and outcomes. However, little is known about how best to implement them across communities, especially in communities that are not highly integrated. The Western New York (WNY) primary care community consists largely of independent practices using at least 20 different EHR products. This paper discusses the processes undertaken to develop a communitywide EHR disease registry in WNY, improvements it engendered, barriers overcome, and the lessons learned. HEALTHeLINK, under the Office of the National Coordinator for Health Information Technology Beacon Community Initiative, reached out to 98 primary care practices in the WNY region to establish EHR-based diabetes registries. Working with practices, community partners, and vendors, registry specifications were created. The registry was piloted with practices using one local vendor's EHR product and then rolled out to other practices, including five other EHR products. Using identified and de-identified registry datasets, quality benchmarking within and between practices and population health management were undertaken. From 2011 to 2013, the WNY Beacon Community assisted 98 practices (344 providers) serving over 50,000 adult diabetic patients. A major focus was on EHR registry development across diverse systems, and overcoming the challenges this presented. The Beacon diabetes registry was implemented at 85 of the 98 targeted practices. Of these registries, 65 met the criteria described in a later section for quality benchmarking and population health management purposes. Practices received quarterly benchmark reports summarizing their performance on key diabetes quality metrics and were compared to community practice averages. Practices used their registries for population health management by identifying and targeting patients in need of follow-up or specific diabetes-related care. The creation of the registry

  2. Developing a Communitywide Electronic Health Record Disease Registry in Primary Care Practices: Lessons Learned from the Western New York Beacon Community

    PubMed Central

    Heider, Arvela R.; Maloney, Nancy A.; Satchidanand, Nikhil; Allen, Geoffrey M.; Mueller, Raymond; Gangloff, Steven; Singh, Ranjit

    2014-01-01

    Background and Introduction: Disease registries, as part of electronic health records (EHRs), have shown promise in improving care and outcomes. However, little is known about how best to implement them across communities, especially in communities that are not highly integrated. The Western New York (WNY) primary care community consists largely of independent practices using at least 20 different EHR products. This paper discusses the processes undertaken to develop a communitywide EHR disease registry in WNY, improvements it engendered, barriers overcome, and the lessons learned. Methods: HEALTHeLINK, under the Office of the National Coordinator for Health Information Technology Beacon Community Initiative, reached out to 98 primary care practices in the WNY region to establish EHR-based diabetes registries. Working with practices, community partners, and vendors, registry specifications were created. The registry was piloted with practices using one local vendor’s EHR product and then rolled out to other practices, including five other EHR products. Using identified and de-identified registry datasets, quality benchmarking within and between practices and population health management were undertaken. Findings: From 2011 to 2013, the WNY Beacon Community assisted 98 practices (344 providers) serving over 50,000 adult diabetic patients. A major focus was on EHR registry development across diverse systems, and overcoming the challenges this presented. The Beacon diabetes registry was implemented at 85 of the 98 targeted practices. Of these registries, 65 met the criteria described in a later section for quality benchmarking and population health management purposes. Practices received quarterly benchmark reports summarizing their performance on key diabetes quality metrics and were compared to community practice averages. Practices used their registries for population health management by identifying and targeting patients in need of follow-up or specific

  3. Keep It Up: development of a community-based health screening and HIV prevention strategy for reaching young African American men.

    PubMed

    O'Donnell, Lydia; Bonaparte, Beverly; Joseph, Heather; Agronick, Gail; Leow, Deborah McLean; Myint-U, Athi; Stueve, Ann

    2009-08-01

    This article addresses the challenge of developing HIV prevention interventions that not only prove to be efficacious but also are designed from the outset to overcome obstacles to reaching priority populations. We describe how community input has informed development of Keep It Up (KIU), a community health screening and behavioral prevention program for young Black men. KIU embeds HIV prevention in a broader health promotion campaign, with the goal of reducing stigma and reaching a population that bears a disproportionate burden of HIV/AIDS and other health problems-hypertension, high cholesterol, diabetes, asthma, and obesity. Information from community partners, expert advisers, and focus groups was collected at key junctures and incorporated into four core components: social marketing, a computerized behavioral learning module, biological testing for HIV and other conditions, and a personalized health profile and risk reduction plan. A pilot with 116 participants provided evidence that the KIU model of integrating HIV prevention with other health screening is acceptable and has the potential to reach Black men at risk for HIV as well as other chronic health conditions.

  4. Epidemiological study of mental morbidity in an urban slum community in India for the development of a community mental health programme.

    PubMed

    Silvanus, V; Subramanian, P

    2012-03-01

    A crossectional field study was carried out in an urban slum in order to assess the prevalence and nature of mental morbidity and identify stressors in the community. A face to face interview was conducted with the help of a questionnaire. The interview consisted of three sections as follows: Data identifying the informant by age, sex, marital status, education, occupation, age at marriage, number of members, children and monthly income. General Health Questionnaire (GHQ) 5- item version used as a screening instrument to assess the present mental health status of the informant and data of past illnesses in self or family and questions framed to elicit perceptions regarding mental illness, alcoholism, their causation and treatment. The subjects who scored above 2 ie 3,4,and 5 in the GHQ were requested to follow up at the Mental Health OPD and subjected to a standardized psychiatric interview by a Psychiatrist. The Diagnostic and Statistical Manual Third Revised (DSM 3 R) criteria were used for diagnosis. After the interview and examination, the appropriate treatment was instituted. A total of 443 individuals were screened. The overall prevalence rate of mental illness in the community was 61 per thousand. It is estimated that the case rate ranges from 38 to 84 per thousand within 95% confidence limits. The overall severity ranged from mild to severe morbidity. The prevalence of severe mental morbidity which includes psychosis, depressive illness, mental retardation was 22.5 per thousand. Neurosis (63.31%) especially Major Depression and Adjustment disorder, Psychosis (10.00%), Somatization disorder (6.66%) and Psychiatric symptoms secondary to physical illness were the major groups of illness. Women were found to have more mental health problems than men. The morbidity pattern also differs significantly with the gender. Neurosis was seen more among the female subjects. There was a significant association of mental health problems with low educational status

  5. 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…

  6. 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…

  7. Patient Moderator Interaction in Online Health Communities

    PubMed Central

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

    2013-01-01

    An increasing number of people visit online health communities to share experiences and seek health information. Although studies have enumerated reasons for patients’ visits to online communities for health information from peers, we know little about how patients gain health information from the moderators in these communities. We qualitatively analyze 480 patient and moderator posts from six communities to understand how moderators fulfill patients’ information needs. Our findings show that patients use the community as an integral part of their health management practices. Based on our results, we suggest enhancements to moderated online health communities for their unique role to support patient care. PMID:24551364

  8. Patient moderator interaction in online health communities.

    PubMed

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

    2013-01-01

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

  9. Contributing to the Community: The Economic Significance of Academic Health Centers and Their Role in Neighborhood Development. Report IV. Report of the Task Force on Academic Health Centers.

    ERIC Educational Resources Information Center

    Commonwealth Fund, New York, NY.

    This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a…

  10. Development of a community sustainability visualization tool through integration of US EPA’s Sustainable and Health Community Research Program tasks

    EPA Science Inventory

    We propose a 2-day session combining multiple components of an ongoing integrative research program in USEPA’s Office of Research and Development into a functional community sustainability visualization and assessment tool. The working group will include project leads for a US H...

  11. Development of a community sustainability visualization tool through integration of US EPA’s Sustainable and Health Community Research Program tasks

    EPA Science Inventory

    We propose a 2-day session combining multiple components of an ongoing integrative research program in USEPA’s Office of Research and Development into a functional community sustainability visualization and assessment tool. The working group will include project leads for a US H...

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

    PubMed

    Tichy, N M; Taylor, J I

    1976-01-01

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

  13. 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…

  14. Ethnographic approach to community organization and health empowerment.

    PubMed

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

    1994-01-01

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

  15. Korea Community Health Survey Data Profiles.

    PubMed

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

    2015-06-01

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

  16. On the Development of a Framework to Improve the Environmental Health of Vulnerable Communities in North America

    EPA Pesticide Factsheets

    Overview of the development of a framework to build capacity among individuals throughout North America (with a particular focus on vulnerable populations) to make more informed decisions about how to protect their health from environmental contaminants.

  17. [Expanding the boundaries of clinics. Development of a community mental health program for children and teenagers from a rights perspective in the City of Buenos Aires].

    PubMed

    Barcala, Alejandra; Torricelli, Flavia

    2013-01-01

    There are forms of severe suffering in contemporary life that are not accommodated within the mechanisms offered by the mental health care system or that are not described on diagnostics handbooks, which need an appropriate response. This paper deals with the development of a community mental health program that provided care to children and teenagers with severe mental disorders and with a significant subjective suffering in the City of Buenos Aires from 2006 until the beginning of 2012. Pursuant to international standards in force in terms of mental health and human rights, this community, collective and territorial mental health practice suggested an inter-discipline and cross-sector approach that took into consideration the multi-dimension of social health determiners to provide comprehensive care. In order to offer a reply to fragmentation and the repeated traumas to which a large number of these children and teenagers have been exposed to, the program designed individual clinical-community strategies for each child or teenager, based on a network of continuous and reliable institutional supports. Conceived from a psychoanalytical approach, this praxis intended to benefit subjectification processes and the building of social bonds aiming at preventing the growing trends of administering medication and admitting children and teenagers as patients in mental health facilities.

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

    PubMed

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

    2016-10-20

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

  19. Using needs assessment to develop curricula for screening, brief intervention, and referral to treatment (SBIRT) in academic and community health settings.

    PubMed

    Satre, Derek D; McCance-Katz, Elinore F; Moreno-John, Gina; Julian, Katherine A; O'Sullivan, Patricia S; Satterfield, Jason M

    2012-01-01

    This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social service providers in a nearby suburban county (n = 21). Informed by curriculum development theory and motivational interviewing strategies, questions regarding clinical and educational priorities, perceived importance and confidence with screening and intervention techniques, and referral resource availability were included. Medical center faculty expressed greater concern about limited appointment time (P = .003), adequacy of training (P = .025), and provider confidence (P = .038) as implementation obstacles and had lower confidence in delivering SBIRT (P = .046) and providing treatment referrals (P = .054) than community providers. The authors describe their approach to integrating needs assessment results into subsequent curriculum development. Findings highlight potential differences between physician and nonphysician training needs.

  20. Using Needs Assessment to Develop Curricula for Screening, Brief Intervention and Referral to Treatment (SBIRT) in Academic and Community Health Settings

    PubMed Central

    Satre, Derek D.; McCance-Katz, Elinore F.; Moreno-John, Gina; Julian, Katherine A.; O’Sullivan, Patricia S.; Satterfield, Jason

    2016-01-01

    This article describes the use of a brief needs assessment survey in the development of Screening, Brief Intervention and Referral to Treatment (SBIRT) curricula in two health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n= 27) and non-physician community health and social service providers in a nearby suburban county (n= 21). Informed by curriculum development theory and motivational interviewing strategies, questions regarding clinical and educational priorities, perceived importance and confidence with screening and intervention techniques, and referral resource availability were included. Medical center faculty expressed greater concern about limited appointment time (p=.003), adequacy of training (p=.025) and provider confidence (p=.038) as implementation obstacles and had lower confidence in delivering SBIRT (p=.046) and providing treatment referrals (p=.054) than community providers. We describe our approach to integrating needs assessment results into subsequent curriculum development. Findings highlight potential differences between physician and non-physician training needs. PMID:22738009

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

    Corbin, David E.; Leach, Marilyn M.

    1985-01-01

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

  5. Communities of Practice as a Professional and Organizational Development Strategy in Local Public Health Organizations in Quebec, Canada: An Evaluation Model

    PubMed Central

    Richard, Lucie; Chiocchio, François; Essiembre, Hélène; Tremblay, Marie-Claude; Lamy, Geneviève; Champagne, François; Beaudet, Nicole

    2014-01-01

    Communities of practice (CoPs) are among the professional development strategies most widely used in such fields as management and education. Though the approach has elicited keen interest, knowledge pertaining to its conceptual underpinnings is still limited, thus hindering proper assessment of CoPs' effects and the processes generating the latter. To address this shortcoming, this paper presents a conceptual model that was developed to evaluate an initiative based on a CoP strategy: Health Promotion Laboratories are a professional development intervention that was implemented in local public health organizations in Montreal (Quebec, Canada). The model is based on latest theories on work-group effectiveness and organizational learning and can be usefully adopted by evaluators who are increasingly called upon to illuminate decision-making about CoPs. Ultimately, validation of this conceptual model will help advance knowledge and practice pertaining to CoPs as well as professional and organizational development strategies in public health. PMID:24726072

  6. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level.

    PubMed

    Weiss, Daniel; Lillefjell, Monica; Magnus, Eva

    2016-02-11

    Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various

  7. A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.

    PubMed

    Cordova, David; Bauermeister, Jose A; Fessler, Kathryn; Delva, Jorge; Nelson, Annabelle; Nurenberg, Rachel; Mendoza Lua, Frania; Alers-Rojas, Francheska; Salas-Wright, Christopher P

    2015-12-18

    Despite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care. The purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as "S4E"). A total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis. A total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician-adolescent HIV/STI and drug use communication

  8. Collaborative Community: Health Education Web Site

    ERIC Educational Resources Information Center

    McCabe, Setta

    2004-01-01

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

  9. [Development trends and future challenges in community nurse practitioner].

    PubMed

    Chen, Ching-Min

    2012-04-01

    Community health nursing is an innovative aspect of healthcare that has grown in response to changing environmental and social structure changes into a worldwide movement. Taiwan's fast growing elderly population, improving health technologies and rising healthcare costs impact significantly upon the development and definition of the scope of practice for community health nurse nurses. This paper explores the innovative community care model development experiences of several countries and reviews the scope of practice of community health nurse practitioners in each. We further explore the current situation of nurse practitioners in Taiwan and suggest a future path for Taiwan community health nurse practitioners development and policymaking.

  10. Military Mental Health First Aid: Development and Preliminary Efficacy of a Community Training for Improving Knowledge, Attitudes, and Helping Behaviors.

    PubMed

    Mohatt, Nathaniel Vincent; Boeckmann, Robert; Winkel, Nicola; Mohatt, Dennis F; Shore, Jay

    2017-01-01

    Persistent stigma, lack of knowledge about mental health, and negative attitudes toward treatment are among the most significant barriers to military service members and veterans seeking behavioral health care. With the high rates of untreated behavioral health needs among service members and veterans, identifying effective programs for reducing barriers to care is a national priority. This study adapted Mental Health First Aid (MHFA), an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing laypeople's confidence in helping and frequency of referring people in need, for military and veteran populations and pilot tested the adapted training program with 4 Army National Guard armories. A total of 176 community first responders (CFRs) participated in a comparative outcomes study, with 69 receiving the training and 107 participating in the control group. CFRs were individuals in natural positions within the Armory or home communities of Guard members to identify and help service members in mental health crisis. Surveys assessing confidence in helping, attitudes toward help seeking, knowledge of resources, use of MHFA practices, and stigma were completed before the training, immediately post-training, at 4 months post-training, and at 8 months post-training. Analyses included repeated measures analysis of variances on data from CFRs who received the training and mixed between-within subjects analysis of variances comparing the intervention and control group longitudinally at three time points. Institutional review board approval for this study was received from Montana State University and the U.S. Army Medical Department, Medical Research and Materiel Command, Human Research Protection Office. Significant and meaningful improvements in confidence (p < 0.05, η(2) = 0.49), knowledge (p < 0.05, η(2) = 0.39), behaviors (p < 0.05, η(2) = 0.27), and stigma (p < 0.05, η(2) = 0.16) were observed among trainees. When compared to a

  11. Community health education: reaching ethnically diverse elders.

    PubMed

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

    2006-01-01

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

  12. 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.

  13. Community factors supporting child mental Health.

    PubMed

    Earls, F

    2001-10-01

    discussion. The first conclusion suggests that research in child development generally, and child mental health specifically, does not incorporate the social ecology of the child is seriously flawed. There is a broad recognition within most sectors of society that the quality of civic engagement is of critical importance to community efforts to improve the health and well-being of children. This is true for all communities and families, regardless of their levels of material wealth and educational achievement. It is also well understood that poverty undermines the well-being and life chances of children. For this reason, the third conclusion requires that intensive, sustained efforts be made to eradicate poverty and reverse the current economic trend toward growing economic disparity. The implications of this knowledge for the practice of child psychiatry are not new ones. In many ways, they advocate for a re-examination of the historical roots of the field as it defined approaches to juvenile justice, school counseling, and early intellectual enrichment for economically disadvantaged preschool children. All these efforts were sensitive to children's social environment, and child psychiatrists viewed their success in taking on the challenges of changing schools, courts, and community and family environments. These challenges hardly have been overcome. The requirements of understanding and evaluating community supports for children are a fundamental component in the training and practice of child psychiatry. To quote the U.S. Surgeon General in a preamble to the recent Report on Child Mental Health: One way to ensure that our health system meets children's mental health needs is to move toward a community based health system that balances health promotion, disease prevention, early detection and universal access.

  14. 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.

  15. 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

  16. Micro-regional planning: evidence-based community buy-in for health development in five of Mexico’s poorest rural districts

    PubMed Central

    2011-01-01

    Background Community participation was a core tenet of Primary Health Care as articulated in the 1970s. How this could be generated and maintained was less clear. This historical article describes development of protocols for evidence-based community mobilisation in five local administrative units (municipios) in the Mexican state of Guerrero between 1992 and 1995. Methods A sample of five to eight sentinel sites represented each of the most impoverished municipalities of the poorest five of the state's seven regions. A 1992 baseline survey of diarrhoea and its actionable determinants provided the substrate for discussion with local planners and communities. Municipal planners used different strategies to promote participation. In one municipality, new health committees took control of water quality. In another, municipal authorities hired health promoters; a song promoted oral rehydration, and house-to-house interpersonal discussions promoted chlorination. In the poorest and most mountainous municipality, radio casera (home-made radio) soap operas used local "stars". In the largest and most disparate municipality, a child-to-family scheme relied on primary and secondary school teachers. The research team assessed outcomes at intervals and used the results to reinforce local planning and action. Results Diarrhoea rates declined in all five municipalities, and there were several positive intermediate outcomes from the communication strategies – changing knowledge, household practices and uptake of services. There was a strong link between specific contents of the communication package and the changing knowledge or practices. Conclusions Apart from these evidence-based interventions, other factors probably contributed to the decline of childhood diarrhoea. But, by monitoring implementation of planning decisions and the impact this has at community level, micro-regional planning can stimulate and reinforce actions likely to improve the health of communities. The

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

    SciTech Connect

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

    2011-07-15

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

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

    PubMed

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

    2017-10-01

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

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

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

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

  20. Lessons in Community Health Activism

    PubMed Central

    Maldonado, Linda

    2016-01-01

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

  1. Application of Intervention Mapping to develop a community-based health promotion pre-pregnancy intervention for adolescent girls in rural South Africa: Project Ntshembo (Hope)

    PubMed Central

    2014-01-01

    Background South Africa (SA) is undergoing multiple transitions with an increasing burden of non-communicable diseases and high levels of overweight and obesity in adolescent girls and women. Adolescence is key to addressing trans-generational risk and a window of opportunity to intervene and positively impact on individuals’ health trajectories into adulthood. Using Intervention Mapping (IM), this paper describes the development of the Ntshembo intervention, which is intended to improve the health and well-being of adolescent girls in order to limit the inter-generational transfer of risk of metabolic disease, in particular diabetes risk. Methods This paper describes the application of the first four steps of IM. Evidence is provided to support the selection of four key behavioural objectives: viz. to eat a healthy, balanced diet, increase physical activity, reduce sedentary behaviour, and promote reproductive health. Appropriate behaviour change techniques are suggested and a theoretical framework outlining components of relevant behaviour change theories is presented. It is proposed that the Ntshembo intervention will be community-based, including specialist adolescent community health workers who will deliver a complex intervention comprising of individual, peer, family and community mobilisation components. Conclusions The Ntshembo intervention is novel, both in SA and globally, as it is: (1) based on strong evidence, extensive formative work and best practice from evaluated interventions; (2) combines theory with evidence to inform intervention components; (3) includes multiple domains of influence (community through to the individual); (4) focuses on an at-risk target group; and (5) embeds within existing and planned health service priorities in SA. PMID:25080940

  2. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    PubMed

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  3. Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention.

    PubMed

    Steed, Liz; Sohanpal, Ratna; James, Wai-Yee; Rivas, Carol; Jumbe, Sandra; Chater, Angel; Todd, Adam; Edwards, Elizabeth; Macneil, Virginia; Macfarlane, Fraser; Greenhalgh, Trisha; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert

    2017-08-11

    To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. Phase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II: We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III: We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. Eight community pharmacies in three inner east London boroughs. 12 Stop Smoking Advisers. Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. UKCRN ID 18446, Pilot. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    PubMed Central

    Milio, N

    1996-01-01

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

  5. Community Development in Emergent Countries.

    ERIC Educational Resources Information Center

    Hodgdon, Linwood L.; And Others

    Part of a report of seminar proceedings, these papers on community development in developing nations deal largely with conditions, requirements, and effective principles of rural extension; the government system of community development village workers in outlying regions of Thailand; the methods, organization, accomplishments, and prospects of…

  6. Development of a composite outcome score for a complex intervention - measuring the impact of Community Health Workers.

    PubMed

    Watt, Hilary; Harris, Matthew; Noyes, Jane; Whitaker, Rhiannon; Hoare, Zoe; Edwards, Rhiannon Tudor; Haines, Andy

    2015-03-21

    In health services research, composite scores to measure changes in health-seeking behaviour and uptake of services do not exist. We describe the rationale and analytical considerations for a composite primary outcome for primary care research. We simulate its use in a large hypothetical population and use it to calculate sample sizes. We apply it within the context of a proposed cluster randomised controlled trial (RCT) of a Community Health Worker (CHW) intervention. We define the outcome as the proportion of the services (immunizations, screening tests, stop-smoking clinics) received by household members, of those that they were eligible to receive. First, we simulated a population household structure (by age and sex), based on household composition data from the 2011 England and Wales census. The ratio of eligible to received services was calculated for each simulated household based on published eligibility criteria and service uptake rates, and was used to calculate sample size scenarios for a cluster RCT of a CHW intervention. We assume varying intervention percentage effects and varying levels of clustering. Assuming no disease risk factor clustering at the household level, 11.7% of households in the hypothetical population of 20,000 households were eligible for no services, 26.4% for 1, 20.7% for 2, 15.3% for 3 and 25.8% for 4 or more. To demonstrate a small CHW intervention percentage effect (10% improvement in uptake of services out of those who would not otherwise have taken them up, and additionally assuming intra-class correlation of 0.01 between households served by different CHWs), around 4,000 households would be needed in each of the intervention and control arms. This equates to 40 CHWs (each servicing 100 households) needed in the intervention arm. If the CHWs were more effective (20%), then only 170 households would be needed in each of the intervention and control arms. This is a useful first step towards a process-centred composite score of

  7. Financing geriatric programs in community health centers.

    PubMed Central

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

    1991-01-01

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

  8. Social History, Mental Health, and Community Control

    ERIC Educational Resources Information Center

    Hersch, Charles

    1972-01-01

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

  9. [Impact analysis on the health management programs among community-based 0-36-month-olds on their growth and development].

    PubMed

    Yang, Huimin; Xiao, Feng; Yin, Delu; Li, Ruili; Xin, Qianqian; Zheng, Xiaoguo; Yin, Tao; Wang, Lihong; Cui, Mingming; Xu, Qi; Chen, Bowen

    2014-11-01

    To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development. 18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected. A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05). The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.

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

    PubMed

    Ahmed, Christine

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

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

    PubMed

    Al-Osaimi, Ali

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Katz, Arthur J., Ed.

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

  13. Development and application of a community sustainability visualization tool through integration of US EPA’s Sustainable and Health Community Research Program tasks

    EPA Science Inventory

    Maintaining a harmonious balance between economic, social, and environmental well-being is paramount to community sustainability. Communities need a practical/usable suite of measures to assess their current position on a "surface" of sustainability created from the interaction ...

  14. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

    PubMed

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

  15. A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process

    PubMed Central

    van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

    2015-01-01

    Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services. PMID:26346580

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

    PubMed

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

    2012-01-01

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

  17. Institutional racism and pregnancy health: using Home Mortgage Disclosure act data to develop an index for Mortgage discrimination at the community level.

    PubMed

    Mendez, Dara D; Hogan, Vijaya K; Culhane, Jennifer

    2011-01-01

    We used Home Mortgage Disclosure Act (HMDA) data to demonstrate a method for constructing a residential redlining index to measure institutional racism at the community level. We examined the application of the index to understand the social context of health inequities by applying the residential redlining index among a cohort of pregnant women in Philadelphia. We used HMDA data from 1999-2004 to create residential redlining indices for each census tract in Philadelphia County, Pennsylvania. We linked the redlining indices to data from a pregnancy cohort study and the 2000 Census. We spatially mapped the levels of redlining for each census tract for this pregnancy cohort and tested the association between residential redlining and other community-level measures of segregation and individual health. From 1999-2004, loan applicants in Philadelphia County, Pennsylvania, of black race/ethnicity were almost two times as likely to be denied a mortgage loan compared with applicants who were white (e.g., 1999 odds ratio [OR] = 2.00, 95% confidence interval [CI] 1.63, 2.28; and 2004 OR=2.26, 95% CI 1.98, 2.58). The majority (77.5%) of the pregnancy cohort resided in redlined neighborhoods, and there were significant differences in residence in redlined areas by race/ethnicity (p<0.001). Among the pregnancy cohort, redlining was associated with residential segregation as measured by the percentage of black population (r=0.155), dissimilarity (r=0.250), exposure (r=-0.115), and isolation (r=0.174) indices. The evidence of institutional racism may contribute to our understanding of health disparities. Residential redlining and mortgage discrimination against communities may be a major factor influencing neighborhood structure, composition, development, and wealth attainment. This residential redlining index as a measure for institutional racism can be applied in health research to understand the unique social and neighborhood contexts that contribute to health inequities.

  18. Institutional Racism and Pregnancy Health: Using Home Mortgage Disclosure Act Data to Develop an Index for Mortgage Discrimination at the Community Level

    PubMed Central

    Mendez, Dara D.; Hogan, Vijaya K.; Culhane, Jennifer

    2011-01-01

    Objectives We used Home Mortgage Disclosure Act (HMDA) data to demonstrate a method for constructing a residential redlining index to measure institutional racism at the community level. We examined the application of the index to understand the social context of health inequities by applying the residential redlining index among a cohort of pregnant women in Philadelphia. Methods We used HMDA data from 1999–2004 to create residential redlining indices for each census tract in Philadelphia County, Pennsylvania. We linked the redlining indices to data from a pregnancy cohort study and the 2000 Census. We spatially mapped the levels of redlining for each census tract for this pregnancy cohort and tested the association between residential redlining and other community-level measures of segregation and individual health. Results From 1999–2004, loan applicants in Philadelphia County, Pennsylvania, of black race/ethnicity were almost two times as likely to be denied a mortgage loan compared with applicants who were white (e.g., 1999 odds ratio [OR] = 2.00, 95% confidence interval [CI] 1.63, 2.28; and 2004 OR=2.26, 95% CI 1.98, 2.58). The majority (77.5%) of the pregnancy cohort resided in redlined neighborhoods, and there were significant differences in residence in redlined areas by race/ethnicity (p<0.001). Among the pregnancy cohort, redlining was associated with residential segregation as measured by the percentage of black population (r=0.155), dissimilarity (r=0.250), exposure (r=–0.115), and isolation (r=0.174) indices. Conclusions The evidence of institutional racism may contribute to our understanding of health disparities. Residential redlining and mortgage discrimination against communities may be a major factor influencing neighborhood structure, composition, development, and wealth attainment. This residential redlining index as a measure for institutional racism can be applied in health research to understand the unique social and neighborhood

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

    PubMed

    Carman, Angela L; McGladrey, Margaret L

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

  20. [Influence of comprehensive intervention composed of nutrition and exercise on the development of exercise habits and self-perceived health among community-dwelling elderly individuals].

    PubMed

    Takai, Itsushi

    2013-01-01

    The purpose of this study was to investigate the effects of comprehensive intervention on the development of exercise habits and self-perceived health among community-dwelling elderly individuals. A total of 44 elderly individuals (mean age: 71.1±5.0SD) who had provided consent to participate in the study were randomly allocated to either an intervention (n=23) or control group (n=21). The intervention group participated in a comprehensive intervention program (including nutrition classes, group exercise and enjoying meals with other community members). The following factors were measured: age, the frequency of going out, a history of falls, the frequency of exercise, the duration of exercise, self-efficacy for exercise, the stage model of change, self-perceived health before, immediately after and one month after the intervention. The attendance rate in the intervention group was over 90%. The intervention group exhibited significant improvements in the frequency of exercise (p=0.001), duration of exercise (p=0.02) and self-efficacy for exercise (p=0.012) compared with the control group following the intervention program. On follow-up, the intervention group demonstrated significant improvements in the frequency of exercise (p=0.027) and self-efficacy for exercise (p=0.043) compared with the control group. These findings suggested that a comprehensive intervention program composed of nutrition and exercise can improve the developing exercise habits and self-perceived health. Self-perceived health was improved by several factors, which appeears to have contributed to the results. These factors include sharing and exchanging ideas and having the opportunity to enjoy meals with other community members. Further activities promoting such interactions and exercise habits are therefore necessary.

  1. Fetal Health and Development

    MedlinePlus

    ... fetus grows and develops. There are specific prenatal tests to monitor both the mother's health and fetal health during each trimester. With modern technology, health professionals can Detect birth defects Identify problems ...

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

    PubMed

    Hendrate, L

    1981-01-01

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

  3. Global mental health reforms: Challenges in developing a community-based program for maltreated children and adolescents in Brazil.

    PubMed

    Scivoletto, Sandra; de Medeiros Filho, Mauro Vitor; Stefanovics, Elina; Rosenheck, Robert A

    2014-02-01

    This column describes the planning and development of The Equilibrium Program (TEP) for multiply traumatized and neglected children and adolescents with mental and general medical problems in São Paulo, Brazil. The program is a partnership between university faculty, various service providers, the courts, and the city government. In the first step, child psychiatry faculty from the University of São Paulo visited central-city areas and group shelters to talk to street youths to better understand their needs. A nearby community sports center building was chosen to be a center where youths could access services and engage in recreational activities and where the work of family integration could be facilitated. A multidisciplinary team conducts an in-depth assessment and creates an intervention plan, overseen by a case manager. Challenges to implementing such programs are discussed.

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

    PubMed

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

    1997-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    1998-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

    Quillian, J P

    1993-01-01

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

  9. Observational study on factors related to health-promoting community activity development in primary care (frAC Project): a study protocol

    PubMed Central

    Ripoll, Joana; Ruiz-Giménez, Juan Luís; Montaner Gomis, Isabel; Benedé Azagra, Carmen Belén; Elizalde Soto, Lázaro; Vidal, Mª Clara; Bauzà Amengual, M de Lluc; Planas Juan, Trinidad; Maria Pérez Mariano, Damiana; Llull Sarralde, Micaela; Bajo Viñas, Rosa; Jordan Martin, Matilde; Solano Villarubia, Carmen; Rodriguez Bajo, Maria; Cordoba Victoria, Manuela; Badia Capdevila, Marta; Serrano Ferrandez, Elena; Bosom Diumenjo, Maria; Zabaleta del Olmo, Nieves; Bolívar-Ribas, Bonaventura; Antoñanzas Lombarte, Angel; Bregel Cotaina, Samantha; Calvo Tocado, Ana; Olivan Blázquez, Barbara; Magallón Botaya, Rosa; Marín Palacios, Pilar; Echauri Ozcoidi, Margarita; Perez-Jarauta, Mª Jose; Ramos, Maria

    2012-01-01

    Introduction According to Spanish health regulations, primary care professionals have the responsibility to carry out health-promoting community activities (CAs). However, in practice, their implementation is not as widespread as it should be. The aims of this study were to identify factors within the team, the community and the professionals that influence the development of these activities and to describe the community interventions in progress. Methods and analysis This study is an observational analytical retrospective study. The information will be collected from five Spanish regions: Catalonia, Madrid, the Balearic Islands, Navarra and Aragón. The authors will contact primary care teams (PCTs) and identify the CAs from the previous year. The research team will conduct a peer review whether the inclusion criteria are met. In the health centres where CAs are implemented, the authors will select professionals carrying them out and randomly select an identical number of professionals not doing these activities. In the centres where no CA is implemented, three professionals will be randomly selected. The selected professionals will complete the questionnaires for individual-level variables. Information about the registered population and the PCTs will be collected through questionnaires and secondary sources. Outcomes Variables will be collected from the community, the PCTs, the individual professionals and CAs. Analysis A descriptive analysis of all the variables will be carried out, along with a bivariate and a logistic regression analysis, with CAs being the primary outcome. Ethics and dissemination This study has been approved by the Research Ethics Committee of the Jordi Gol y Gurina Foundation in Barcelona and area 11 in Madrid. The questionnaire distributed to the professionals will be anonymous. PMID:22586288

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

    PubMed

    White, Mike

    2006-05-01

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

  11. Constraints perceived by psychiatrists working in community mental health services. Development and pilot study of a novel instrument.

    PubMed

    Galeazzi, Gian Maria; Mackinnon, Andrew; Curci, Paolo

    2007-12-01

    An inventory of institutional constraints perceived as limiting therapeutic choices was developed and completed by psychiatrists working in Italian public mental health services. Constraints considered most limiting were social and institutional pressures toward social control, violence risk assessment and prevention, and lack of control over workload. The total mean score of the perceived constraints instrument was significantly negatively correlated with ratings of perceived freedom in therapeutic choices and with overall job satisfaction. Reliability was good (alpha = 0.85). Addressing perceived constraints may result in more choice options to reach therapeutic goals in a collaborative framework with patients, and improve job satisfaction.

  12. Development of Young Adults Eating and Active for Health (YEAH) internet-based intervention via a community-based participatory research model.

    PubMed

    Kattelmann, Kendra K; White, Adrienne A; Greene, Geoffrey W; Byrd-Bredbenner, Carol; Hoerr, Sharon L; Horacek, Tanya M; Kidd, Tandalayo; Colby, Sarah; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa; Shelnutt, Karla P; Morrell, Jesse Stabile

    2014-01-01

    To develop a tailored, theory-based, Web-delivered intervention to prevent excessive weight gain in young adults using a Community-Based Participatory Research model. Investigators from 14 universities developed the intervention and supporting administrative portal using the 4 phases of the PRECEDE model. Steering committees were composed of the target audience (aged 19-24 years) and key health/wellness personnel were formed at each institution and provided information during each phase that was used to guide development of the intervention, Project YEAH (Young Adults Eating and Active for Health). Piloting results were used to refine the curriculum and identify and avoid barriers to delivery. Qualitative and quantitative data collected at each phase informed Project YEAH development. In Phase 1, factors of highest priority to young adults were identified. In Phase 2, environmental supports for healthful lifestyles were elucidated. In Phase 3, behavior and environmental changes considered important and changeable were identified. In Phase 4, the 10-week, theory-based, stage-tailored, interactive-learning intervention with a 10-month reinforcement period was developed. Applying the PRECEDE model with fidelity during development of Project YEAH resulted in an intervention that pilot participants found relevant and useful, gained attention, instilled confidence in the ability to apply the information, and provided a sense of satisfaction. Copyright © 2014. Published by Elsevier Inc.

  13. Community Health Nursing through a Global Lens.

    PubMed

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia

    2015-01-01

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

  14. 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

  15. Considering place in community health nursing.

    PubMed

    Bender, Amy; Clune, Laurie; Guruge, Sepali

    2007-09-01

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

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

    PubMed Central

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

    2013-01-01

    An emerging best practice of addressing health and improving health disparities in communities is ensuring that academic health centers (AHCs) are engaged with area schools, primary care practices, and community advocates as equal partners in research, services, and programs. The literature documents the importance of ensuring that academic-community collaboration is based on equity, trust, and respect, and that there is capacity (time and resources) and a shared culture (language, skills, and applied knowledge) for accomplishing mutual goals in academic-community research partnerships. It is also essential that an academic-community collaboration results in tangible and measurable goals and outcomes for both the target community and the AHC. Currently, the models for implementing best practices in community health partnerships, especially training programs, are limited. This paper article summarizes the goals and outcomes for the Community Leaders Institute (CLI), a six-week innovative leadership development training program designed to enhance academic-community research, integrate the interests of community leaders and AHC researchers, and build research capacity and competencies within the community. Based on two years of outcome data, the CLI is achieving its intended goals of engaging faculty as trainer-scholars while promoting academic-community partnerships that align with community and AHC priorities. The training and collaborative research paradigm utilized by the CLI has served to accelerate AHC-community engagement and integration efforts, as CLI graduates are now serving on AHC steering, bioethics, and other committees. PMID:23348087

  17. 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.

  18. Managerial support of community mental health nurses.

    PubMed

    Funakoshi, Akiko; Miyamoto, Yuki; Kayama, Mami

    2007-05-01

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

  19. Promoting Community Health Resources: Preferred Communication Strategies

    USDA-ARS?s Scientific Manuscript database

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

  20. Environmental and community health: a reciprocal relationship

    Treesearch

    Jeffery Sugarman

    2009-01-01

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

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

    PubMed

    Siegel, Wilma Bulkin; Bartley, Mary Anne

    2004-01-01

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

  2. Function Model for Community Health Service Information

    NASA Astrophysics Data System (ADS)

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

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

  3. 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.

  4. A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study

    PubMed Central

    Bauermeister, Jose A; Fessler, Kathryn; Delva, Jorge; Nelson, Annabelle; Nurenberg, Rachel; Mendoza Lua, Frania; Alers-Rojas, Francheska; Salas-Wright, Christopher P

    2015-01-01

    Background Despite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care. Objectives The purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as “S4E”). Methods A total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis. Results A total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician

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

    PubMed

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

    2017-04-08

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

  6. Sustainable Development: The Challenge for Community Development.

    ERIC Educational Resources Information Center

    Gamble, Dorothy N.; Weil, Marie O.

    1997-01-01

    Five areas of inquiry shape the sustainable development movement: environmental movement, women's movement, overpopulation concerns, critique of development models, and new indicators of social progress. Community development workers are challenged to prepare local development projects within a sustainable development framework. (SK)

  7. Sustainable Development: The Challenge for Community Development.

    ERIC Educational Resources Information Center

    Gamble, Dorothy N.; Weil, Marie O.

    1997-01-01

    Five areas of inquiry shape the sustainable development movement: environmental movement, women's movement, overpopulation concerns, critique of development models, and new indicators of social progress. Community development workers are challenged to prepare local development projects within a sustainable development framework. (SK)

  8. Faculty development for community practitioners.

    PubMed

    DeWitt, T G

    1996-12-01

    Developing the academic skills of the individuals who will serve as educators and role models in the community is critical to pediatric resident education in community settings. The main focus of any faculty development program must be on teaching, although for a subset of individuals, the development of research skills should also be a consideration. The three key elements that must be considered for an effective faculty development program include: (1) creating a culture of mutual respect between full-time and community faculty; (2) basing the program on sound principles of education theory, especially adult learning theory, using appropriately trained faculty; and (3) establishing ongoing institutional financial and philosophical support. Effectively addressing these elements should create a faculty development program that will help the community practitioner become an effective role model and practitioner- preceptor-educator.

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

    PubMed

    Menon, Sanjay T

    2002-01-01

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

  10. The Challenge of Ghetto Community Mental Health.

    ERIC Educational Resources Information Center

    Mullan, Hugh

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

  11. Ohio Valley Community Health Information Network.

    ERIC Educational Resources Information Center

    Guard, Roger; And Others

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

  12. Communities of practice as a professional and organizational development strategy in local public health organizations in Quebec, Canada: an evaluation model.

    PubMed

    Richard, Lucie; Chiocchio, François; Essiembre, Hélène; Tremblay, Marie-Claude; Lamy, Geneviève; Champagne, François; Beaudet, Nicole

    2014-02-01

    Communities of practice (CoPs) are among the professional development strategies most widely used in such fields as management and education. Though the approach has elicited keen interest, knowledge pertaining to its conceptual underpinnings is still limited, thus hindering proper assessment of CoPs' effects and the processes generating the latter. To address this shortcoming, this paper presents a conceptual model that was developed to evaluate an initiative based on a CoP strategy: Health Promotion Laboratories are a professional development intervention that was implemented in local public health organizations in Montreal (Quebec, Canada). The model is based on latest theories on work-group effectiveness and organizational learning and can be usefully adopted by evaluators who are increasingly called upon to illuminate decision-making about CoPs. Ultimately, validation of this conceptual model will help advance knowledge and practice pertaining to CoPs as well as professional and organizational development strategies in public health. Copyright © 2014 Longwoods Publishing.

  13. 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.

  14. Community nutrition programmes, globalization and sustainable development.

    PubMed

    Suárez-Herrera, José Carlos

    2006-08-01

    On an international scale, the last seventy-five years have been a period of deep social, economic and political transformation for the developing countries. They have been especially influenced by the international phenomenon of globalization, the benefits of which have been unequally distributed among countries. In this context, the strategies used to improve the general nutritional health of the population of developing countries include broad approaches integrating nutritional interventions in a context of sustainable community development, while valuing the existing relations between fields as diverse as agriculture, education, sociology, economy, health, environment, hygiene and nutrition. The community nutrition programmes are emblematic of these initiatives. Nevertheless, in spite of the increasing evidence of the potential possibilities offered by these programmes to improve the nutritional status and contribute to the development and the self-sufficiency of the community, their success is relatively limited, due to the inappropriate planning, implementation and evaluation of the programmes. In the present article, I attempt to emphasie the importance of community participation of the population of developing countries in the community nutrition programmes within the context of globalization. This process is not only an ethical imperative, but a pragmatic one. It is a crucial step in the process of liberation, democratization and equality that will lead to true sustainable development.

  15. Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams: a mixed-methods approach.

    PubMed

    El Ansari, Walid; Lyubovnikova, Joanne; Middleton, Hugh; Dawson, Jeremy F; Naylor, Paul B; West, Michael A

    2016-05-01

    Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

  16. A Community-based Participatory Research Approach to the Development of a Peer Navigator Health Promotion Intervention for People with Spinal Cord Injury

    PubMed Central

    Newman, Susan D.; Gillenwater, Gwen; Toatley, Sherwood; Rodgers, Marka D.; Todd, Nathan; Epperly, Diane; Andrews, Jeannette O.

    2014-01-01

    Background Recent trends indicate research targeting outcomes of importance to people with disabilities, such as spinal cord injury (SCI), may be best informed by those individuals; however, there are very few published rehabilitation intervention studies that include people with disabilities in the research process in a role beyond study participant. Objective To describe a community-based participatory research (CBPR) approach to the development and pilot testing of an intervention using community-based Peer Navigators with SCI to provide health education to individuals with SCI, with the goal of reducing preventable secondary conditions and rehospitalizations, and improving community participation. Methods A CBPR framework guides the research partnership between academic researchers and a community-based team of individuals who either have SCI or provide SCI-related services. Using this framework, the processes of our research partnership supporting the current study are described including: partnership formation, problem identification, intervention development, and pilot testing of the intervention. Challenges associated with CBPR are identified. Results Using CBPR, the SCI Peer Navigator intervention addresses the partnership’s priority issues identified in the formative studies. Utilization of the framework and integration of CBPR principles into all phases of research have promoted sustainability of the partnership. Recognition of and proactive planning for challenges that are commonly encountered in CBPR, such as sharing power and limited resources, has helped sustain our partnership. Conclusions The CBPR framework provides a guide for inclusion of individuals with SCI as research partners in the development, implementation, and evaluation of interventions intended to improve outcomes after SCI. PMID:25224988

  17. Community Defined Health: Thinking from the Inside Out.

    ERIC Educational Resources Information Center

    Blecke, Janalou; Hadden, Lisa

    2000-01-01

    Describes the "Community Defined Health" (trademark) process developed by the Center for Health Professions, Saginaw, Michigan, to capture caring, citizen engagement, and the quality of relationships and assure that these intangible assets become as valuable as institutionally defined health indicators in curricula for the health…

  18. Community Defined Health: Thinking from the Inside Out.

    ERIC Educational Resources Information Center

    Blecke, Janalou; Hadden, Lisa

    2000-01-01

    Describes the "Community Defined Health" (trademark) process developed by the Center for Health Professions, Saginaw, Michigan, to capture caring, citizen engagement, and the quality of relationships and assure that these intangible assets become as valuable as institutionally defined health indicators in curricula for the health…

  19. 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.

  20. Evolution of an Aggregate-Based Community Health Curriculum.

    ERIC Educational Resources Information Center

    Segall, Mary; McKay, Rose

    1984-01-01

    Discusses the graduate program in community health nursing at the University of Colorado that is structured according to the aggregate/family and group model. Describes the development of the program and its evaluation. (JOW)

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

    PubMed

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

    2017-01-01

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

  2. Technology and Community Development.

    ERIC Educational Resources Information Center

    DeVore, Paul W.

    1984-01-01

    Alternative technical systems are needed that can be designed, developed, operated, and controlled at the local level. Technology education can provide the knowledge and skills needed to educate citizens. This effort would strengthen basic democratic processes and would develop new sources of energy to sustain a stable technology. (JB)

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

    PubMed

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

    2007-04-01

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

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

    PubMed

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

    2014-04-01

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

  5. Weaving Clinical Expertise in Online Health Communities.

    PubMed

    Huh, Jina; Pratt, Wanda

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

  6. Facilitating Health Data Sharing Across Diverse Practices and Communities

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  8. Community Health Records: Establishing a Systematic Approach to Improving Social and Physical Determinants of Health

    PubMed Central

    2017-01-01

    To systematically improve population health in the United States, community health records (CHRs) must be defined, developed, and implemented. Like electronic and personal health records, CHRs have both unique and overlapping information. CHRs contain data about communities, including the social, physical, and lifestyle determinants of health. These records will serve to complement electronic and personal health records to provide a more complete view of population health, allowing stakeholders to target community health and quality-of-life interventions in a data-driven and evidence-based manner, establishing the basis from which organizations can develop a systematic approach to improving community health. This commentary calls on the United States to conduct a set of consensus activities to define and implement CHRs. PMID:28103072

  9. Community Health Records: Establishing a Systematic Approach to Improving Social and Physical Determinants of Health.

    PubMed

    Van Brunt, Deryk

    2017-03-01

    To systematically improve population health in the United States, community health records (CHRs) must be defined, developed, and implemented. Like electronic and personal health records, CHRs have both unique and overlapping information. CHRs contain data about communities, including the social, physical, and lifestyle determinants of health. These records will serve to complement electronic and personal health records to provide a more complete view of population health, allowing stakeholders to target community health and quality-of-life interventions in a data-driven and evidence-based manner, establishing the basis from which organizations can develop a systematic approach to improving community health. This commentary calls on the United States to conduct a set of consensus activities to define and implement CHRs.

  10. 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.

  11. Developing Health Education Programs in Rural Areas.

    ERIC Educational Resources Information Center

    Colle, Royal D.

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

  12. Health Educators and Community Health Workers

    MedlinePlus

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

  13. The value of community-focused interprofessional care in peru for developing cultural competency in health professions students.

    PubMed

    Allen, Carol B; Smart, Denise A; Odom-Maryon, Tamara; Swain, Deborah

    2013-07-04

    International immersion experiences for health-care students have increased over the past 10 years. Students and faculty expect these experiences to increase cultural competency; however, research on outcomes of these programs has lacked rigor. Over a 4-year period, groups of nursing and other health professions students spent 3 weeks in Peru providing primary care and health education. Students attended pre-departure seminars addressing personal travel health and safety, culture and health care in Peru, working with interpreters, and ethics of international health care. Student participants (N=77) completed an instrument assessing self-perceived cultural competency before and after the experience. Results of pre- and post-immersion scores showed significant increases in perceived cultural competency and increased self-efficacy in cultural knowledge, skills, and attitudes for four groups of students. Implications and future directions are discussed and recommended.

  14. Improvement of dietary oil consumption following a community trial in a developing country: The role of translational research in health promotion.

    PubMed

    Mohammadifard, Noushin; Toghianifar, Nafiseh; Sajjadi, Firoozeh; Alikhasi, Hassan; Kelishadi, Roya; Maghroun, Maryam; Esmaeili, Mostafa; Ehteshami, Shahram; Tabaie, Hamzeh; Sarrafzadegan, Nizal

    2013-01-01

    This study aimed to determine the effects of the interventions of Isfahan Healthy Heart Program (IHHP) on the type of oil consumed at the population level. It also tried to assess how this strategy has been effective as a health policy. The IHHP, a six-year community intervention program (2001-07), aimed at health promotion through the modification of cardiovascular disease risk factors. It was performed in Isfahan and Najafabad counties (intervention area) and Arak county (reference area), all in central Iran. This study targeted the whole population of over 2,000,000 in the intervention area. The findings of annual independent sample surveys were compared with the reference area. Dietary interventions were performed as educational, environmental, and/or legislative strategies. From 2001 to 2007, the mean of changes for hydrogenated oil consumption was -3.2 and -3.6, and for liquid oil it was 3.6 and 2.8 times per week in the intervention and reference areas, respectively (P < 0.001). According to Commerce office record, the increase in liquid oil distribution during 2000-2007 was significantly higher in Isfahan than Arak (34% vs. 25%). The effects of the simple, comprehensive, and integrated action-oriented interventions of our program could influence policy making and its results at the community level. It can be adopted by other developing countries.

  15. Improvement of dietary oil consumption following a community trial in a developing country: The role of translational research in health promotion

    PubMed Central

    Mohammadifard, Noushin; Toghianifar, Nafiseh; Sajjadi, Firoozeh; Alikhasi, Hassan; Kelishadi, Roya; Maghroun, Maryam; Esmaeili, Mostafa; Ehteshami, Shahram; Tabaie, Hamzeh; Sarrafzadegan, Nizal

    2013-01-01

    BACKGROUND This study aimed to determine the effects of the interventions of Isfahan Healthy Heart Program (IHHP) on the type of oil consumed at the population level. It also tried to assess how this strategy has been effective as a health policy. METHODS The IHHP, a six-year community intervention program (2001-07), aimed at health promotion through the modification of cardiovascular disease risk factors. It was performed in Isfahan and Najafabad counties (intervention area) and Arak county (reference area), all in central Iran. This study targeted the whole population of over 2,000,000 in the intervention area. The findings of annual independent sample surveys were compared with the reference area. Dietary interventions were performed as educational, environmental, and/or legislative strategies. RESULTS From 2001 to 2007, the mean of changes for hydrogenated oil consumption was -3.2 and -3.6, and for liquid oil it was 3.6 and 2.8 times per week in the intervention and reference areas, respectively (P < 0.001). According to Commerce office record, the increase in liquid oil distribution during 2000-2007 was significantly higher in Isfahan than Arak (34% vs. 25%). CONCLUSION The effects of the simple, comprehensive, and integrated action-oriented interventions of our program could influence policy making and its results at the community level. It can be adopted by other developing countries. PMID:23696757

  16. Effective Regional Community Development

    ERIC Educational Resources Information Center

    Nesbitt, Rebecca; Merkowitz, Rose Fisher

    2014-01-01

    Times are changing, and so are Extension programs. These changes affect every aspect of the educational effort, including program development, project funding, educational delivery, partnership building, marketing, sharing impacts, and revenue generation. This article is not about how Extension is restructuring to adapt to changes; instead, it…

  17. Effective Regional Community Development

    ERIC Educational Resources Information Center

    Nesbitt, Rebecca; Merkowitz, Rose Fisher

    2014-01-01

    Times are changing, and so are Extension programs. These changes affect every aspect of the educational effort, including program development, project funding, educational delivery, partnership building, marketing, sharing impacts, and revenue generation. This article is not about how Extension is restructuring to adapt to changes; instead, it…

  18. 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…

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

    PubMed

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

    2012-01-01

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

  20. The reach and rationale for community health fairs

    PubMed Central

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

    2013-01-01

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

  1. Educating patients at home. Community Health Rap.

    PubMed

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

    1996-10-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-11-07

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

  4. Literacy Practitioner. Literacy and Community Development Issue.

    ERIC Educational Resources Information Center

    Literacy Practitioner, 1997

    1997-01-01

    This theme issue of a newsletter for adult literacy practitioners focuses on community development. Nine articles on this topic include the following: "Adult Literacy and Community Development" (Hal Beder); "Why Community Development?" (Kirk Baker); "Freire's Revolution" (Ruth Pelz); "Impacting Communities…

  5. Developing a culturally appropriate preconception health promotion strategy for newly immigrated Latinos through a community-based program in South Carolina.

    PubMed

    Torres, Myriam E; Smithwick-Leone, Julie; Willms, Lucy; Franco, Margarita M; McCandless, Romina; Lohman, Mary

    2013-01-01

    Maternal and Child Health (MCH) experts emphasize the importance of preconception health (PCH) in achieving healthy pregnancies and positive birth outcomes. Research demonstrates that Latinas face significant PCH disparities, yet no comprehensive PCH promotion strategy exists to reach them. As a trusted community-based organization that uses culturally competent strategies to promote MCH in the Latino community, PASOs is well-positioned to address PCH among Latinos in South Carolina. With the input and support of Latino community members, PASOs is pioneering a PCH strategy using its successful model of education, outreach, partnerships and resource navigation.

  6. Developing a scholarship community.

    PubMed

    Cumbie, Sharon; Weinert, Clarann; Luparell, Susan; Conley, Virginia; Smith, James

    2005-01-01

    To report the results of a multidisciplinary, interinstitutional writing support group established to facilitate faculty scholarly productivity. ORGANIZING CONCEPT: The road to scholarship can be filled with many obstacles, among them time constraints, teaching and meeting demands, student needs, office interruptions, and lack of colleagueship. The problems associated with lack of colleagueship, in particular, can be compounded for faculty who work in isolated contexts with few, if any, senior faculty to serve as mentors. METHODS OF DEVELOPMENT: The Western Writers Coercion Group evolved over a 2-year period from a small group of nursing faculty at a single institution to include, by its second year, 21 faculty from five western university campuses and three academic disciplines. The group met biweekly via teleconference with the objectives of defining and accomplishing realistic individual scholarship goals and providing a forum for the critical exchange of ideas. The ongoing support and mentoring of the group led to significant writing outcomes in the form of manuscripts submitted for publication, abstracts submitted for conference presentation, grant proposals developed, and collegial relationships formed. Although the benefits of group participation varied somewhat for faculty at different points in the career trajectory, they seemed to accrue at all levels of development. Group members underscored the many less quantifiable advantages of group participation: exposure to broader professional perspectives, the formation of key professional relationships, the enrichment of multidisciplinary input, and individualized assistance with time management, goal setting, and actual drafts. The structure and experience of this group, which continues to meet regularly, might be a model to guide other groups of scholars who face geographic isolation and who struggle with balancing time and work and finding motivation for the process of writing.

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

    PubMed

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

    2006-03-01

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

  8. The Wellness Mobile: Bringing Preventative Health Services to Rural Communities.

    ERIC Educational Resources Information Center

    Nilson, Ralph; And Others

    1996-01-01

    The Wellness Mobile transports medical supplies, equipment, informational materials, and staff to rural Saskatchewan communities to assist them in developing wellness programs that stress disease prevention. Staff from the Wellness Mobile offer health-risk screening and appraisal to community members and work with local practitioners and schools…

  9. The Wellness Mobile: Bringing Preventative Health Services to Rural Communities.

    ERIC Educational Resources Information Center

    Nilson, Ralph; And Others

    1996-01-01

    The Wellness Mobile transports medical supplies, equipment, informational materials, and staff to rural Saskatchewan communities to assist them in developing wellness programs that stress disease prevention. Staff from the Wellness Mobile offer health-risk screening and appraisal to community members and work with local practitioners and schools…

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

    PubMed

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

    2001-02-01

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

  11. The future of community health trusts.

    PubMed

    Browning, R

    1996-02-01

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

  12. The Volunteer Health Advisor Program of Cambridge Health Alliance: "A Bridge Between the Community and the Health Care System" Cambridge, Massachusetts

    ERIC Educational Resources Information Center

    Perspectives in Peer Programs, 2005

    2005-01-01

    Cambridge Health Alliance's Volunteer Health Advisor (VHA) Program was developed to create an effective and cost efficient outreach network to improve community health status. The program's mission is to improve community health by working collaboratively with faith-based and community-based organizations to recruit, train, and support a…

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

    PubMed

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

    2009-01-01

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

  14. 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.

  15. Improving population health: the business community imperative.

    PubMed

    Webber, Andrew; Mercure, Suzanne

    2010-11-01

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

  16. 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

  17. Developing consumer-directed care for people with a disability: 10 lessons for user participation in health and community care policy and program development.

    PubMed

    Ottmann, Goetz F; Laragy, Carmel

    2010-11-01

    This paper outlines 10 lessons derived from the development of a consumer-directed care program for families with disabled children in Melbourne, Australia. The following program elements proved to be of importance over the course of the development process: (1) research participants should be involved as early as possible; (2) an open, inclusive communication style in conjunction with a good understanding of potential concerns and a careful framing of the policy issue is required to build trust and allow meaningful collaboration; (3) various strands of evidence have to be woven together; (4) ongoing commitment and support from management and key stakeholders; (5) effective knowledge transfer and cultural change processes; (6) capacity building; (7) mediation of power differentials; (8) community building; (9) participant re-engagement strategies; and (10) solid project management skills.

  18. Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

    PubMed

    Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars

    2015-08-15

    The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow

  19. Community-Based Participatory Research for Improved Mental Health

    PubMed Central

    Smikowski, Jane; Dewane, Sarah; Johnson, Mark E.; Brems, Christiane; Bruss, Catherine; Roberts, Laura W.

    2009-01-01

    Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This paper describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage increased participation by special populations, and narrow the parity gap in effective mental health treatment and services delivery. PMID:20186257

  20. Asthma - Improving Health in Communities and Schools

    EPA Pesticide Factsheets

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

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

    PubMed Central

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

    2001-01-01

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

  2. Development of the Community Midwifery Education initiative and its influence on women’s health and empowerment in Afghanistan: a case study

    PubMed Central

    2014-01-01

    Background Political transition in Afghanistan enabled reconstruction of the destroyed health system. Maternal health was prioritised due to political will and historically high mortality. However, severe shortages of skilled birth attendants - particularly in rural areas - hampered safe motherhood initiatives. The Community Midwifery Education (CME) programme began training rural midwives in 2002, scaling-up nationally in 2005. Methods This case study analyses CME development and implementation to help determine successes and challenges. Data were collected through documentary review and key informant interviews. Content analysis was informed by Walt and Gilson’s policy triangle framework. Results The CME programme has contributed to consistently positive indicators, including up to a 1273/100,000 reduction in maternal mortality ratios, up to a 28% increase in skilled deliveries, and a six-fold increase in qualified midwives since 2002. Begun as a small pilot, CME has gained support of international donors, the Afghan government, and civil society. Conclusion CME is considered by stakeholders to be a positive model for promoting women’s education, employment, and health. However, its future is threatened by insecurity, corruption, lack of regulation, and funding uncertainties. Strategic planning and resource mobilisation are required for it to achieve its potential of transforming maternal healthcare in Afghanistan. PMID:25220577

  3. The effect of water supply, handling and usage on water quality in relation to health indices in a developing community in South Africa.

    PubMed

    Genthe, B; Strauss, N; Vundule, C; Maforah, F; Seager, J

    1995-09-01

    This study examined the relationship between the quality of water consumed by people in a developing community in South Africa, and health outcomes for diarrhea. Water sources included no formal water supply, communal taps used by over 100 people, outdoor taps on individual plots, and indoor taps. The aim of this 3-year study was to determine water quality at point of collection, to examine patterns of water usage, and to determine the health consequences. This was a case control study and epidemiological assessment. The sample included over 300 households. Cases included pre-school children with severe diarrhea who visited a health facility in the study area. Interviews were conducted to determine hygiene, sanitation, education, and socioeconomic information. Controls of similar age and type of water supply were obtained from neighborhoods in the study area. Findings indicate that water, based on microbiological assay, was of good quality and complied with the South African Bureau of Standards. Water was significantly more contaminated after handling and storage compared to point of source. Cases and controls had equally poor water quality after collection and storage. Control indoor cases had higher levels of E. coli. There was a strong association between diarrhea and the attendance at a day care center. Increased risk of diarrhea was associated with poor kitchen hygiene and low levels of knowledge about hygiene and diarrhea prevention. Communal tap facilities had lower water quality than private taps.

  4. Mothers' Community Participation and Child Health

    ERIC Educational Resources Information Center

    Nobles, Jenna; Frankenberg, Elizabeth

    2009-01-01

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

  5. INTERIM REPORT, DEVELOP A COMMUNITY INVOLVEMENT STRATEGY: PREPARE TO IMPLEMENT A COHORT STUDY OF CHILDREN'S ENVIRONMENTAL HEALTH

    EPA Science Inventory

    Introduction

    The National Children's Study (NCS) is an ambitious undertaking: a 20-year prospective cohort

    study that will investigate the relationships between a broad range of environmental factors and the health

    and well-being of children. Approximately 10...

  6. INTERIM REPORT, DEVELOP A COMMUNITY INVOLVEMENT STRATEGY: PREPARE TO IMPLEMENT A COHORT STUDY OF CHILDREN'S ENVIRONMENTAL HEALTH

    EPA Science Inventory

    Introduction

    The National Children's Study (NCS) is an ambitious undertaking: a 20-year prospective cohort

    study that will investigate the relationships between a broad range of environmental factors and the health

    and well-being of children. Approximately 10...

  7. NIMH Prototype Management Information System for Community Mental Health Centers

    PubMed Central

    Wurster, Cecil R.; Goodman, John D.

    1980-01-01

    Various approaches to centralized support of computer applications in health care are described. The NIMH project to develop a prototype Management Information System (MIS) for community mental health centers is presented and discussed as a centralized development of an automated data processing system for multiple user organizations. The NIMH program is summarized, the prototype MIS is characterized, and steps taken to provide for the differing needs of the mental health centers are highlighted.

  8. Development of an in situ mammalian biomonitor to assess the effect of environmental contaminants on population and community health

    SciTech Connect

    McMurray, S.T.

    1993-01-01

    The influence of environmental contaminants (e.g., lead, benzene, organic hydrocarbons) on immune function of laboratory and field cotton rats (Sigmodon hispidus) and population and community dynamics of small mammals residing on an oil refinery were studied. Cellular immune function in benzene and lead exposed cotton rats were assessed to determine the sensitivity of immune function as a potential biomarker of toxicant exposure. Additionally, cellular immune function, population density, reproduction, recruitment, and survival were assessed for wild cotton rats collected from an abandoned oil refinery to field test the utility of cotton rats as an in situ bioindicator. Cellular immune function in juvenile and adult cotton rats was sensitive to the immunosuppressive effects of lead and benzene. However, benzene-induced immunosuppression was marginal presumably due to the ability of cotton rats to quickly metabolize the compound and recover from the toxic effects. Wild cotton rats collected on the refinery also demonstrated sensitivity in immune function to the complex mixtures of contaminants found on site. Lymphoproliferative responses of splenocytes was the most consistent indicator toxicant exposure. Population parameters of cotton rats indicated marked depression in density, recruitment, and survival. Results also indicated a shift in community structure due to large numbers of house mice (Mus musculus) on toxic sites. Immune function and population parameters appear to be good prospects in situ bioindicators of environmental contamination.

  9. Diabetes Training for Community Health Workers

    PubMed Central

    Aponte, Judith

    2016-01-01

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

  10. [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.

  11. Sexual health needs and the LGBT community.

    PubMed

    Campbell, Sue

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

  12. Urban Problems and Community Development.

    ERIC Educational Resources Information Center

    Ferguson, Ronald F., Ed.; Dickens, William T., Ed.

    The essays in this collection promote a conception of community development that entails building practical capacities to improve the quality of life among residents of targeted neighborhoods. The causes, consequences, and potential solutions of urban problems that lie both inside and outside neighborhood borders are emphasized. The chapters are:…

  13. Developing community friendly appropriate biomarkers

    USDA-ARS?s Scientific Manuscript database

    In this presentation we discuss the statistical methodology used in the development of biomarkers to track disease as an outcome for nutrition or exercise interventions in community settings. Obesity and co-morbidities are of growing concern. Nutrition and physical activity interventions have been d...

  14. Urban Problems and Community Development.

    ERIC Educational Resources Information Center

    Ferguson, Ronald F., Ed.; Dickens, William T., Ed.

    The essays in this collection promote a conception of community development that entails building practical capacities to improve the quality of life among residents of targeted neighborhoods. The causes, consequences, and potential solutions of urban problems that lie both inside and outside neighborhood borders are emphasized. The chapters are:…

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

    PubMed

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

    2002-04-01

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

  16. 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

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

    PubMed

    Pérez, Leda M; Martinez, Jacqueline

    2008-01-01

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

  18. Association of Community Health Nursing Educators: disaster preparedness white paper for community/public health nursing educators.

    PubMed

    Kuntz, Sandra W; Frable, Pamela; Qureshi, Kristine; Strong, Linda L

    2008-01-01

    The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing educators, researchers, and practitioners. In response to societal issues, increased emphasis on disaster preparedness in nursing and public health, and requests from partner organizations to contribute to curriculum development endeavors regarding disaster preparedness, the ACHNE Disaster Preparedness Task Force was appointed in spring 2007 for the purpose of developing this document. Task Force members developed a draft of the document in summer and fall 2007, input was solicited and received from ACHNE members in fall 2007, and the document was approved and published in January 2008. The members of ACHNE extend their appreciation to the members of the Emergency Preparedness Task Force for their efforts: Pam Frable, N.D., R.N.; Sandra Kuntz, Ph.D., C.N.S.-B.C. (Chair); Kristine Qureshi, D.N.Sc., C.E.N., R.N.; Linda Strong, Ed.D., R.N. This white paper is aimed at meeting the needs of community/public health nursing educators and clarifying issues for the nursing and public health communities. ACHNE is committed to promotion of the public's health through ensuring leadership and excellence in community and public health nursing education, research, and practice.

  19. Health promoting community radio in rural Bali: an impact evaluation.

    PubMed

    Waters, D; James, R; Darby, J

    2011-01-01

    This article reports and discusses the process and key recommendations of an evaluation of a community oriented radio station in a rural village in Bali, Indonesia. Community development and health promotion strategies were adopted with the purpose of positively impacting the health and social needs of the local community. The essential element of participation in communication for development was extended to the choice of an evaluation methodology that facilitated community empowerment. The Most Significant Change method was utilised to interview 74 participants (combination of individual interview and focus groups) and to provide the basis for the community itself to identify what it considered to be significant change brought about by the on-air and off-air interventions delivered by the radio station. The 2007 study found that, in contrast to the findings of a needs assessment in 2004, the community now largely valued the input of the radio station with community members stating they were 'very proud of the radio station'. Changes in community perceptions are considered attributable to the radio station adopting a health promotion/community development approach to a combination of on-air programming to support off-air activities within the community. The radio station is in a valuable position to continue making a positive contribution to the village of Tulikup and to the wider region of Bali. Heartline Bali FM made a positive impact on the quality of life of local people through a combination of strategically designed on- and off-air activities based on a community development and community participation approach to radio programming. Most Significant Change evaluation extended and strengthened the participatory dynamic of the 3 year project.

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

    ERIC Educational Resources Information Center

    Kriseman, Jeffrey Michael

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Kriseman, Jeffrey Michael

    2012-01-01

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

  2. Virginia Western Community College's Health Technology Admissions Evaluation System.

    ERIC Educational Resources Information Center

    Houston, Charles A.; Sellers, Harry

    Due to factors such as high enrollment demands, limited institutional space, and high program costs, certain admissions requirements in the guidance/selection of students for health technology programs at Virginia Western Community College (VWCC) have become necessary. A Health Technology Admissions Evaluation System was created to develop and…

  3. Exploring community health through the Sustainable Livelihoods Framework

    PubMed Central

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

    2011-01-01

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

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

    PubMed

    Al-Delaimy, W K; Webb, M

    2017-06-01

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

  5. Community Engagement and Data Disclosure in Environmental Health Research.

    PubMed

    Haynes, Erin N; Elam, Sarah; Burns, Roxanne; Spencer, Alonzo; Yancey, Elissa; Kuhnell, Pierce; Alden, Jody; Walton, Mike; Reynolds, Virgil; Newman, Nicholas; Wright, Robert O; Parsons, Patrick J; Praamsma, Meredith L; Palmer, Christopher D; Dietrich, Kim N

    2016-02-01

    Federal funding agencies increasingly support stakeholder participation in environmental health studies, and yet there is very little published research on engagement of community members in the development of data disclosure (DD) strategies. The Ohio Environmental Protection Agency reported airborne manganese (Mn) concentrations in East Liverpool, Ohio, 30 times higher than the reference concentration, which led to an academic–community research partnership to address community concern about Mn exposure, particularly among children. Children and their families were recruited to participate in a pilot study. Samples of blood and hair were collected from the children and analyzed for metals. DD mechanisms were developed using an iterative approach between community and academic partners. Individual DD letters were mailed to each participating family, and a community meeting was held. A post-meeting survey was administered to gauge community perception of the DD strategies. The purpose of this article is to demonstrate the effectiveness of engaging community partners in the conduct of environmental health research and in the development of DD strategies for individuals and the community at large. Scientists should include community partners in the development of DD strategies to enhance translation of the research findings and support the right of study participants to know their individual results.

  6. Community Engagement and Data Disclosure in Environmental Health Research

    PubMed Central

    Haynes, Erin N.; Elam, Sarah; Burns, Roxanne; Spencer, Alonzo; Yancey, Elissa; Kuhnell, Pierce; Alden, Jody; Walton, Mike; Reynolds, Virgil; Newman, Nicholas; Wright, Robert O.; Parsons, Patrick J.; Praamsma, Meredith L.; Palmer, Christopher D.; Dietrich, Kim N.

    2016-01-01

    Summary: Federal funding agencies increasingly support stakeholder participation in environmental health studies, and yet there is very little published research on engagement of community members in the development of data disclosure (DD) strategies. The Ohio Environmental Protection Agency reported airborne manganese (Mn) concentrations in East Liverpool, Ohio, 30 times higher than the reference concentration, which led to an academic–community research partnership to address community concern about Mn exposure, particularly among children. Children and their families were recruited to participate in a pilot study. Samples of blood and hair were collected from the children and analyzed for metals. DD mechanisms were developed using an iterative approach between community and academic partners. Individual DD letters were mailed to each participating family, and a community meeting was held. A post-meeting survey was administered to gauge community perception of the DD strategies. The purpose of this article is to demonstrate the effectiveness of engaging community partners in the conduct of environmental health research and in the development of DD strategies for individuals and the community at large. Scientists should include community partners in the development of DD strategies to enhance translation of the research findings and support the right of study participants to know their individual results. PMID:26829152

  7. Working with Toronto neighbourhoods toward developing indicators of community capacity.

    PubMed

    Jackson, Suzanne F; Cleverly, Shelley; Poland, Blake; Burman, David; Edwards, Richard; Robertson, Ann

    2003-12-01

    Often the goal of health and social development agencies is to assess communities and work with them to improve community capacity. Particularly for health promoters working in community settings and to ensure consistency in the definition of health promotion, the evaluation of health promotion programmes should be based on strengths and assets, yet existing information for planning and evaluation purposes usually focuses on problems and deficits. A model and definition of community capacity, grounded in community experience and focusing on strengths and assets, was developed following a 4-year, multi-site, qualitative, action research project in four Toronto neighbourhoods. There was significant community involvement in the four Community Advisory Committees, one for each study site. Semi-structured, open-ended interviews and focus groups were conducted with 161 residents and agency workers identified by the Community Advisory Committees. The data were analyzed with the assistance of NUDIST software. Thematic analysis was undertaken in two stages: (i) within each site and (ii) across sites, with the latter serving as the basis for the development of indicators of community capacity. This paper presents a summary of the research, the model and the proposed indicators. The model locates talents and skills of community members in a larger context of socioenvironmental conditions, both inside and outside the community, which can act to enable or constrain the expression of these talents and skills. The significance of the indicators of community capacity proposed in the study is that they focus on identifying and measuring the facilitating and constraining socioenvironmental conditions.

  8. Making ENDS Meet: Community Networks and Health Promotion Among Blacks in the City of Brotherly Love

    PubMed Central

    2011-01-01

    This historical inquiry illustrates the power of social networks by examining the Starr Centre and the Whittier Centre, two civic associations that operated in Philadelphia during the early 20th century, a time when Black Americans faced numerous public health threats. Efforts to address those threats included health initiatives forged through collaborative social networks involving civic associations, health professionals, and members of Black communities. Such networks provided access to important resources and served as cornerstones of health promotion activities in many large cities. I trace the origins of these two centers, the development of their programs, their establishment of ties with Black community residents, and the relationship between strong community ties and the development of community health initiatives. Clinicians, researchers, and community health activists can draw on these historical precedents to address contemporary public health concerns by identifying community strengths, leveraging social networks, mobilizing community members, training community leaders, and building partnerships with indigenous community organizations. PMID:21680936

  9. 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

  10. Expanding the Trilinos developer community.

    SciTech Connect

    Heroux, Michael Allen

    2010-10-01

    The Trilinos Project started approximately nine years ago as a small effort to enable research, development and ongoing support of small, related solver software efforts. The 'Tri' in Trilinos was intended to indicate the eventual three packages we planned to develop. In 2007 the project expanded its scope to include any package that was an enabling technology for technical computing. Presently the Trilinos repository contains over 55 packages covering a broad spectrum of reusable tools for constructing full-featured scalable scientific and engineering applications. Trilinos usage is now worldwide, and many applications have an explicit dependence on Trilinos for essential capabilities. Users come from other US laboratories, universities, industry and international research groups. Awareness and use of Trilinos is growing rapidly outside of Sandia. Members of the external research community are becoming more familiar with Trilinos, its design and collaborative nature. As a result, the Trilinos project is receiving an increasing number of requests from external community members who want to contribute to Trilinos as developers. To-date we have worked with external developers in an ad hoc fashion. Going forward, we want to develop a set of policies, procedures, tools and infrastructure to simplify interactions with external developers. As we go forward with multi-laboratory efforts such as CASL and X-Stack, and international projects such as IESP, we will need a more streamlined and explicit process for making external developers 'first-class citizens' in the Trilinos development community. This document is intended to frame the discussion for expanding the Trilinos community to all strategically important external members, while at the same time preserving Sandia's primary leadership role in the project.

  11. How do health workers see community participation?

    PubMed

    Freyens, P; Mbakuliyemo, N; Martin, M

    1993-01-01

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

  12. California Community Colleges Health Services Survey.

    ERIC Educational Resources Information Center

    McIntyre, Chuck

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

  13. Second Thoughts on Community Mental Health

    ERIC Educational Resources Information Center

    Buxbaum, Carl B.

    1973-01-01

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

  14. Visual localisation of community health needs to rational decision-making in public health services.

    PubMed

    Kaneko, Yoshihiro; Takano, Takehito; Nakamura, Keiko

    2003-09-01

    The objectives were to visualise the locations of community health needs and to develop a community health needs assessment geographic information system (GIS) for rational decision-making in public health services. We compiled census data, digital data of basic planning maps, digital data of topographic maps, contents of registers of medical and welfare facilities, and statistics of establishments into a geographical database; visualised geographical distributions of specific community health needs by integrating sets of indicators to reflect individual needs; and quantified their clustering by the nearest neighbour method. The database aggregated 3400 items of demographic, life and environmental factors. Thematic maps and clustering values showed different patterns of geographical distribution of the individual community needs. Means to match needs with services in smaller geographical units were discussed. This GIS will support appropriate resource allocation, intersectoral collaboration and greater transparency in planning and implementing services, by visualising locations of community health needs.

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

    PubMed

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

    2009-10-01

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

  16. 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

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

    PubMed

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

    2013-10-15

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

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

    PubMed Central

    Smith, Selina A.; Blumenthal, Daniel S.

    2013-01-01

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

  19. Collaborative Health Education Training for African American Health Ministers and Providers of Community Services.

    ERIC Educational Resources Information Center

    Lloyd, Jacqueline J.; And Others

    1994-01-01

    A 56-hour interdisciplinary, train-the-trainer model was developed for lay health ministers in African American churches in Tennessee. Workshops examined aging, health promotion, and prevention. The program increased networking and community resources but encountered problems in religion's effect on health beliefs and in the need for cultural…

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

    PubMed Central

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

    2016-01-01

    other communities. Members used websites to disseminate information, supportive evidence, resources for social support, and other ways to communicate. Conclusions Online health communities can be used as important health care information resources for patients and caregivers. Our findings inform patients’ health information–sharing activities. This information assists health care providers, informaticians, and online health information entrepreneurs and developers in helping patients and caregivers make informed choices. PMID:26764193

  1. A Longitudinal Study of the Prevalence, Development, and Persistence of HIV/STI Risk Behaviors in Delinquent Youth: Implications for Health Care in the Community

    PubMed Central

    Romero, Erin Gregory; Teplin, Linda A.; McClelland, Gary M.; Abram, Karen M.; Welty, Leah J.; Washburn, Jason J.

    2009-01-01

    Objective . To examine the prevalence, development, and persistence of sex and drug behaviors that place delinquent youth at risk for human immunodeficiency virus and other sexually transmitted infections (HIV/STI). Methods At the baseline interview, HIV/STI drug and sex risk behaviors were assessed in a stratified random sample of 800 juvenile detainees, aged 10 to 18 years. Participants were re-interviewed approximately 3 years later (mean [SD] follow-up, 3.2 [0.3] years; median follow-up, 3.1 years). The final sample in these analyses (n = 724) includes 316 females and 408 males, 393 African Americans, 198 Hispanics, 131 non-Hispanic whites, and 2 participants who self-identified as “other.” Results Nearly three quarters of youth engaged in one or more unprotected sexual risk behaviors at follow-up. Over 60% had engaged in 10 or more risk behaviors at their baseline interview, and nearly two thirds of them persisted in 10 or more risk behaviors at follow-up. Among youth living in the community, many behaviors were more prevalent at follow-up than at baseline. Among incarcerated youth, the opposite pattern prevailed. Development and persistence of HIV/STI risk behaviors differed by gender, race/ethnicity, and age, even after adjusting for incarceration status. Compared with females, males had higher prevalence rates of many HIV/STI risk behaviors and were more likely to persist in some behaviors and develop new ones. Yet, injection risk behaviors were more prevalent among females than males and were also more likely to develop and persist. Compared with persons younger than 18, persons 18 and older had higher prevalence rates of many HIV/STI risk behaviors at follow-up. Overall, there were few racial and ethnic differences in patterns of HIV/STI risk behaviors; most involved the initiation and persistence of substance use among non-Hispanic whites and Hispanics. Conclusions Because detained youth have a median stay of only 2 weeks, HIV/STI risk behaviors in

  2. Building trusting relationships in online health communities.

    PubMed

    Zhao, Jing; Ha, Sejin; Widdows, Richard

    2013-09-01

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

  3. Community care of North Carolina: improving care through community health networks.

    PubMed

    Steiner, Beat D; Denham, Amy C; Ashkin, Evan; Newton, Warren P; Wroth, Thomas; Dobson, L Allen

    2008-01-01

    The United States leads the world in health care costs but ranks far below many developed countries in health outcomes. Finding ways to narrow this gap remains elusive. This article describes the response of one state to establish community health networks to achieve quality, utilization, and cost objectives for the care of its Medicaid recipients. The program, known as Community Care of North Carolina, is an innovative effort organized and operated by practicing community physicians. In partnership with hospitals, health departments, and departments of social services, these community networks have improved quality and reduced cost since their inception a decade ago. The program is now saving the State of North Carolina at least $160 million annually. A description of this experience and the lessons learned from it can inform others seeking to implement effective systems of care for patients with chronic illness.

  4. Applying community-based participatory research methods to improve maternal and child health in Karachi, Pakistan.

    PubMed

    Karmaliani, Rozina; McFarlane, Judith; Asad, Nargis; Madhani, Farhana; Hirani, Saima; Shehzad, Shireen; Zaidi, Anita

    2009-01-01

    To achieve health for all, the development of partnerships between community residents and researchers is essential. Community-based participatory research (CBPR) engages community members, uses local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. CBPR pivots on an iterative process of open communication, mutual respect, and power sharing to build community capacity to sustain effective health interventions. This article describes how the tenets of CBPR were applied by a multidisciplinary, international research team of maternal-child health specialists toward better health for women and children in multilingual, multiethnic, low socioeconomic communities in Karachi, Pakistan.

  5. Community Participation, Cultural Discourse, and Health Education Projects in Developing Areas: The Case of the Radio Communication Project in Nepal

    ERIC Educational Resources Information Center

    Linn, J. Gary

    2008-01-01

    In this article, the author comments on the article by Dutta and Basnyat (see EJ802883) that provides an insightful and comprehensive critique of a United States Agency for International Development (USAID) entertainment-education program, The Radio Communication Program (RCP) in Nepal, which has been reported to be highly participatory. Despite…

  6. Community Participation, Cultural Discourse, and Health Education Projects in Developing Areas: The Case of the Radio Communication Project in Nepal

    ERIC Educational Resources Information Center

    Linn, J. Gary

    2008-01-01

    In this article, the author comments on the article by Dutta and Basnyat (see EJ802883) that provides an insightful and comprehensive critique of a United States Agency for International Development (USAID) entertainment-education program, The Radio Communication Program (RCP) in Nepal, which has been reported to be highly participatory. Despite…

  7. Preparing the U.S. health community for climate change.

    PubMed

    Jackson, Richard; Shields, Kyra Naumoff

    2008-01-01

    In society's effort to address and prepare for climate change, the health community itself must ensure that it is prepared. Health personnel will require flexible and iterative action plans to address climate change at the individual, hospital, local health department, state, and national levels. This requires that health workers analyze the impact of climate change with a view to human health, and then formulate robust policy and demonstrate authentic leadership. In this review, we summarize the status of the health community's preparation for climate change and provide specific recommendations for action at each level. Although preparation status and recommendations vary, our observation is that it is not enough for public health and medical care agencies and departments to develop policies and advocate change. They have a direct responsibility to demonstrate substantive leadership.

  8. 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

  9. Community Development in Brazil: Two Experiences.

    ERIC Educational Resources Information Center

    O'Gorman, Frances; Speyer, Anne Marie; Tedrus, Maria Aparecida L.

    1998-01-01

    O'Gorman provides "Five Points for Reflection" on nongovernmental and community organizations in Brazil. Speyer and Tedrus discuss "Community Libraries: An Experience in Community Development in the Periphery of Sao Paulo." (SK)

  10. Community Development in Brazil: Two Experiences.

    ERIC Educational Resources Information Center

    O'Gorman, Frances; Speyer, Anne Marie; Tedrus, Maria Aparecida L.

    1998-01-01

    O'Gorman provides "Five Points for Reflection" on nongovernmental and community organizations in Brazil. Speyer and Tedrus discuss "Community Libraries: An Experience in Community Development in the Periphery of Sao Paulo." (SK)

  11. Community Development Services in the Community Junior College.

    ERIC Educational Resources Information Center

    Romine, Stephen

    A survey was conducted through the Mountain-Plains Community College Leadership Program of the University of Colorado to: (1) ascertain the value of various activities that might be useful as part of a community development program; (2) determine the extent of community development services now being provided and the extent to which they should be…

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

    PubMed

    Long, A; Baxter, R

    2001-05-01

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

  13. Beyond Individual Risk Assessment: Community Wide Approaches to Promoting the Health and Development of Families and Children. Conference Proceedings (Hanover, New Hampshire, November 1-4, 1987).

    ERIC Educational Resources Information Center

    Chamberlin, Robert W., Ed.

    A conference held in 1987 at Dartmouth explored the design and implementation of a comprehensive, coordinated community-wide approach to promoting the health of families and children. This publication provides: (1) conference presentations; (2) reports of delegations from Maine, Vermont, and New Hampshire; (3) participants' discussion of issues;…

  14. Developing Learning Communities: Using Communities of Practice within Community Psychology

    ERIC Educational Resources Information Center

    Lawthom, Rebecca

    2011-01-01

    The idea that communities need to be inclusive is almost axiomatic. The process, whereby, community members engage in inclusive practices is far less understood. Similarly, UK universities are being encouraged to include the wider community and extent campus boundaries. Here, I suggest a particular theoretical lens which sheds light on engagement…

  15. Developing Learning Communities: Using Communities of Practice within Community Psychology

    ERIC Educational Resources Information Center

    Lawthom, Rebecca

    2011-01-01

    The idea that communities need to be inclusive is almost axiomatic. The process, whereby, community members engage in inclusive practices is far less understood. Similarly, UK universities are being encouraged to include the wider community and extent campus boundaries. Here, I suggest a particular theoretical lens which sheds light on engagement…

  16. 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

  17. The evolution of the Fenway Community Health model.

    PubMed

    Mayer, K; Appelbaum, J; Rogers, T; Lo, W; Bradford, J; Boswell, S

    2001-06-01

    Fenway Community Health was founded by community activists in 1971 in the Fenway neighborhood of Boston, Mass, and within a decade had rapidly expanded its medical services for gay men in response to the AIDS epidemic. Increased expertise and cultural competence in lesbian, gay, bisexual, and transgender (LGBT) care led to expansion of medical services to address broader community concerns, ranging from substance use to parenting issues to domestic and homophobic violence, as well as specialized programs for lesbians, bisexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recorded 5000 patient care visits; in 2000, Fenway's clinical departments recorded 50,850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff people responsible for clinical programs, community education, research, administration, planning, and development. Over the past few years, Fenway's annual budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGBT health issues for other health providers and has developed programs to educate the general community about specific LGBT health concerns. This health center may provide a model of comprehensive LGBT health services that have a local impact.

  18. Building sustainable health and education partnerships: stories from local communities.

    PubMed

    Blank, Martin J

    2015-11-01

    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. 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. 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. 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. © 2015 Institute for Educational Leadership. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

  19. Resource dependency and community participation in primary health care.

    PubMed

    Zakus, J D

    1998-01-01

    strategy, identified as the resource dependency approach to community participation, led to several flaws in the participatory process and resulted in far less than what could potentially have been achieved in terms of improving health outcomes. Ultimately, the participatory mechanisms became additional dependencies of the health system and not integral components of a process of community development. Large institutional programmes of community participation can benefit by understanding this approach and avoiding its inherent problems.

  20. Communities of solution: partnerships for population health.

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  2. Therapeutic Communities and Mental Health System Reform

    PubMed Central

    Dickey, Barbara; Ware, Norma C.

    2009-01-01

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

  3. Bringing faculty development to community-based preceptors.

    PubMed

    Langlois, John P; Thach, Sarah B

    2003-02-01

    Community-based education of health profession students has increased dramatically, yet providing faculty development to a large, dispersed, and diverse population of community-based faculty is challenging. The authors describe lessons learned from 1997 to 2000 in developing, using, and disseminating a collection of preceptor development materials designed to be relevant to community-based faculty and easy to use. These activities were carried out by the Preceptor Development Program, which was developed by the Mountain Area Health Education Center of Asheville, North Carolina, which works with over 500 community preceptors of health profession students and medical residents. The program includes materials on nine core faculty development topics in a variety of formats: seminars, monographs, Web modules, and one-page summary "thumbnails." Faculty developers can download these free, customizable materials from the Web and are encouraged to adapt them for their own use.

  4. Connecting community with campus to address cancer health disparities: a community grants program model.

    PubMed

    Vines, Anissa I; Teal, Randall; Meyer, Crystal; Manning, Michelle; Godley, Paul

    2011-01-01

    With growing interest in the CBPR approach to cancer health disparities research, mechanisms are needed to support adherence to its principles. The Carolina Community Network (CCN), 1 of 25 Community Network Programs funded by the National Cancer Institute (NCI), developed a model for providing funds to community-based organizations. This paper presents the rationale and structure of a Community Grants Program (CGP) model, describes the steps taken to implement the program, and discusses the lessons learned and recommendations for using the grants model for CBPR. Three types of projects-cancer education, implementation of an evidence-based intervention, and the development of community-academic research partnerships-could be supported by a community grant. The CGP consists of four phases: Pre-award, peer-review process, post-award, and project implementation. The CGP serves as a catalyst for developing and maintaining community-academic partnerships through its incorporation of CBPR principles. Providing small grants to community-based organizations can identify organizations to serve as community research partners, fostering the CBPR approach in the development of community-academic partnerships by sharing resources and building capacity.

  5. Community health nursing advocacy: a concept analysis.

    PubMed

    Ezeonwu, Mabel C

    2015-01-01

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

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2013-09-01

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

  8. Visual Methodologies in Community-Based Participatory Research for Health: Using Photography, Video, and New Media to Engage Communities in Research and Action

    ERIC Educational Resources Information Center

    Catalani, Caricia Eleanora Celebes

    2009-01-01

    The challenges facing public health today are too vast, complex, and urgent to be met by public health professionals alone. To improve the health and wellbeing of diverse communities around the globe, public health leaders are developing tools that engage communities in research and action, most particularly community-based participatory research…

  9. Visual Methodologies in Community-Based Participatory Research for Health: Using Photography, Video, and New Media to Engage Communities in Research and Action

    ERIC Educational Resources Information Center

    Catalani, Caricia Eleanora Celebes

    2009-01-01

    The challenges facing public health today are too vast, complex, and urgent to be met by public health professionals alone. To improve the health and wellbeing of diverse communities around the globe, public health leaders are developing tools that engage communities in research and action, most particularly community-based participatory research…

  10. Assessing community health center (CHC) assets and capabilities for recruiting physicians: the CHC Community Apgar Questionnaire.

    PubMed

    Baker, E T; Schmitz, D F; Wasden, S A; MacKenzie, L A; Epperly, T

    2012-01-01

    Recent trends suggest that community health centers (CHCs) may experience a shortage of qualified physicians required to meet current and future demand. The purpose of this study was to develop an evaluation instrument, the CHC Community Apgar Questionnaire (CHC CAQ) for Idaho CHCs to use in physician recruitment. The instrument was developed based on the Critical Access Hospital Community Apgar Questionnaire (CAH CAQ). The CHC CAQ was customized for CHC use and 12 new factors were identified for substitution in the CHC instrument. All 13 CHCs in Idaho participated in this study. One site was chosen per CHC if the CHC had multiple service locations. In each community, the administrator of the CHC and the physician with recruiting responsibilities participated individually in a structured interview. A total of 11 physicians and 11 administrators participated in the study. Differences were found across and within classes of factors associated with success in physician recruitment. Alpha communities, those historically having more success in physician recruitment, scored higher on CAQ metrics than less successful beta communities. No material differences were noted across physician and administrator ratings. Cumulative mean Community Apgar scores (CHC CAQ) were mostly higher in alpha communities. The CHC CAQ, like the CAH CAQ, seems to discriminate between communities with differing assets and capabilities based on historical community-specific workforce trends. This assessment may suggest which factors are most important for a community to address with limited available resources and which factors are useful in marketing their CHC to prospective physicians.

  11. Social Networks as a Mode of Informal Learning in Health Care--Comparison of Networks in Three Systems: Health, Education and Community Development.

    ERIC Educational Resources Information Center

    Patrick, Walter K.

    An attempt was made to study the influence of social networks in Sri Lanka by identifying, selecting, and training volunteers to serve as informal educators of their own social networks. These educators who each were to serve a cluster of 20-25 families were young adults; the majority were females linked to health, education, or community…

  12. Social Networks as a Mode of Informal Learning in Health Care--Comparison of Networks in Three Systems: Health, Education and Community Development.

    ERIC Educational Resources Information Center

    Patrick, Walter K.

    An attempt was made to study the influence of social networks in Sri Lanka by identifying, selecting, and training volunteers to serve as informal educators of their own social networks. These educators who each were to serve a cluster of 20-25 families were young adults; the majority were females linked to health, education, or community…

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  16. The Tennessee Department of Health workshops on use of secondary data for community health assessment, 2012.

    PubMed

    Behringer, Bruce A; Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B

    2014-01-02

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community's health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county public health departments as trusted leaders in providing population data and engaging community stakeholders in assessments. The Tennessee Department of Health's Division of Policy, Planning, and Assessment conducted regional 2-day training workshops to explain and guide completion of computer spreadsheets on 12 health topics. Participants from 93 counties extracted data from multiple and diverse sources to quantify county demographics, health status, and resources and wrote problem statements based on the data examined. The workshops included additional staff development through integration of short lessons on data analysis, epidemiology, and social-behavior theory. Participants reported in post-workshop surveys higher degrees of comfort in interpreting data and writing about their findings on county health issues, and they shared their findings with health, hospital, school, and government leaders (including county health council members) in their counties. Completion of the assessments enabled counties and the Tennessee Department of Health to address performance-improvement goals and assist counties in preparing to meet public health accreditation prerequisites. The methods developed for using secondary data for community health assessment are Tennessee's first-phase response to counties' request for a statewide structure for conducting such assessments.

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

    PubMed Central

    2013-01-01

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

  18. 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