Government dependence of Chinese and Vietnamese community organizations and fiscal politics of immigrant services.

PubMed

Tseng, Winston

2005-01-01

Few studies have examined the impact of government support and policies on immigrant services within ethnic enclaves. This paper seeks to address this gap and examines the structure and challenges of ethnic community based organizations (CBOs) that serve low income immigrant populations and the impact of government support and policies on these CBOs. The study utilized case study and ethnographic methodologies and examined 2 Chinese and 2 Vietnamese CBOs in the San Francisco Bay Area. The findings show that ethnic CBOs critically depend on government fiscal support for survival. In exchange for fiscal support, ethnic CBOs represent public assistance and legitimacy interests for government in immigrant communities. However, culturally proficient and community leadership resources of ethnic CBOs can serve as bargaining chips to secure government funding, reduce compliance to government demands, and advance immigrant community interests. Nevertheless, in times of government fiscal crisis, ethnic CBOs and immigrant services tend to be most vulnerable to budget cuts due to lack of political voice. In sum, government-community collaboration through ethnic CBOs has a central role to play in facilitating and strengthening health and human services for rapidly growing, culturally diverse immigrant populations. These collaborative efforts in immigrant services are vital to cultivating healthy immigrant human capital and multicultural communities across the United States.

Culture-sensitive counselling, psychotherapy and support groups in the Orthodox-Jewish community: how they work and how they are experienced.

PubMed

Loewenthal, Kate Miriam; Rogers, Marian Brooke

2004-09-01

There is political and scientific goodwill towards the provision of culture-sensitive support, but as yet little knowledge about how such support works and what are its strengths and difficulties in practice. To study groups offering culture-sensitive psychological and other support to the strictly orthodox Jewish community in London. Semi-structured interviews with service providers, potential and actual users from the community, and professionals serving the community. Interviews asked about the aims, functioning and achievements of 10 support groups. Thematic analysis identified seven important themes: admiration for the work of the groups; appreciation of the benefits of culture-sensitive services; concerns over confidentiality and stigma; concerns over finance and fund-raising; concerns about professionalism; the importance of liaison with rabbinic authorities; need for better dissemination of information. The strengths and difficulties of providing culture-sensitive services in one community were identified. Areas for attention include vigilance regarding confidentiality, improvements in disseminating information, improvements in the reliability of funding and attention to systematic needs assessment, and to the examination of efficacy of these forms of service provision.

The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices.

PubMed

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications. (c) 2007 Wiley-Liss, Inc.

An Organizational Model for Instructional Support at a Community College.

ERIC Educational Resources Information Center

Mundell, Jacqueline; Celene-Martel, Coryl; Braziunas, Tom

2003-01-01

Describes the Instructional and Information Support Services (IISS) division at North Seattle Community College, which brings together the college's library, media services, and distance learning units as well as the Teaching and Learning center to support instruction campus-wide. Discusses the campus technological infrastructure, online courses,…

Building Culturally & Linguistically Competent Services to Support Young Children, Their Families, and School Readiness

ERIC Educational Resources Information Center

Hepburn, Kathy Seitzinger

2004-01-01

The purpose of this tool kit is to provide guidance, tools, and resources that will assist communities in building culturally and linguistically competent services, supports, programs, and practices related to young children, their families. By offering services in culturally and linguistically meaningful ways, communities can engage all families…

Community Consultation and Intervention: Supporting Students Who Do Not Access Counseling Services

ERIC Educational Resources Information Center

Mier, Sharon; Boone, Matthew; Shropshire, Sonya

2009-01-01

Although the severity of psychological problems among college students and the demand for campus counseling services has increased, many students who could benefit from mental health services still do not access them. This article describes Community Consultation and Intervention, a program designed to support students who are unlikely to access…

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2011 CFR

2011-07-01

... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The following activities are authorized under community-based projects: (1) Job search assistance. (2) Job... Community-Based Supported Employment projects for the provision of extended supported employment services...

Understanding Student Success and Institutional Outcomes in Service-Learning Coursework at a North Carolina Community College: A Propensity Score Study

ERIC Educational Resources Information Center

Marts, Jennifer Leigh

2016-01-01

Service-learning has roots deep in higher education. Community colleges and service-learning have an organic relationship as they both strive to represent and support their local communities. This study implemented propensity score matching to study the impact of service-learning on student outcomes for community college students. Much of the…

Facilitating a transition from compulsory detention of people who use drugs towards voluntary community-based drug dependence treatment and support services in Asia.

PubMed

Tanguay, Pascal; Kamarulzaman, Adeeba; Aramrattana, Apinun; Wodak, Alex; Thomson, Nicholas; Ali, Robert; Vumbaca, Gino; Lai, Gloria; Chabungbam, Anand

2015-10-16

Evidence indicates that detention of people who use drugs in compulsory centers in the name of treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based drug dependence treatment and support services. In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, drug policy reform to eliminate barriers to community-based drug dependence treatment and support services, and the integration of community-based drug dependence treatment in existing national health and social service systems.In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results. The need to accelerate national-level transitions to voluntary community-based drug dependence treatment and support services is compelling--on economic, medical, sustainable community development, and ethical grounds--as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based drug dependence treatment and support services across the region, as well as the steady scale-down of compulsory centers for drug users.Components of voluntary community-based drug dependence treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use drugs in Asia.

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.

Support Success. Services That May Help Low-Income Students Succeed in Community College. Opening Doors

ERIC Educational Resources Information Center

Purnell, Rogeair; Blank, Susan

2004-01-01

This paper examines how U.S. community colleges can and do organize the diverse set of guidance, counseling, and other supports--collectively known as student services--that surround their academic programming. To many Americans, community colleges are the most accessible way to earn the postsecondary degrees that can be stepping stones to…

Developing culturally responsive approaches with Southeast Asian American families experiencing developmental disabilities.

PubMed

Baker, Dian L; Miller, Elizabeth; Dang, Michelle T; Yaangh, Chiem-Seng; Hansen, Robin L

2010-12-01

Southeast Asian American families are underrepresented among recipients of special education and social services for people with developmental disabilities. Our aims were to use a community-based participatory research approach to examine Hmong and Mien families' perceptions of developmental disabilities and understand barriers to and facilitators of service provision among families experiencing developmental disabilities. We describe here a case study of a successful attempt to engage marginalized and underserved communities to understand their needs to improve access and services for persons with developmental disabilities. We conducted 2 focus groups with 11 key informants and 1 focus group with 10 family members of persons with developmental disabilities, as well as in-depth interviews with 3 shamans. Using a thematic analysis approach, we coded notes and transcripts to assess community members' understanding of developmental disabilities, experiences negotiating educational and health care systems, and barriers to high-quality care. A predominant theme was the perception that reliance on governmental support services is not appropriate. Common barriers identified included lack of accurate information, language difficulties, lack of trust, and limited outreach. These perceptions and barriers, combined with limited access to services, interfere with community acceptance and use of available support services. Despite these barriers, participants indicated that with education, outreach, and culturally responsive support, families would likely accept services. Community-based participatory methods are effective for eliciting root causes of health inequities in marginalized communities. Outreach to community-based organizations and an inclusive research practice identified social and cultural reasons for low service uptake and provided a pathway for the community to improve services for persons with developmental disabilities.

Reorganization of mental health services: from institutional to community-based models of care.

PubMed

Saraceno, B; Gater, R; Rahman, A; Saeed, K; Eaton, J; Ivbijaro, G; Kidd, M; Dowrick, C; Servili, C; Funk, M K; Underhill, C

2015-09-28

Mental health services in the Eastern Mediterranean Region are predominantly centralized and institutionalized, relying on scarce specialist manpower. This creates a major treatment gap for patients with common and disabling mental disorders and places an unnecessary burden on the individual, their family and society. Six steps for reorganization of mental health services in the Region can be outlined: (1) integrate delivery of interventions for priority mental disorders into primary health care and existing priority programmes; (2) systematically strengthen the capacity of non-specialized health personnel for providing mental health care; (3) scale up community-based services (community outreach teams for defined catchment, supported residential facilities, supported employment and family support); (4) establish mental health services in general hospitals for outpatient and acute inpatient care; (5) progressively reduce the number of long-stay beds in mental hospitals through restricting new admissions; and (6) provide transitional/bridge funding over a period of time to scale up community-based services and downsize mental institutions in parallel.

The European ALMA Regional Centre: a model of user support

NASA Astrophysics Data System (ADS)

Andreani, P.; Stoehr, F.; Zwaan, M.; Hatziminaoglou, E.; Biggs, A.; Diaz-Trigo, M.; Humphreys, E.; Petry, D.; Randall, S.; Stanke, T.; van Kampen, E.; Bárta, M.; Brand, J.; Gueth, F.; Hogerheijde, M.; Bertoldi, F.; Muxlow, T.; Richards, A.; Vlemmings, W.

2014-08-01

The ALMA Regional Centres (ARCs) form the interface between the ALMA observatory and the user community from the proposal preparation stage to the delivery of data and their subsequent analysis. The ARCs provide critical services to both the ALMA operations in Chile and to the user community. These services were split by the ALMA project into core and additional services. The core services are financed by the ALMA operations budget and are critical to the successful operation of ALMA. They are contractual obligations and must be delivered to the ALMA project. The additional services are not funded by the ALMA project and are not contractual obligations, but are critical to achieve ALMA full scientific potential. A distributed network of ARC nodes (with ESO being the central ARC) has been set up throughout Europe at the following seven locations: Bologna, Bonn-Cologne, Grenoble, Leiden, Manchester, Ondrejov, Onsala. These ARC nodes are working together with the central node at ESO and provide both core and additional services to the ALMA user community. This paper presents the European ARC, and how it operates in Europe to support the ALMA community. This model, although complex in nature, is turning into a very successful one, providing a service to the scientific community that has been so far highly appreciated. The ARC could become a reference support model in an age where very large collaborations are required to build large facilities, and support is needed for geographically and culturally diverse communities.

A Study of the Relationship between Distance Learners' Perception of the Value of Student Support Services and a Sense of Belonging in the University's Learning Community

ERIC Educational Resources Information Center

Emmanuel-Frenel, Rouseline

2017-01-01

This study asked two primary questions: (1) to what extent do distance learners find value in student support services; and (2) is there a relationship between the value placed on student support services and students' sense of belonging in the university's learning community? Value was defined as the frequency of use, importance, and satisfaction…

Beyond Superheroes and Sidekicks: Empowerment, Efficacy, and Education in Community Partnerships

ERIC Educational Resources Information Center

Stanlick, Sarah; Sell, Marla

2016-01-01

To support the work of service-learning and community engagement (SLCE) being done in a high-quality, sustainable way, ("Combining Service and Learning: A Resource Book for Community and Public Service"), Kendall offered three Principles of Good Practice: (1) integrating service-learning programs into the central mission and goals of the…

Le Bon Samaritain: A Community-Based Care Model Supported by Technology.

PubMed

Gay, Valerie; Leijdekkers, Peter; Gill, Asif; Felix Navarro, Karla

2015-01-01

The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner. This paper proposes a new community-based care model, supported by technology, that aims at reducing healthcare and emergency services costs while allowing community to become resilient in response to health and emergency situations. We looked at models of care in different industries and identified the type of technology that can support the suggested new model of care. Two prototypes were developed to validate the adequacy of the technology. The result is a new community-based model of care called 'Le Bon Samaritain'. It relies on a network of people called 'Bons Samaritains' willing to help and deal with the basic care and safety aspects of their community. Their role is to make sure that people in their community receive and understand the messages from emergency and health services. The new care model is integrated with existing emergency warning, community and health services. Le Bon Samaritain model is scalable, community-based and can help people feel safer, less isolated and more integrated in their community. It could be the key to reduce healthcare cost, increase resilience and drive the change for a more integrated emergency and care system.

Linking case management and community development.

PubMed

Austin, Carol D; McClelland, Robert W; Gursansky, Di

2006-01-01

Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

Community-partnered evaluation of depression services for clients of community-based agencies in under-resourced communities in Los Angeles.

PubMed

Miranda, Jeanne; Ong, Michael K; Jones, Loretta; Chung, Bowen; Dixon, Elizabeth L; Tang, Lingqi; Gilmore, Jim; Sherbourne, Cathy; Ngo, Victoria K; Stockdale, Susan; Ramos, Esmeralda; Belin, Thomas R; Wells, Kenneth B

2013-10-01

As medical homes are developing under health reform, little is known regarding depression services need and use by diverse safety-net populations in under-resourced communities. For chronic conditions like depression, primary care services may face new opportunities to partner with diverse community service providers, such as those in social service and substance abuse centers, to support a collaborative care model of treating depression. To understand the distribution of need and current burden of services for depression in under-resourced, diverse communities in Los Angeles. Baseline phase of a participatory trial to improve depression services with data from client screening and follow-up surveys. Of 4,440 clients screened from 93 programs (primary care, mental health, substance abuse, homeless, social and other community services) in 50 agencies, 1,322 were depressed according to an eight-item Patient Health Questionnaire (PHQ-8) and gave contact information; 1,246 enrolled and 981 completed surveys. Ninety-three programs, including 17 primary care/public health, 18 mental health, 20 substance abuse, ten homeless services, and 28 social/other community services, participated. Comparisons by setting in 6-month retrospective recall of depression services use. Depression prevalence ranged from 51.9 % in mental health to 17.2 % in social-community programs. Depressed clients used two settings on average to receive depression services; 82 % used any setting. More clients preferred counseling over medication for depression treatment. Need for depression care was high, and a broad range of agencies provide depression care. Although most participants had contact with primary care, most depression services occurred outside of primary care settings, emphasizing the need to coordinate and support the quality of community-based services across diverse community settings.

A community-based peer support service for persons with severe mental illness in China.

PubMed

Fan, Yunge; Ma, Ning; Ma, Liang; Xu, Wei; Steven Lamberti, J; Caine, Eric D

2018-06-04

Peer support services for patients with severe mental illness (SMI) originated from Western countries and have become increasingly popular during the past twenty years. The aim of this paper is to describe a peer service model and its implementation in China, including the model's feasibility and sustainability. A peer support service was developed in four Chinese communities. Implementation, feasibility and sustainability were assessed across five domains: Service process, service contents, peer training and supervision, service satisfaction, and service perceived benefit. Service process: 214 peer support activities were held between July 2013 and June 2016. No adverse events occurred during three years. Each activity ranged from 40 to 120 min; most were conducted in a community rehabilitation center or community health care center. Service content: Activities focused on eight primary topics-daily life skills, social skills, knowledge of mental disorders, entertainment, fine motor skill practice, personal perceptions, healthy life style support, emotional support. Peer training and supervision: Intensive training was provided for all peers before they started to provide services. Regular supervision and continued training were provided thereafter; online supervision supplemented face to face meetings. Service satisfaction: Nineteen consumers (79.2%) (χ 2 (1) = 12.76, p < 0.001) were satisfied with the peers and 17 consumers (70.8%) (χ 2 (1) = 8.05, p = 0.005) expressed a strong desire to continue to participate in the service. Fourteen caregivers (93.3%) (χ 2 (1) = 11.27, p = 0.001) wanted the patients to continue to organize or participate in the service. Service perceived benefit: Six peers (85.7%) (χ 2 (1) = 3.57, p = 0.059) reported an improvement of working skills. Ten consumers (41.7%) (χ 2 (1) = 0.05, p = 0.827) reported better social communication skills. Six caregivers (40%) (χ 2 (1) = 1.67, p = 0.197) observed patients' increase in social communication skills, five (33.3%) (χ 2 (1) = 1.67, p = 0.197) found their own mood had been improved. Peer support services for patients with SMI can be sustainably implemented within Chinese communities without adverse events that jeopardize safety and patient stability. Suggestions for future service development include having professionals give increased levels of support to peers at the beginning of a new program. A culturally consistent peer service manual, including peer role definition, peer training curriculum, and supervision methods, should be developed to help implement the service smoothly.

Surveying Community Nursing Support for Persons with an Intellectual Disability and Palliative Care Needs

ERIC Educational Resources Information Center

Bailey, Maria; Doody, Owen; Lyons, Rosemary

2016-01-01

Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of…

A pharmacy carer support service: obtaining new insight into carers in the community.

PubMed

McMillan, Sara S; King, Michelle A; Stapleton, Helen; Sav, Adem; Kelly, Fiona; Wheeler, Amanda J

2018-05-06

Unpaid carers have many and varied responsibilities in society, which can include medication management for the person they support. However, the potential for Australian community pharmacies to better assist carers is relatively unexplored. This mixed-methods study investigated the acceptability of a local carer support service by trained community pharmacy staff, including issues regarding the implementation and impact of this service. Staff from 11 community pharmacies in South East Queensland, Australia, were trained to deliver a six-step carer support service between September 2016 and March 2017. Pharmacies were supported by a carer and pharmacist mentor pair and asked to recruit up to six carers each. Evaluations of staff training were descriptively analysed. Semi-structured interviews were undertaken with pharmacy staff, and interview transcripts were analysed thematically. Staff training evaluations were positive; participants acquired new information about carers and rated the service highly in terms of its importance within the pharmacy setting. Feedback was obtained on how to improve the training, such as further opportunities for role-play. Seven staff members were interviewed, and data analysis revealed two main themes: (1) implementation of the carer support service and (2) perceived impact on pharmacy staff. Positive attitudes towards recognising and supporting carers, and training and mentoring were identified with community pharmacies viewed as a suitable place for delivering this new service. New insights into the impact of caring were widely reported, which staff had not appreciated from previous carer interactions. Structural issues, including space and time pressures, and a lack of awareness about the types of support currently available to carers were emphasised. Pharmacy staff are well positioned to support carers. Engaging carers in conversation to better understand their needs is a small step with potential for big gains, including a more empathetic understanding of their individual circumstances and overall well-being. © 2018 Royal Pharmaceutical Society.

Breastfeeding Supports and Services in Rural Hawaii: Perspectives of Community Healthcare Workers.

PubMed

Flood, Jeanie L

2017-01-01

Background . In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs) working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community's (specifically Hilo, Hawai'i) breastfeeding service and support issues. Method . The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs ( N = 23) about their individual or shared experience(s) about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results . Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment , Coexisting Messages , and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed.

The evaluation of NIMROD, a community-based service for people with mental handicap: revenue costs.

PubMed

Davies, L; Felce, D; Lowe, K; de Paiva, S

1991-11-01

The cost implications of moving from a system of services for people with mental handicaps centred on large institutions to a network of community-based services are not precisely known. The provision of the NIMROD service in a part of Cardiff, with its aim not only to meet the residential needs of adults comprehensively by providing a number of houses in the community but also to develop a support service to people living in their family home, gave an opportunity to investigate and report the revenue costs of a number of service elements with respect to a defined total population. The residential costs of intensively staffed houses in 1986-87, varying in size from two to six places, were found to range between pounds 16,473 and pounds 23,319 per person per year. With the addition of community support costs, such as the provision of day services, the total costs of care per resident averaged pounds 21,708; range, pounds 18,883-pounds 26,009. These compared to the total costs in a minimally staffed house of pounds 9,678 per resident. The costs of community support services for people living in their family homes averaged pounds 5,614 inclusive of DSS benefits, of which pounds 1,743 was accounted for by the NIMROD domiciliary support service, office base and administrative overheads. The residential costs reported were compared to other cost data in the literature. The study supports previous conclusions that there is little evidence of diseconomy attached to small scale per se but that the way staffing levels and therefore staff costs are determined is critical. No evidence was found in this study to link greater cost to better quality.

Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis.

PubMed

Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

2018-04-02

Specialist supported accommodation services have become a key component of most community-based mental healthcare systems. While mental health policies highlight the importance of service user involvement in service development and care planning, there are no comprehensive literature reviews synthesising services users' perspectives on, or experiences of, supported accommodation services. This systematic review was undertaken to fill this gap. We searched electronic databases (January 2015, updated June 2017), conducted hand searches and used forward-backward snowballing to identify 13,678 papers. We inspected the full-text of 110 papers and included 50 of these in the final review. Data extraction and quality assessments were conducted. We used narrative synthesis to develop a conceptual model of service users' experiences that included structural, process, relational and contextual factors, such as the characteristics of the service, relationships with staff and other service users, the intensity and nature of support, the physical environment, and social and community integration. The review highlights the complex interplay of individual, service-level and community factors in shaping the lived experience of service users and their impact on personal identity and recovery. Our approach addressed some of the widely reported limitations of the quantitative research in this field, providing a conceptual model relevant to service user experiences across supported accommodation service types, population groups and countries. © 2018 John Wiley & Sons Ltd.

Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.

PubMed

Amjad, Halima; Wong, Stephanie K; Roth, David L; Huang, Jin; Willink, Amber; Black, Betty S; Johnston, Deirdre; Rabins, Peter V; Gitlin, Laura N; Lyketsos, Constantine G; Samus, Quincy M

2018-02-01

To investigate effects of a novel dementia care coordination program on health services utilization. A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team. Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months. From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005). While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use. © Health Research and Educational Trust.

Commercial aviation : programs and options for providing air service to small communities : testimony before the Subcommittee on Aviation, Committee on Transportation and Infrastructure, U.S. House of Representatives

DOT National Transportation Integrated Search

2007-04-25

Congress established two key programs to help support air service to small communities the Essential Air Service (EAS) providing about $100 million in subsidies per year and the Small Community Air Service Development Program (SCASDP) that provide...

Community Services. Institutional, Community, Home Management and Support Services. Course Outline. Home Economics and Consumer Education.

ERIC Educational Resources Information Center

Union County High School District No. 1, Springfield, NJ.

This course outline contains materials for use in conducting a course designed to prepare high school students for a number of community service occupations. Addressed in the individual units of the course are the following topics: interpersonal relationships with those needing services (families; aged, poor, handicapped, ill, and pregnant…

The Influence of Community-Based Services on the Burden of Spouses Caring for Their Partners with Dementia

ERIC Educational Resources Information Center

Sussman, Tamara; Regehr, Cheryl

2009-01-01

Despite the vast literature on caregiver stress, few studies have explored how community services affect the stress process for spousal caregivers. The current study explores the differential effects of emotional and tangible support provided by family and friends and by formal services, and caregivers' perceptions of community services on spousal…

[Consideration of national policies to support the development of medical services for dementia].

PubMed

Awata, Shuichi

2014-01-01

To consider national policies to support the development of medical services for dementia, we conducted three studies. Study 1: We evaluated the dementia management capacity of clinics using a questionnaire on medical services for dementia 1) Clinics that employed doctors who had attended a lecture on dementia management had a superior capacity to provide primary care services, make diagnoses, manage behavioral and psychological symptoms of dementia (BPSD), provide home healthcare for dementia, and promote community integration compared to clinics that did not employ such doctors. 2)Clinics that employed"dementia support doctors"had a superior capacity to provide such dementia management as mentioned above compared to clinics employing doctors who had attended a lecture on dementia management. However, 3) the questionnaire data suggested that only some clinics that employed "dementia support doctors" could provide such medical services as diagnosis of dementia, management of BPSD, and promotion of community integration in their regular clinical practice. Study 2: We evaluated the current activities of Medical Centers for Dementia (MCDs). 1) MCDs had more efficient activities in general compared to Dementia Centers for the Elderly (DCEs) established in 1989 and suspended in 2007. However, there was a large disparity among the facilities in terms of their activities. 2) Many MCDs thought that they could not provide adequate services due to the size of their catchment area. 3) Emergency services for dementia patients with concurrent medical conditions were supported by staff of many MCDs located in general hospitals without the designation of a special MCD for providing emergency services. 4) Inpatient stays tended to be longer in psychiatric hospitals where MCDs were located. Study 3: We conducted a preliminary investigation on activities in possible "dementia support clinics". These clinics had an inferior capacity to provide inpatient services but a similar capacity to make diagnoses, provide management of BPSD, and promote community integration compared to MCDs. From these findings, we made recommendations as follows: (1) It is necessary to not only increase the number of "dementia support doctors", but also to develop adequate numbers of "dementia support clinics" that provide such medical services as diagnosis of dementia, management of BPSD, and promotion of community integration in cooperation with community general support centers in regular clinical practice. (2) It is necessary to monitor the level of activities and develop adequate numbers of MCDs based on the size of the area and population. MCDs should take part in establishing community-based, integrated care systems in cooperation with the local government. Equipping "dementia support teams" might be indispensable in general hospitals that provide emergency medical services for dementia patients. (3) It would be significant to arrange "dementia support clinics" as a medical resource to make diagnoses, provide management of BPSD, and promote community integration for dementia in local dementia planning by a municipality.

Stakeholders' Home and Community Based Services Settings Rule Knowledge

ERIC Educational Resources Information Center

Friedman, Carli

2018-01-01

Medicaid Home and Community Based Services (HCBS) waiver programs provide the majority of long-term services and supports for people with intellectual and developmental disabilities (IDD). Relatively new (2014) HCBS rules (CMS 2249-F/2296-F) governing these programs require "meaningful community" integration of people with disabilities…

National transportation system : options and analytical tools to strengthen DOT's approach to supporting communities' access to the system.

DOT National Transportation Integrated Search

2009-07-01

Since 1978, the Essential Air : Service (EAS) program has : subsidized air service to eligible : communities that would otherwise : not have scheduled service. The : cost of this program has risen as : the number of communities being : served and sub...

Health Matters: From Research to Practice. Research Brief. Winter 2014

ERIC Educational Resources Information Center

Kleinert, Harold L.; Sheppard-Jones, Kathy

2014-01-01

Kentucky has been focused upon improving outcomes for individuals receiving Supports for Community Living (SCL) Waiver services. SCL is the state's residential Medicaid developmental disabilities waiver; the SCL waiver provides a broad array of services for waiver recipients (residential, supported employment, transportation, community access,…

"It Was Like Walking without Knowing Where I Was Going": A Qualitative Study of Autism in a UK Somali Migrant Community

ERIC Educational Resources Information Center

Fox, Fiona; Aabe, Nura; Turner, Katrina; Redwood, Sabi; Rai, Dheeraj

2017-01-01

Increasing recognition of autism in Somali migrant communities means that appropriate support services are needed. Attitudes to autism and barriers related to help-seeking in these communities are poorly understood. We aimed to assess what families affected by autism need, and how health, education and social care services can support them. In…

The role of support person for Ngaanyatjarra women during pregnancy and birth.

PubMed

Simmonds, Donna M; West, Lalla; Porter, Julie; Davies, Melva; Holland, Carol; Preston-Thomas, Annie; O'Rourke, Peter K; Tangey, Annie

2012-06-01

This study took place in a remote community on the Ngaanyatjarra Lands, Western Australia. Ngaanyatjarra women's cultural practices have been subject to erosion during the past 70 years. Women are now expected to birth hundreds of kilometres from home and, due to financial barriers, without family support. Older women lament their lack of input into, and control of, contemporary birthing services. In order to provide culturally appropriate maternity services we asked: What issues would the Ngaanyatjarra women of the community like to see resolved in the area of antenatal and birthing services? Eligible participants were any Ngaanyatjarra women of the study community who had birthed at least once. We utilised a participatory research methodology. 36 women were interviewed. This paper discusses one finding related to support for child-bearing women. The role is important in many ways. Ngaanyatjarra women did not traditionally have their support persons with them during labour and birth, nor do they necessarily expect them to be present in current times. Most women do, however, wish to have a support person with them during antenatal checkups and when they travel to town to await birth. Aboriginal women from remote communities should be able to have a support person with them when they access regional birthing services, but the nature of this role must not be assumed. A culturally appropriate service has input from the community, provides options and respects choices. Copyright © 2011 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

45 CFR 2517.710 - Are there limits on the use of funds?

Code of Federal Regulations, 2010 CFR

2010-10-01

... NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Funding Requirements § 2517.710... financial support to any participant in a service-learning program under this part except reimbursement for...

45 CFR 2517.710 - Are there limits on the use of funds?

Code of Federal Regulations, 2011 CFR

2011-10-01

... NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Funding Requirements § 2517.710... financial support to any participant in a service-learning program under this part except reimbursement for...

A Community Development Approach to Service-Learning: Building Social Capital between Rural Youth and Adults

ERIC Educational Resources Information Center

Henness, Steven A.; Ball, Anna L.; Moncheski, MaryJo

2013-01-01

Using 4-H and FFA case study findings, this article explores how community service-learning supports the building of social capital between rural youth and adults and the positive effects on community viability. Key elements of practice form a community development approach to service-learning, which opens up doorways for youth to partner with…

Saint Anthony Hospital: Infusing Developmental and Family Support Services in Community-Based Medical Practice

ERIC Educational Resources Information Center

Casas, Paula; Isarowong, Nucha

2015-01-01

Physicians affiliated with small community hospitals face numerous barriers to using developmentally oriented best practices in primary care with young children. Saint Anthony Hospital's Developmental Support Project model promotes improved developmental outcomes for children through two complementary strands of services: (a) training and…

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION SPECIAL PROJECTS AND DEMONSTRATIONS FOR PROVIDING SUPPORTED EMPLOYMENT SERVICES TO INDIVIDUALS... 34 Education 2 2010-07-01 2010-07-01 false What activities may the Secretary fund under community...

Community Pharmacists' Attitudes Toward Palliative Care: An Australian Nationwide Survey

PubMed Central

Hewitt, Lauren Y.; Tuffin, Penelope H.R.

2013-01-01

Abstract Background: Pharmacists are among the most accessible health care professionals in the community, yet are often not involved in community palliative care teams. Objective: We investigated community pharmacists' attitudes, beliefs, feelings, and knowledge about palliative care as a first step towards determining how best to facilitate the inclusion of community pharmacists on the palliative care team. Method: A cross-sectional descriptive survey design was used. Subjects: Community pharmacists around Australia were invited to participate; 250 completed surveys were returned. Measurements: A survey was constructed to measure pharmacists' knowledge and experience, emotions and beliefs about palliative care. Results: Pharmacists were generally positive about providing services and supports for palliative care patients, yet they also reported negative beliefs and emotions about palliative care. In addition, pharmacists had good knowledge of some aspects of palliative care, but misconceptions about other aspects. Pharmacists' beliefs and knowledge about palliative care predicted—and therefore underpinned—a positive attitude towards palliative care and the provision of services and supports for palliative care patients. Conclusion: The results provide evidence that pharmacists need training and support to facilitate their involvement in providing services and supports for palliative care patients, and highlight areas that training and support initiatives should focus on. PMID:24147876

Community pharmacists' attitudes toward palliative care: an Australian nationwide survey.

PubMed

O'Connor, Moira; Hewitt, Lauren Y; Tuffin, Penelope H R

2013-12-01

Pharmacists are among the most accessible health care professionals in the community, yet are often not involved in community palliative care teams. We investigated community pharmacists' attitudes, beliefs, feelings, and knowledge about palliative care as a first step towards determining how best to facilitate the inclusion of community pharmacists on the palliative care team. A cross-sectional descriptive survey design was used. Community pharmacists around Australia were invited to participate; 250 completed surveys were returned. A survey was constructed to measure pharmacists' knowledge and experience, emotions and beliefs about palliative care. Pharmacists were generally positive about providing services and supports for palliative care patients, yet they also reported negative beliefs and emotions about palliative care. In addition, pharmacists had good knowledge of some aspects of palliative care, but misconceptions about other aspects. Pharmacists' beliefs and knowledge about palliative care predicted--and therefore underpinned--a positive attitude towards palliative care and the provision of services and supports for palliative care patients. The results provide evidence that pharmacists need training and support to facilitate their involvement in providing services and supports for palliative care patients, and highlight areas that training and support initiatives should focus on.

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

PubMed Central

2013-01-01

Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability. PMID:23958272

Community pharmacists' perceptions of services that benefit older people in New Zealand.

PubMed

Tordoff, June; Chang, Shih Yen; Norris, Pauline T

2012-04-01

There is limited information in New Zealand about community pharmacists' perceptions of services that benefit older people. To explore the perceptions of community pharmacists' of services that benefit older people; the benefits perceived; and the experiences of pharmacists providing such services. Community pharmacies in New Zealand. A cross-sectional purpose-developed survey was carried out of all community pharmacies in New Zealand. This was followed by twenty qualitative telephone interviews of pharmacists identified as providing at least one specialized service. Interviews were recorded, transcribed verbatim, and coded for themes using constant comparison. Community pharmacists' opinions and perceptions in the cross-sectional survey and qualitative interviews. Responses were received from pharmacists in 403/905 evaluable pharmacies. All pharmacies provided some baseline services (advice, dispensing of prescriptions, medicines disposal) and 90% provided home deliveries of medicines. Adherence to medicines was supported by compliance packaging (96%), medication review (Medicines Use Review, MUR) (28%), and repeat prescription reminders (27%). Thirty-five percent provided screening (e.g. cholesterol, blood pressure), and 32% provided medicines education to community groups. Compliance packaging and home delivery were thought the services most beneficial for older people, and should help people adhere to their medicines. The 20 pharmacists interviewed by telephone provided 20 different specialized services (median 2, range 1-4). These included MUR, services to residential homes, visiting educators/special clinics, INR monitoring, services to hospices, and flu vaccination. Benefits perceived included improvements in adherence, patient safety, and patient-knowledge of medicines, and convenient access to services. "Patient need" was a frequent driver of services, and common facilitators for services were having appropriate training/skills, co-operation with health professionals, peer or expert support, sufficient time and funding. A lack of these facilitators were considered barriers as were resistance from general practitioners or the general public, or high set-up costs. Community pharmacists in New Zealand perceived they provide a range of services of potential benefit to older people for managing their medicines. Establishing new services requires cooperation from other health professionals, peer support, training, funding and time. Further research into patients' outcomes from new and established services is needed.

Why aren't people with young onset dementia and their supporters using formal services? Results from the INSPIRED study

PubMed Central

Withall, Adrienne; Horsfall, Ruth; Denham, Nicole; White, Fiona; Trollor, Julian; Loy, Clement; Brodaty, Henry; Sachdev, Perminder; Gonski, Peter; Demirkol, Apo; Cumming, Robert G.; Draper, Brian

2017-01-01

Background/Aims Despite reporting high levels of burden, supporters of people with young onset dementia (YOD) underuse formal community services. Previous quantitative studies in YOD are of limited utility in guiding service design because they did not consider important contextual barriers to service use. The aim of this study was to identify all relevant barriers and describe the service features considered most important to improving uptake by people with YOD and their supporters. Methods Eighty-six people with consensus-confirmed YOD (mean onset age 55.3 years) and/or their primary supporter participated in quantitative interviews, and 50 also participated in one of seven qualitative focus groups. Interview participants reported levels of community service use and reasons for non-use, functional impairment, behavioural and psychological symptoms, supporter burden, social network, and informal care provision. Focus group participants expanded on reasons for non-use and aspects of an ideal service. Results Although at least one community service was recommended to most participants (96.8%), 66.7% chose not to use one or more of these. Few of the clinical or demographic factors included here were related to service use. Qualitative analyses identified that lack of perceived need, availability, and YOD-specific barriers (including ineligibility, unaffordability, lack of security, lack of childcare) were commonly reported. Five aspects of an ideal service were noted: unique, flexibile, affordable, tailored, and promoting meaningful engagement. Conclusion People with YOD and their families report that formal community services do not meet their personal and psychological needs. Researchers can provide ongoing assessment of program feasibility, suitability, and generalisability. PMID:28723931

Building Communities: How Rural Community Colleges Develop Their Communities and the People Who Live in Them

ERIC Educational Resources Information Center

Miller, Michael T.; Tuttle, Courtney C.

2007-01-01

Community colleges in rural environments provide a variety of services. There is a great deal of documentation supporting those services that are academic and economic. The noneconomic and nonacademic results of community college activities, however, have an undocumented yet significant impact on local communities. The current study focused on how…

Commentary: The failure of social inclusion: an alternative approach through community development.

PubMed

Mandiberg, James M

2012-01-01

Mental health services have not resulted in broad-based inclusion of people with psychiatric disabilities. Rather, many maintain their community lives only through the support of formal mental health services, which is financially unsustainable given current fiscal realities. Fundamental assumptions about sources of support for everyday life need to be reassessed. The economic and social development of the mental health recovery community provides an alternative approach to helping people maintain successful community lives and shifts some of the supports from mental health providers to business infrastructure within the mental health recovery identity community. Some projects that have utilized this approach, such as business incubators and work integration social enterprises, are described, and community development that builds on concepts of recovery is discussed.

Do College Youth Serve Others? How and under Which Circumstances? Implications for Promoting Community Service

ERIC Educational Resources Information Center

Griffith, James; Thomas, Todd

2014-01-01

This chapter describes how data on the extent of community service among a national representative sample of young college students were associated with "supports," including human, social, and cultural capital. This chapter helps fill missing information on estimates of the occurrence and persistence of community service, types of…

Predictors of needs for families of children with cerebral palsy.

PubMed

Almasri, Nihad A; O'Neil, Margaret; Palisano, Robert J

2014-01-01

This study examined child, family and service characteristics that are predictors of family needs for community, financial, family support and services needs for families of children with cerebral palsy (CP). CP is a non-progressive neurological condition caused by lesions in the central nervous system resulting in limitations in motor function and associated co-morbid conditions. Children with CP often require multiple health, rehabilitation, and community services. To identify risk and protective factors among predictors of needed resources and services (i.e. community, financial, family support) and to discuss implications for coordination of medical, rehabilitation, and community services for children with CP and their families. Secondary data analysis was conducted with a national dataset (n = 441) of mothers of children with CP. The average age of children was 10.7 years (SD = 4.5) and was distributed across the various Gross Motor Function Classification System levels. Four logistic regression models were conducted to examine predictive power of child, family and current service characteristics on needed resources and services. Limited child gross motor function was a risk factor (odds ratio (OR): 1.30-1.70) while perception of family-centered services (FCS) was a protective factor (OR: 0.57-0.63) in having the needs met. Mothers of children with CP who are able to walk, reported strong family relationships, and perceived need-oriented and FCS expressed less needs for community, financial, family support and services' resources needs. Implications for service providers are provided.

Breastfeeding Supports and Services in Rural Hawaii: Perspectives of Community Healthcare Workers

PubMed Central

2017-01-01

Background. In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs) working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community's (specifically Hilo, Hawai‘i) breastfeeding service and support issues. Method. The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs (N = 23) about their individual or shared experience(s) about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed. PMID:28168053

Developing Cost Accounting and Decision Support Software for Comprehensive Community-Based Support Systems: An Analysis of Needs, Interest, and Readiness in the Field.

ERIC Educational Resources Information Center

Harrington, Robert; Jenkins, Peter; Marzke, Carolyn; Cohen, Carol

Prominent among the new models of social service delivery are organizations providing comprehensive, community-based supports and services (CCBSS) to children and their families. A needs analysis explored CCBSS sites' interest in and readiness to use a software tool designed to help them make more effective internal resource allocation decisions…

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

PubMed Central

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. Conclusions The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

PubMed

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

Avoiding institutional outcomes for older adults living with disability: the use of community-based aged care supports.

PubMed

Ellison, Caroline; White, Amy; Chapman, Libby

2011-09-01

Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived access to community-based aged care supports assisted with avoiding receiving more institutional models of service as they age. Qualitative research processes were used to explore the perceptions of 60 individuals with a disability aged 50 years and over, in relation to ageing and the value of community-based aged care. Findings indicated that participants receiving community-based aged care supports reported benefits including opportunities to develop relationships, maintain daily living skills and participate in community activities. Due to a lack of confidence in the availability of access to mainstream community-based aged care services, many participants felt vulnerable or unsure about their future and ability to remain living in their own home. Several participants commented that this meant that an undesired early relocation into residential aged care or congregate disability services appeared inevitable.

Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy.

PubMed

Patterson, Brandon J; Bakken, Brianne K; Doucette, William R; Urmie, Julie M; McDonough, Randal P

The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies. Copyright © 2016 Elsevier Inc. All rights reserved.

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.

PubMed

Stergiopoulos, Vicky; Saab, Dima; Francombe Pridham, Kate; Aery, Anjana; Nakhost, Arash

2018-01-24

Across many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto's local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation. We purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis. Findings revealed wide-ranging endorsement for the two team-based models' success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions. Findings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review.

PubMed

Wouters, Edwin; Van Damme, Wim; van Rensburg, Dingie; Masquillier, Caroline; Meulemans, Herman

2012-07-09

Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART) scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1) the lack of integration of ART services into the general health system; (2) the growing need for comprehensive care, (3) patient empowerment, (4) and defaulter tracing; and (5) the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. The review demonstrates that community support initiatives are a potentially effective strategy to address the growing shortage of health workers, and to broaden care to accommodate the needs associated with chronic HIV/AIDS. The existing evidence suggests that community support programmes, although not necessarily cheap or easy, remain a good investment to improve coverage of communities with much needed health services, such as ART. For this reason, health policy makers, managers, and providers must acknowledge and strengthen the role of community support in the fight against HIV/AIDS.

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

PubMed Central

2012-01-01

Background Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART) scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. Methods We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. Results The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1) the lack of integration of ART services into the general health system; (2) the growing need for comprehensive care, (3) patient empowerment, (4) and defaulter tracing; and (5) the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. Conclusions The review demonstrates that community support initiatives are a potentially effective strategy to address the growing shortage of health workers, and to broaden care to accommodate the needs associated with chronic HIV/AIDS. The existing evidence suggests that community support programmes, although not necessarily cheap or easy, remain a good investment to improve coverage of communities with much needed health services, such as ART. For this reason, health policy makers, managers, and providers must acknowledge and strengthen the role of community support in the fight against HIV/AIDS. PMID:22776682

One-Stop Shop

ERIC Educational Resources Information Center

Protheroe, Nancy

2010-01-01

Full-service community schools do more than educate; they partner with the community to provide the supports and services that students and families need through one comprehensive, coordinated effort. By offering services on-site, full-service schools can help eliminate some barriers that families face such as problems with transportation, lack of…

Using Learning Communities to Build Faculty Support for Pedagogical Innovation: A Multi-Campus Study

ERIC Educational Resources Information Center

Furco, Andrew; Moely, Barbara E.

2012-01-01

To encourage greater adoption of a pedagogical innovation (service-learning), semester long faculty learning communities were established at eight institutions. These learning community experiences produced gains in participants' (N = 152) self-assessed expertise with service-learning, ability to collaborate with community partners, and…

Perceived Community Functions and Supportive Residential Environments.

ERIC Educational Resources Information Center

Blake, Brian F.

Results of an illustrative study emphasize the importance of the images that the elderly and the general public have of a rural community's services for senior citizens. These images help to identify ways in which programs and services can be tailored to the requirements of the elderly. Public support for political action that bears directly upon…

Family Education and Support Services in Systems of Care

ERIC Educational Resources Information Center

Gyamfi, Phyllis; Walrath, Christine; Burns, Barbara J.; Stephens, Robert L.; Geng, Yisong; Stambaugh, Leyla

2010-01-01

This study examines the use of family education and support (FES) services within community-based mental health systems. Using data from the national evaluation of the Children's Mental Health Initiative (CMHI), 2,853 caregivers and their children ages 6 to 18 years from 39 communities participated in this study. The findings indicated that during…

HIV medication therapy management services in community pharmacies

PubMed Central

Kauffman, Yardlee; Nair, Vidya; Herist, Keith; Thomas, Vasavi; Weidle, Paul J.

2015-01-01

Objectives To present a rationale and a proposed structure to support pharmacist-delivered medication therapy management (MTM) for human immunodeficiency virus (HIV) disease and to outline challenges to implementing and sustaining the service. Data sources Professional literature. Summary Historically, the effect of pharmacy services for HIV-infected persons has been demonstrated in inpatient and clinic-based settings. Developing similar programs adapted for community pharmacists could be a model of care to improve patient adherence to antiretroviral therapy and retention in care. Initiation of antiretroviral therapy and regular monitoring of CD4+ cell count, HIV RNA viral load, adverse drug events, and adherence form the backbone of successful medical management of HIV infection. Support for these services can be provided to HIV-infected patients through pharmacist-managed HIV MTM programs in community pharmacy settings in collaboration with primary providers and other health care professionals. Conclusion Community pharmacists can help meet the growing need for HIV care through provision of MTM services. Although resources have been developed, including the general MTM framework, challenges of adequate training, education, and support of community pharmacists need to be addressed in order for HIV MTM to be a successful model. PMID:23229993

Successful outsourcing: improving quality of life through integrated support services.

PubMed

Bates, Jason; Sharratt, Martin; King, John

2014-01-01

This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.

An explanatory model of community pharmacists' support in the secondary prevention of cardiovascular disease.

PubMed

Puspitasari, Hanni P; Costa, Daniel S J; Aslani, Parisa; Krass, Ines

2016-01-01

Community pharmacists have faced ongoing challenges in the delivery of clinical pharmacy services. Various attitudinal and environmental factors have been found to be associated with the provision of general clinical pharmacy services or services which focus on a specific condition, including cardiovascular disease (CVD). However, the interrelationship and relative influence of explanatory factors has not been investigated. To develop a model illustrating influences on CVD support provision by community pharmacists. Mail surveys were sent to a random sample of 1350 Australian community pharmacies to investigate determinants of CVD support provision. A theoretical model modified from the Theory of Planned Behavior (TPB) was used as a framework for the survey instrument. Structural equation modeling was used to determine how pharmacists' attitudes and environmental factors influence CVD support. A response rate of 15.8% (209/1320) was obtained. The model for CVD support provision by community pharmacists demonstrated good fit: χ(2)/df = 1.403, RMSEA = 0.047 (90% CI = 0.031-0.062), CFI = 0.962, TLI = 0.955 and WRMR = 0.838. Factors found to predict CVD support included: two attitudinal latent factors ("subjective norms of pharmacists' role in CVD support" and "pharmacists' perceived responsibilities in CVD support") and environmental factors i.e. pharmacy infrastructure (documentation and a private area), workload, location; government funded pharmacy practice programs; and pharmacists' involvement with Continuing Professional Development and attendance at CVD courses. Pharmacists' attitudes appeared to be the strongest predictor of CVD support provision. The TPB framework was useful in identifying "subjective norms" and "pharmacists' beliefs" as key constructs of community pharmacists' attitudes. Community pharmacies would be able to provide such an advanced clinical service if they strongly believed that this was an acknowledged part of their scope of practice, had adequate infrastructure and employed sufficient numbers of pharmacists with appropriate and relevant knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizations That Offer Support Services

MedlinePlus

... help finding support services? View more than 100 organizations nationwide that provide emotional, practical, and financial support ... Groups Treatment Review our tips to find helpful organizations and resources in your community. Print E-mail ...

Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

PubMed

Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

2016-05-01

To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

The emerging role of faith community nurses in prevention and management of chronic disease.

PubMed

McGinnis, Sandra L; Zoske, Frances M

2008-08-01

Faith community nursing, formerly known as parish nursing, is one model of care that relies heavily on older registered nurses (RNs) to provide population-based and other nonclinical services in community settings. Faith community nursing provides services not commonly available in the traditional health care system (e.g., community case management, community advocacy, community health education). With appropriate support, this model of nursing could be expanded into other settings within the community and has the potential to draw on the skills of experienced RNs to provide communities with services that address unmet health care needs.

Community health worker in hard-to-reach rural areas of Myanmar: filling primary health care service gaps.

PubMed

Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway

2016-10-21

Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than the next 5 years which was determined by their ages, confidence, and training batch. CHWs are the health volunteers in the community supporting the midwives in hard-to-reach areas; given their contributions and easy access, policies to strengthen support to sustain their contributions and ensure the quality of services are recommended.

An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities.

PubMed

Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W

2016-12-01

To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Integrating Personalized and Community Services for Mobile Travel Planning and Management

NASA Astrophysics Data System (ADS)

Yu, Chien-Chih

Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

PubMed

Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

2014-01-01

Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Disability Support Services in Community Colleges. AACC Research Brief.

ERIC Educational Resources Information Center

Barnett, Lynn; Li, Yong

To determine the extent to which community colleges provide services and programs for students with disabilities, the American Association of Community Colleges (AACC) conducted a national survey in 1995 of public and private community, technical, and junior colleges in the United States, U.S. territories, and Canada. Fall 1995 headcounts for both…

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

Community Services: Block Grant Helps Address Local Social Service Needs. Report to Congressional Committees.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

The overall objective of this review was to obtain information on several issues raised in the Congress pertaining to the reauthorization of the Community Services Block Grant (CSBG) program. The information includes: (1) what CSBG funds are used for and whether CSBG-supported services duplicate other local social service programs, (2) what role…

A theory of how rural health services contribute to community sustainability.

PubMed

Farmer, Jane; Prior, Maria; Taylor, Judy

2012-11-01

Study and opinion suggest that health services play a significant role in supporting the social fabric of fragile rural communities. We draw on empirical evidence about the added-value contributions of health services to communities and unite it with theory of capitals to propose a theoretical model depicting how rural health services contribute to community sustainability. While providing an analytical framework, the paper also points to construction of a measurement tool for enabling planners to measure the contributions of diverse sectors to community sustainability and predict or measure the impact of changes to models of service delivery on the future of rural communities. Copyright © 2012 Elsevier Ltd. All rights reserved.

The American Association of Variable Star Observers: Serving the Research Community in 2010 and Beyond

NASA Astrophysics Data System (ADS)

Templeton, Matthew R.; Henden, A. A.; Davis, K.; Kinne, R.; Watson, C.; Saladyga, M.; Waagen, E.; Beck, S.; Menali, G.; Price, A.; Turner, R.

2010-05-01

The American Association of Variable Star Observers (AAVSO) holds the largest single online database of variable star data in the world, collected from thousands of amateur and professional observers during the past century. One of our core missions is to preserve and distribute these data to the research community in service to the science of variable star astronomy. But as an organization, the AAVSO is much more than a data archive. Our services to the research community include: monitoring for and announcement of major astronomical events like novae and supernovae; organization and management of observing campaigns; support for satellite and other TOO observing programs by the professional community; creation of comparison star sequences and generation of charts for the observer community; and observational and other support for the amateur, professional, and educator communities in all things related to variable stars. As we begin a new century of variable star astronomy we invite you to take advantage of the services the AAVSO can provide, and to become a part of our organization yourselves. In this poster, we highlight some of the most important services the AAVSO can provide to the professional research community, as well as suggest ways in which your research may be enhanced with support from the AAVSO.

Becoming a Neighbor: An Examination of the Placement of People with Mental Retardation in Connecticut Communities.

ERIC Educational Resources Information Center

Bradley, Valerie J.; And Others

This study examined the impact of deinstitutionalization of the mentally retarded on their communities, the extent of availability of support services, and the extent to which the Connecticut Department of Mental Retardation assures adequate quality of support services and day programs for people with mental retardation living in community…

Where Would You Turn for Help? Older Adults' Awareness of Community Support Services

ERIC Educational Resources Information Center

Denton, M.; Ploeg, J.; Tindale, J.; Hutchison, B.; Brazil, K.; Akhtar-Danesh, N.; Quinlan, M.; Lillie, J.; Plenderleith, J. Millen; Boos, L.

2008-01-01

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults…

Flying beneath the Radar of Health Reform: The Community Living Assistance Services and Supports (CLASS) Act

ERIC Educational Resources Information Center

Miller, Edward Alan

2011-01-01

The Patient Protection and Affordable Care Act attempts to address prevailing deficiencies in long-term care (LTC) financing through the Community Living Assistance Services and Supports (CLASS) Act, a national voluntary LTC insurance program administered by the Federal government. The CLASS Act is intended to supplement rather than supplant…

45 CFR 2519.500 - How does the Corporation review an application?

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOR NATIONAL AND COMMUNITY SERVICE HIGHER EDUCATION INNOVATIVE PROGRAMS FOR COMMUNITY SERVICE... an application submitted under this part on the basis of the quality, innovation, replicability, and... higher education, other than by demonstrating the commitment of its students, to supporting the community...

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

PubMed

Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

2013-03-01

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

Layered Learning, Eustress, and Support: Impact of a Pre-Service-Learning Training on Students' Self-Efficacy in Teaching in the Community

ERIC Educational Resources Information Center

Cooke, Natalie K.; Pursifull, Anne K.; Jones, Kerry M.; Goodell, L. Suzanne

2017-01-01

Service-learning programs provide students with opportunities to gain discipline-specific skills, while providing community organizations with a steady pool of volunteers. However, because students may lack the skills needed to effectively serve the community, skills-based training may need to be incorporated into service-learning courses.…

Community Reintegration for People with Psychiatric Disabilities: Challenging Systemic Barriers to Service Provision and Public Policy through Participatory Action Research

ERIC Educational Resources Information Center

Mirza, Mansha; Gossett, Andrea; Chan, Nathan Kai-Cheong; Burford, Larry; Hammel, Joy

2008-01-01

People with psychiatric disabilities represent a growing group within the population of nursing home residents in the USA. Despite a preference for living in community-based settings, the availability of supportive services for community living is hindered by barriers at both the service provision and public policy levels. Therefore, understanding…

Learner Support Services for Online Students: Scaffolding for Success.

ERIC Educational Resources Information Center

Ludwig-Hardman, Stacey; Dunlap, Joanna C.

2003-01-01

Effective retention for online students requires learner support services. Based on the principle of scaffolding, these services include intake and diagnosis during recruitment and admission, orientation to online learning, one-to-one advising, and access to a learning community. These supports can help overcome isolation, lack of self-direction…

75 FR 68975 - Supportive Services for Veteran Families Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... or provide supportive services to very low-income veteran families who are residing in permanent...-income veteran family's needs and preferences. The new SSVF Program is within the continuum of VA's...-income veterans served in an area or community should be considered when scoring the supportive services...

Consumers' and case managers' perceptions of mental health and community support service needs.

PubMed

Crane-Ross, D; Roth, D; Lauber, B G

2000-04-01

Consumers with serious and persistent mental illness (N = 385) and their case managers rated the amount of help needed and the amount of help received with mental health and community support services. Consumers also identified their primary source of help with each type of need. Results highlighted areas of agreement and disagreement between consumers' and case managers' perceptions. Consumers' reports revealed a strong reliance on sources of support outside the mental health system (e.g., family and friends) for many community support service needs, interpersonal needs, and crisis-related needs. In general, correlations between consumers' and case managers' ratings of help needed and help received were low. Consumers perceived the majority of their needs to be unmet; case managers perceived the majority of consumer needs to be overly met. Discussion focuses on the importance of increasing consensus between consumers and case managers regarding needs by including consumers in treatment planning and providing them with more information about available services. It is recommended that researchers and evaluators examine perceptions of help needed, help received, and sources of help when assessing service needs.

Promoting Community-Based Services: Implications for Program Design, Implementation, and Public Policy.

ERIC Educational Resources Information Center

Powers, Michael D.

1986-01-01

Program design, implementation, and public policy issues are discussed for five urban community-based programs for the developmentally disabled: (1) direct services in intermediate care facilities; (2) a High Risk Infant project; (3) group home consultative services; (4) training for support services to adoptive families; (5) a national…

Community Services Landscape in Canada: Survey of Developmental Disability Agencies.

ERIC Educational Resources Information Center

Pedlar, Alison; Hutchison, Peggy; Arai, Susan; Dunn, Peter

2000-01-01

A survey of 801 support services for adults with developmental disabilities living in community settings in Canada found a diminution of government's role in funding and guiding service provision and the emergence of private-for-profit services. Differences between nonprofit and private sectors include a greater propensity in nonprofit agencies to…

Use of Service-Learning to Teach Health Literacy with Online Graduate Nursing Students.

PubMed

George, Tracy P; DeCristofaro, Claire

To meet Healthy People 2020 goals, health literacy must be included in health care program curricula. In a fully online graduate nursing course, an innovative service-learning activity asked students to collaborate in the creation of low-literacy patient education pamphlets for practice partners at a community rehabilitation facility. Involvement with community stakeholders such as support groups and interprofessional team members enhanced interdisciplinary educational outcomes. Through this innovative project-based activity, students were able to meet the clinical education and decision support needs of rehabilitation patients while translating academic coursework to support actual community needs.

Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia

PubMed Central

Mayston, Rosie; Alem, Atalay; Habtamu, Alehegn; Shibre, Teshome; Fekadu, Abebaw; Hanlon, Charlotte

2016-01-01

Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from community consultation meetings (n = 4), focus group discussions (n = 7) and in-depth interviews (n = 11) with key stakeholders (healthcare administrators and providers, caregivers, service-users and community leaders) which were carried out over a 2-year period in the context of ongoing dialogue with the community. The principle of local delivery of mental health services was agreed upon by all stakeholder groups. Key reasons for supporting local delivery were increased access for the majority due to proximity, reduced cost and reduced stress related to transportation. However, acceptance of the new service was qualified by concerns about the competence of staff to deliver a comprehensive and dependable service of equal quality to that currently provided at the hospital. Adequate training and support, as well as ensuring consistency of medication supply were identified as key components to ensure success. Encouragingly, our results suggest that there is significant support for the service change and an interest for the mobilization of community resources to support this. One of the study strengths was that we were able to present the different perspectives of multiple stakeholder groups. By nesting the study in an ongoing community-based cohort of people with SMD we were able to interview a more representative and empowered group of caregivers and service users than is often available in LMICs. Despite this, the extent to which service-users are able to express their opinions is likely limited by their marginalized role in rural Ethiopian society. PMID:26282860

Community health workers and medicaid managed care in New Mexico.

PubMed

Johnson, Diane; Saavedra, Patricia; Sun, Eugene; Stageman, Ann; Grovet, Dodie; Alfero, Charles; Maynes, Carmen; Skipper, Betty; Powell, Wayne; Kaufman, Arthur

2012-06-01

We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.

Costing Human Rights and Community Support Interventions as a Part of Universal Access to HIV Treatment and Care in a Southern African Setting

PubMed Central

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-01-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, ‘Know Your Rights’ information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion. PMID:21999777

Costing human rights and community support interventions as a part of universal access to HIV treatment and care in a Southern African setting.

PubMed

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-09-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, 'Know Your Rights' information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion.

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.

The association between cognitive impairment and community service use patterns in older people living in Australia.

PubMed

Vecchio, Nerina; Fitzgerald, Janna A; Radford, Katrina; Fisher, Ron

2016-05-01

Family plays a vital role in supporting individuals with dementia to reside in the community, thus delaying institutionalisation. Existing research indicates that the burden of care-giving is particularly high for those caring for a person with dementia. Yet, little is known about the uptake of community services by people with a diagnosis of dementia. Therefore, this study aims to better understand the relationship between cognitive impairment and the receipt of community care services. In order to examine the relationship, secondary data collected across Queensland, Australia, from 59,352 home-care clients aged 65 and over during 2007-2008 are analysed. This cross-sectional study uses regression analyses to estimate the relationship between cognitive impairment and service mix, while controlling for socio-demographic characteristics. The dependent variables include formal services, informal care and total home-care service hours during a 12-month period. The findings of this study demonstrate that cognitive impairment is associated with accessing more hours of respite and day centre care but fewer hours of other formal care services. Additionally, the likelihood of support from an informal caregiver increases when a client becomes cognitively impaired. Therefore, this study demonstrates that there is an increased need for respite programmes to support informal caregivers in the future, as the population of people living with dementia increases. These findings support the need for investigations of new and innovative respite models in the future. © 2015 John Wiley & Sons Ltd.

Empowering European communities to improve natural resource management for human well-being: the OPPLA web portal & communities of practice

NASA Astrophysics Data System (ADS)

Metzger, M.; Brown, C.; Pérez-Soba, M.; Rounsevell, M.; Verweij, P.; Delbaere, B.; Cojocaru, G.; Saarikoski, H.; Harrison, P.; Zellmer, K.

2014-12-01

The ecosystem services concept is seen by many as a useful paradigm to support decision-making at the complex interface between science, policy and practice. However, to be successful, it requires a strong willingness for collaboration and joint understanding. In support of this aspiration, OPPLA is being developed as a web portal to enable European communities to better manage ecosystems for human well-being and livelihoods. OPPLA will provide access to a variety of online resources such as tools, case studies, lessons learned, videos, manuals and training and educational materials. It will also provide expert forums and spaces for discussions between researchers, practitioners and decision makers. Hence a critical aspect of the success of OPPLA is the co-evolution of communities of practice. An example of a community of practice is the recently launched Ecosystem Services Community - Scotland (ESCom-Scotland; escomscotland.wordpress.com). ESCom-Scotland aims to support better management of Scotland's natural resources by helping to establish a community of practice between individuals and groups involved in the science, policy and practice behind sustainable ecosystem management. It aspires to encourage the sharing of ideas, increase collaboration and to initiate a support network for those engaging with the ecosystem services concept and it will use the OPPLA resources to support these activities. OPPLA is currently at the developmental stage and was instigated by two large European Commission funded research projects: OPERAs (www.operas-project.eu) and OpenNESS (www.openness-project.eu), with a combined budget of ca. €24m. These projects aim to improve understanding of how ecosystem services contribute to human well-being in different social-ecological systems. Research will establish whether, how and under what conditions the ecosystem services concept can move beyond the academic domain towards practical implementation in support of sustainable ecosystem management. New insights, and improved or novel tools and instruments, will be tested in practice in case studies that cover a range of socio-ecological systems across locales, sectors, scales and time. This presentation will discuss the development of OPPLA and the communities of practice that are emerging around it.

Understanding occupational therapy students' attitudes, intentions, and behaviors regarding community service.

PubMed

Hoppes, Steve; Hellman, Chan M

2007-01-01

Community-based practice has always been a central domain of occupational therapy, and evidence supporting its increasing importance is growing. Preparing occupational therapy students for community practice has received considerable attention in professional literature, but students' voices have seldom been heard concerning this issue. This study sought to investigate attitudes, intentions, and behaviors regarding community service among occupational therapy students enrolled in one professional program using the Community Service Attitudes Survey. We present the Theory of Planned Behavior as a conceptual framework linking students' attitudes and intentions with behaviors. Results indicate that these occupational therapy students' attitudes and intentions regarding community service tended to be more strongly positive than those of their counterparts in other allied health disciplines; however, the community service behaviors of occupational therapy students were not significantly different from those of other allied health students, possibly because occupational therapy students perceived high costs to community service.

Distance Education Programs in Texas Community & Technical Colleges: Assessing Student Support Services in a Virtual Environment.

ERIC Educational Resources Information Center

Luedtke, Cherry Beth

This project evaluates the status of distance learning at 54 public, two-year community, and technical colleges in Texas. Data was collected from the Web sites of each of the institutions. The Web site data indicted that 44 of the colleges refer specifically to distance education courses offered. To assess what student support services are…

The Effectiveness of the Student Support Service Program on Retention at a Rural Appalachia Community College

ERIC Educational Resources Information Center

Hodge, Deborah D.

2017-01-01

This study examined the role of TRiO Student Support Services (SSS) programs for students who persist in college. The intent of this study was to determine whether the services provided to participants in SSS helped them achieve higher grade-point averages (GPA), retention rates, and graduation rates. Student Support Services programs are designed…

Application of ESE Data and Tools to Air Quality Management: Services for Helping the Air Quality Community use ESE Data (SHAirED)

NASA Technical Reports Server (NTRS)

Falke, Stefan; Husar, Rudolf

2011-01-01

The goal of this REASoN applications and technology project is to deliver and use Earth Science Enterprise (ESE) data and tools in support of air quality management. Its scope falls within the domain of air quality management and aims to develop a federated air quality information sharing network that includes data from NASA, EPA, US States and others. Project goals were achieved through a access of satellite and ground observation data, web services information technology, interoperability standards, and air quality community collaboration. In contributing to a network of NASA ESE data in support of particulate air quality management, the project will develop access to distributed data, build Web infrastructure, and create tools for data processing and analysis. The key technologies used in the project include emerging web services for developing self describing and modular data access and processing tools, and service oriented architecture for chaining web services together to assemble customized air quality management applications. The technology and tools required for this project were developed within DataFed.net, a shared infrastructure that supports collaborative atmospheric data sharing and processing web services. Much of the collaboration was facilitated through community interactions through the Federation of Earth Science Information Partners (ESIP) Air Quality Workgroup. The main activities during the project that successfully advanced DataFed, enabled air quality applications and established community-oriented infrastructures were: develop access to distributed data (surface and satellite), build Web infrastructure to support data access, processing and analysis create tools for data processing and analysis foster air quality community collaboration and interoperability.

A Rebirth of Courage: Service to the Community.

ERIC Educational Resources Information Center

Townsend, Kathleen Kennedy

This speech promotes student involvement in community service activities. The notions of traditional American volunteerism and community spirit support the idea of students devoting their afterschool talents and energy to helpful endeavors such as tutoring, visiting nursing homes, planting trees, cleaning up ocean shores and river banks, clearing…

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.

Factors That Contribute to Community Members' Support of Local Nature Centers

ERIC Educational Resources Information Center

Browning, Matthew H. E. M.; Stern, Marc J.; Ardoin, Nicole M.; Heimlich, Joe E.

2018-01-01

Nature centers can serve as valuable community institutions if they are seen as providing important services to the community. Through survey research in communities surrounding 16 nature centers in the United States, we examine the attitudes, behaviors, and beliefs that drive hypothetical support for nature centers from local residents.…

45 CFR 1355.25 - Principles of child and family services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... a manner that is respectful of and builds on the strengths of the community and cultural groups. (f..., and informal support networks. (g) Most child and family services are community-based, involve...

Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

PubMed

Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally supportive of the initiative but were unaware of the service or potential benefits. Poorly developed existing pharmacist-GP relationships impeded implementation. This study identifies the multifaceted and complex processes involved in implementing a new community pharmacy service in England. Community pharmacy workflow, infrastructure, and public and professional relationships all affect NMS implementation. Greater prior engagement with the pharmacy workforce and GPs, robust piloting and a phased rollout together with ongoing support and updates, are potentials strategies to ensure future implementation of pharmacy services meet their intended aims in practice. Copyright © 2015 Elsevier Inc. All rights reserved.

The role of volunteer support in the community for adults with hearing loss and hearing aids.

PubMed

Pryce, Helen; Hall, Amanda; Gooberman-Hill, Rachael

2015-08-01

To explore interactions between audiology patients and volunteers, to describe encounters and define the role of volunteers. Qualitative ethnographic and interview study of volunteer-patient interactions. Ten volunteer participants from two volunteer schemes in South West England were observed and interviewed. Three patient participants were interviewed. Analysis of observational data showed that volunteers provided support relating to local services and hearing aids, but did not engage in discussions about hearing loss. Interviews with volunteers identified gaps in audiology provision, including accessible services and clear information and highlighted a need for more support from audiology services to enable them to fulfil their role. Volunteer interactions with patients mimicked a clinician-patient encounter and volunteers employed strategies and behaviours used by professional audiologists. Audiology volunteers could provide an accessible bridge between health services and the community but their care is limited to focus on hearing aids. Volunteers enable patients to use hearing aids appropriately and are a core element of current care arrangements. However, volunteers express a need for adequate support from audiology services. Volunteers have the potential to increase service capacity and to bridge the gaps between community and audiology healthcare services. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The Direct Support Workforce Crisis: Can Unions Help Resolve This?

ERIC Educational Resources Information Center

Taylor, Steven J.

2008-01-01

Problems faced by the developmental disability service system in recruiting and retaining direct support staff are exacerbated by demands from competing service industries, including long term supports for the increasing aging population in the United States. Many factors account for high turnover and vacancy rates in the community service system,…

The Market for Community Services for Older People.

ERIC Educational Resources Information Center

Hereford, Russell W.

The Supportive Services Program for Older Persons is designed to demonstrate that a private market for home and community-based health related services can be developed in response to the demand expressed by older people and their families. The objective of the program is to expand the service options available to older people by letting market…

Corporation for National and Community Service: Funding Opportunities for Afterschool. Funding Note

ERIC Educational Resources Information Center

Stelow, Shawn

2009-01-01

This Funding Note focuses on finding funding opportunities for afterschool through the Corporation for National and Community Service (CNCS), the federal agency charged with fostering civic engagement for citizens of all ages through service and volunteering. CNCS's mission includes: (1) Providing support to volunteer organizations which provide…

"Librarian's Anxiety"? How Community College Librarians Feel about Their Reference Desk Service

ERIC Educational Resources Information Center

Powers, Anne

2010-01-01

A survey of community college librarians in California reveals that the nature of reference service required of them, limitations on budget, staffing, technical support, resources, decision-making ability, and professional development opportunities, affect their professional attitudes. Librarians see reference service as primarily a teaching role.…

Placement, support, and retention of health professionals: national, cross-sectional findings from medical and dental community service officers in South Africa.

PubMed

Hatcher, Abigail M; Onah, Michael; Kornik, Saul; Peacocke, Julia; Reid, Stephen

2014-02-26

In South Africa, community service following medical training serves as a mechanism for equitable distribution of health professionals and their professional development. Community service officers are required to contribute a year towards serving in a public health facility while receiving supervision and remuneration. Although the South African community service programme has been in effect since 1998, little is known about how placement and practical support occur, or how community service may impact future retention of health professionals. National, cross-sectional data were collected from community service officers who served during 2009 using a structured self-report questionnaire. A Supervision Satisfaction Scale (SSS) was created by summing scores of five questions rated on a three-point Likert scale (orientation, clinical advising, ongoing mentorship, accessibility of clinic leadership, and handling of community service officers' concerns). Research endpoints were guided by community service programmatic goals and analysed as dichotomous outcomes. Bivariate and multivariate logistical regressions were conducted using Stata 12. The sample population comprised 685 doctors and dentists (response rate 44%). Rural placement was more likely among unmarried, male, and black practitioners. Rates of self-reported professional development were high (470 out of 539 responses; 87%). Participants with higher scores on the SSS were more likely to report professional development. Although few participants planned to continue work in rural, underserved communities (n = 171 out of 657 responses, 25%), those serving in a rural facility during the community service year had higher intentions of continuing rural work. Those reporting professional development during the community service year were twice as likely to report intentions to remain in rural, underserved communities. Despite challenges in equitable distribution of practitioners, participant satisfaction with the compulsory community service programme appears to be high among those who responded to a 2009 questionnaire. These data offer a starting point for designing programmes and policies that better meet the health needs of the South African population through more appropriate human resource management. An emphasis on professional development and supervision is crucial if South Africa is to build practitioner skills, equitably distribute health professionals, and retain the medical workforce in rural, underserved areas.

Day Habilitation Services for People with Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

ERIC Educational Resources Information Center

Friedman, Carli

2016-01-01

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how…

Knowledge Sourcing in IT Support Services

ERIC Educational Resources Information Center

Workman, Sue B.

2011-01-01

Indiana University (IU) provides great support for the technology the community needs to teach, learn, and conduct research. Rather than limiting support by defining a rigid support matrix, IU has chosen instead to utilize knowledge management technology to provide self-service for repetitive information technology (IT) questions, and focus…

Cultivating Sustainable and Authentic Service-Learning Partnerships in the Environmental Sciences

NASA Astrophysics Data System (ADS)

Ivanochko, Tara; Grain, Kari

2017-04-01

The two-term, community service-learning capstone course for Environmental Sciences at the University of British Columbia, Canada, aims to support both community and students using authentic science practice in service of the community. During the course development, we implemented a routine process for student and community feedback, instructor reflection and course revision. Drawing on data from 23 interviews and 9 focus groups collected over three years, findings from this study highlight ways that community partnerships can be sustained while students have an authentic science experience. Based on data collected from community partners, we highlight the key processes, challenges, successes, and practical considerations in the creation and sustainability of a scientifically robust service-learning course.

Structured social relationships: a review of volunteer home visiting programs for parents of young children.

PubMed

Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

2016-06-01

Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological limitations, pointing to a need for further rigorous research. What is known about the topic? Volunteer family support programs have been an important part of the service landscape for vulnerable families, both nationally and internationally, for many years. Anecdotal reports suggest that this is a valued form of support that increases a sense of community connectedness and breaks down barriers for families in accessing other community support services. What does this paper add? This paper proposes a model identifying broad service pathways impacting on family health and well being that takes into account the importance of structured social relationships and social connectedness. What are the implications for practitioners? The proposed model may encourage discussion by practitioners and organisations interested in models of support for families who are socially isolated and/or in need of assistance to access and engage with services within the community.

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

PubMed Central

Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

2015-01-01

Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802

EUDAT: A New Cross-Disciplinary Data Infrastructure For Science

NASA Astrophysics Data System (ADS)

Lecarpentier, Damien; Michelini, Alberto; Wittenburg, Peter

2013-04-01

In recent years significant investments have been made by the European Commission and European member states to create a pan-European e-Infrastructure supporting multiple research communities. As a result, a European e-Infrastructure ecosystem is currently taking shape, with communication networks, distributed grids and HPC facilities providing European researchers from all fields with state-of-the-art instruments and services that support the deployment of new research facilities on a pan-European level. However, the accelerated proliferation of data - newly available from powerful new scientific instruments, simulations and the digitization of existing resources - has created a new impetus for increasing efforts and investments in order to tackle the specific challenges of data management, and to ensure a coherent approach to research data access and preservation. EUDAT is a pan-European initiative that started in October 2011 and which aims to help overcome these challenges by laying out the foundations of a Collaborative Data Infrastructure (CDI) in which centres offering community-specific support services to their users could rely on a set of common data services shared between different research communities. Although research communities from different disciplines have different ambitions and approaches - particularly with respect to data organization and content - they also share many basic service requirements. This commonality makes it possible for EUDAT to establish common data services, designed to support multiple research communities, as part of this CDI. During the first year, EUDAT has been reviewing the approaches and requirements of a first subset of communities from linguistics (CLARIN), solid earth sciences (EPOS), climate sciences (ENES), environmental sciences (LIFEWATCH), and biological and medical sciences (VPH), and shortlisted four generic services to be deployed as shared services on the EUDAT infrastructure. These services are data replication from site to site, data staging to compute facilities, metadata, and easy storage. A number of enabling services such as distributed authentication and authorization, persistent identifiers, hosting of services, workspaces and centre registry were also discussed. The services being designed in EUDAT will thus be of interest to a broad range of communities that lack their own robust data infrastructures, or that are simply looking for additional storage and/or computing capacities to better access, use, re-use, and preserve their data. The first pilots were completed in 2012 and a pre-production ready operational infrastructure, comprised of five sites (RZG, CINECA, SARA, CSC, FZJ), offering 480TB of online storage and 4PB of near-line (tape) storage, initially serving four user communities (ENES, EPOS, CLARIN, VPH) was established. These services shall be available to all communities in a production environment by 2014. Although EUDAT has initially focused on a subset of research communities, it aims to engage with other communities interested in adapting their solutions or contributing to the design of the infrastructure. Discussions with other research communities - belonging to the fields of environmental sciences, biomedical science, physics, social sciences and humanities - have already begun and are following a pattern similar to the one we adopted with the initial communities. The next step will consist of integrating representatives from these communities into the existing pilots and task forces so as to include them in the process of designing the services and, ultimately, shaping the future CDI.

Data near processing support for climate data analysis

NASA Astrophysics Data System (ADS)

Kindermann, Stephan; Ehbrecht, Carsten; Hempelmann, Nils

2016-04-01

Climate data repositories grow in size exponentially. Scalable data near processing capabilities are required to meet future data analysis requirements and to replace current "data download and process at home" workflows and approaches. On one hand side, these processing capabilities should be accessible via standardized interfaces (e.g. OGC WPS), on the other side a large variety of processing tools, toolboxes and deployment alternatives have to be supported and maintained at the data/processing center. We present a community approach of a modular and flexible system supporting the development, deployment and maintenace of OGC-WPS based web processing services. This approach is organized in an open source github project (called "bird-house") supporting individual processing services ("birds", e.g. climate index calculations, model data ensemble calculations), which rely on basic common infrastructural components (e.g. installation and deployment recipes, analysis code dependencies management). To support easy deployment at data centers as well as home institutes (e.g. for testing and development) the system supports the management of the often very complex package dependency chain of climate data analysis packages as well as docker based packaging and installation. We present a concrete deployment scenario at the German Climate Computing Center (DKRZ). The DKRZ one hand side hosts a multi-petabyte climate archive which is integrated e.g. into the european ENES and worldwide ESGF data infrastructure, and on the other hand hosts an HPC center supporting (model) data production and data analysis. The deployment scenario also includes openstack based data cloud services to support data import and data distribution for bird-house based WPS web processing services. Current challenges for inter-institutionnal deployments of web processing services supporting the european and international climate modeling community as well as the climate impact community are highlighted. Also aspects supporting future WPS based cross community usage scenarios supporting data reuse and data provenance aspects are reflected.

Feasibility of a rural palliative supportive service.

PubMed

Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

2015-01-01

Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between January 2013 and May 2014. Scheduled in-person visit duration showed a mean of 67 minutes. During this same time period only 19 scheduled visits were declined, and there was no study attrition except through death, indicating a high degree of acceptability of the intervention. The primary needs that were addressed during these visits have been related to chronic disease management, and the attending physical symptoms were addressed through teaching and support. The use of structured quality of life and family caregiver needs assessments has been useful in facilitating communication, although some participants experienced the nature of the questions as too personal in the early stages of the relationship with the nurse coordinator. Findings from this study illustrate the feasibility of providing home-based services for rural older adults living with life-limiting chronic illness. The RPaSS model has the potential to smooth transitions and enhance quality of life along the disease trajectory and across locations of care by providing a consistent source of support and education. This type of continuity has the potential to foster the patient- and family-centered approach to care that is the ideal of a palliative approach. Further, the use of a rural community capacity-building approach may contribute to sustainability, which is a particularly important part of rural health service delivery.

Behavioral health support and online peer communities: international experiences

PubMed Central

Harding, Claire

2016-01-01

Online peer support communities play an important part in many people’s experience of healthcare. They can be particularly significant in behavioral health/mental health due to the difficulties that people may experience in accessing face to face care for these conditions. There is considerable diversity of practice in service management, target group, and moderation practices of online peer support communities. People using the communities also appear to have diverse aims and experiences. This heterogeneity contributes to a relative lack of data about the value and effectiveness of online peer support in behavioral health, although there is significant research into some aspects of these communities. The digital behavioral health service Big White Wall was launched in the UK in 2007, and in the US in 2015, and is focused on delivering moderated peer support. There are considerable differences in health systems between the two countries, and this has been reflected in different experiences of implementation. The value of online peer support could be maximized if systemic challenges to implementation and adoption were addressed more effectively. PMID:28293613

Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators.

PubMed

Zimmerman, Sheryl; Love, Karen; Cohen, Lauren W; Pinkowitz, Jackie; Nyrop, Kirsten A

2014-01-01

As a result of the Centers for Medicare & Medicaid Services (CMS) interest in creating a unifying definition of "community living" for its Medicaid Home and Community Based Services and Support (HCBS) programs, it needed clarifying descriptors of person-centered (PC) practices in assisted living to distinguish them from institutional ones. Additionally, CMS's proposed language defining "community living" had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This manuscript describes the consensus process through which clarifying language for "community living" and a framework for HCBS PC domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring PC practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing PC indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.

OA20 The positioning of family, friends, community, and service providers in support networks for caring at end-of-life: a social network analysis.

PubMed

Leonard, Rosemary; Horsfall, Debbie; Rosenberg, John; Noonan, Kerrie

2015-04-01

Although there is ample evidence of the risk to carers from the burden of caring, there is also evidence that a caring network can relieve the burden on the principal carer, strengthen community relationships, and increase 'Death Literacy' in the community. There is often an assumption that, in caring networks, family and service providers are central and friends and community are marginal. We examined whether this is the case in practice using SNA. To identify the relative positioning of family, friends, community, and service providers in caring networks. In interviews with carers (N = 23) and focus groups with caring networks (N = 13) participants were asked to list the people in the caring network and rate the strength of their relationships to them (0 no relationship to 3 strong relationship). SNA in UCInet was used to map the networks, examine density (number and strength of relationships) across time (when caring began to the present) and across relationship types (family, friends, community, and service providers) supplemented by qualitative data. The analysis revealed significant increases in the density of the networks over time. The density of relationships with friends was similar to that other family. Community and service providers had significantly lower density. Qualitative analysis revealed that often service providers were not seen as part of the networks. To avoid carer burnout, it is important not to make assumptions about where carers obtain support but work with each carer to mobilise any support that is available. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

‘The government cannot do it all alone’: realist analysis of the minutes of community health committee meetings in Nigeria

PubMed Central

Abimbola, Seye; Molemodile, Shola K; Okonkwo, Ononuju A; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra L

2016-01-01

Since the mid-1980s, the national health policy in Nigeria has sought to inspire community engagement in primary health care by bringing communities into partnership with service providers through community health committees. Using a realist approach to understand how and under what circumstances the committees function, we explored 581 meeting minutes from 129 committees across four states in Nigeria (Lagos, Benue, Nasarawa and Kaduna). We found that community health committees provide opportunities for improving the demand and supply of health care in their community. Committees demonstrate five modes of functioning: through meetings (as ‘village square’), reaching out within their community (as ‘community connectors’), lobbying governments for support (as ‘government botherers’), inducing and augmenting government support (as ‘back-up government’) and taking control of health care in their community (as ‘general overseers’). In performing these functions, community health committees operate within and through the existing social, cultural and religious structures of their community, thereby providing an opportunity for the health facility with which they are linked to be responsive to the needs and values of the community. But due to power asymmetries, committees have limited capacity to influence health facilities for improved performance, and governments for improved health service provision. This is perhaps because national guidelines are not clear on their accountability functions; they are not aware of the minimum standards of services to expect; and they have a limited sense of legitimacy in their relations with sub-national governments because they are established as the consequence of a national policy. Committees therefore tend to promote collective action for self-support more than collective action for demanding accountability. To function optimally, community health committees require national government or non-government organization mentoring and support; they need to be enshrined in law to bolster their sense of legitimacy; and they also require financial support to subsidise their operation costs especially in geographically large communities. PMID:26210167

Mentoring Partnerships in a Community Technology Centre: A Constructionist Approach for Fostering Equitable Service Learning

ERIC Educational Resources Information Center

Kafai, Yasmin B.; Desai, Shiv; Peppler, Kylie A.; Chiu, Grace M.; Moya, Jesse

2008-01-01

Mentoring programmes have gained increasing popularity in institutions of higher education to support undergraduates in community service or outreach efforts. Many of these programmes partner mentors with inner-city youth, providing assistance in underserved communities while mentors gain experiences that connect theory and practice. Here we…

Micro-provision of Social Care Support for Marginalized Communities - Filling the Gap or Building Bridges to the Mainstream?

PubMed

Needham, Catherine; Carr, Sarah

2015-12-01

As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro-providers - very small community-based organizations, which can work directly with individuals. These micro-providers are assumed to be able to cater for the 'seldom heard' groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer-reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small-scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self-organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community-based micro-providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization.

The role of information technology in the development of community pharmacy services: visions and strategic views of international experts.

PubMed

Westerling, Anna M; Haikala, Veikko; Airaksinen, Marja

2011-12-01

Community pharmacy's strategic vision has been to extend practice responsibilities beyond dispensing and provide patient care services. Few studies have evaluated the strategic and long-term development of information technology (IT) systems to support this vision. The objective of this study was to explore international experts' visions and strategic views on IT development needs in relation to service provision in community pharmacies. Semistructured interviews were conducted with a purposive sample of 14 experts from 8 countries in 2007-2008. These experts had expertise in the development of community pharmacy services and IT. The interviews were content analyzed using a constant comparison approach and a SWOT (strengths, weaknesses, opportunities, threats) analysis was undertaken. Most of the experts shared the vision for community pharmacy adopting a patient care orientation; supported by IT-based documentation, new technological solutions, access to information, and shared patient data. Opportunities to achieve this vision included IT solutions, professional skills, and interprofessional collaboration. Threats included costs, pharmacists' attitude, and the absence of IT solutions. Those responsible for IT development in community pharmacy sector should create long-term IT development strategies that are in line with community pharmacy service development strategies. Copyright © 2011 Elsevier Inc. All rights reserved.

Family Support Services. A Review of the Literature and Selected Annotated Bibliography.

ERIC Educational Resources Information Center

Wolcott, Ilene

This document contains a literature review and annotated bibliography on family support services in Australia and overseas. Literature relating to services for families with dependent adolescent children as well as young children is included. The review and bibliography concentrate primarily on community-based services defined in the literature as…

77 FR 14385 - Family Violence Prevention and Services/Grants for Domestic Violence Shelters/Grants to Native...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... Provision of individual and group counseling, peer support groups, and referral to community-based services... violence, or dating violence, including age- appropriate counseling, supportive services, and services for..., or was, lawfully residing. Indian Tribe: Any Indian Tribe, band, nation, or other organized group or...

Modelling of volunteer satisfaction and intention to remain in community service: A stepwise approach

NASA Astrophysics Data System (ADS)

Hasan, Hazlin; Wahid, Sharifah Norhuda Syed; Jais, Mohammad; Ridzuan, Arifi

2017-05-01

The purpose of this study is to obtain the most significant model of volunteer satisfaction and intention to remain in community service by using a stepwise approach. Currently, Malaysians, young and old are showing more interests in involving themselves in community service projects, either locally or internationally. This positive movement of serving the needy is somehow being halted by the lack of human and financial resources. Therefore, the trend today sees organizers of such projects depend heavily on voluntary supports as they enable project managers to add and to expand the quantity and diversity of services offered without exhausting the minimal budget available. Volunteers are considered a valuable commodity as the available pool of volunteers may be declining due to various reasons which include the volunteer satisfaction. In tandem with the existing situation, a selected sample of 215 diploma students from one of the public universities in Malaysia, who have been involved in at least one community service project, agreed that everybody should have a volunteering intention in helping others. The findings revealed that the most significant model obtained contains two factors that contributed towards intention to remain in community service; work assignment and organizational support, with work assignment becoming the most significant factor. Further research on the differences of intention to remain in community service between students' stream and gender would be conducted to contribute to the body of knowledge.

Drug Free Communities Support Program. Prevention Update

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

2012-01-01

Administered by the Office of National Drug Control Policy (ONDCP), in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Free Communities Support Program (DFC) is a federal grant program that provides funding to community-based coalitions that organize to prevent youth substance use. Since the…

Toward Family and Community: Mental Retardation Services in Massachusetts, New England, and the United States.

ERIC Educational Resources Information Center

Braddock, David; Hemp, Richard

1997-01-01

Current trends in mental retardation services in Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Massachusetts' movement toward reducing reliance on state institutions, reallocating funding, and developing community services and family support is…

Professionals' views on mental health service users' education: challenges and support.

PubMed

Nieminen, I; Kaunonen, M

2017-02-01

WHAT IS KNOWN ON THE SUBJECT?: Mental health service users (MHSUs) may experience disruptions in their education. However, education has been shown to have a positive influence on their recovery, potentially offering them broader employment opportunities. The literature suggests that providing support for MHSUs in their educational efforts may be beneficial and is wished for by the service users themselves. However, there is a lack of mental health professionals' views on the topic in the setting of a community mental health centre. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: In the perception of mental health professionals, the predominance of disease in the life of MHSUs and their marginalization may form barriers to their success in education. Professionals can support MHSUs in their educational efforts by strengthening the MHSUs' internal resources and creating a supportive environment with professional expertise available. A service user-centred education might further help MHSUs to achieve their educational goals. Our findings confirm previous knowledge of a recovery-oriented approach to supporting MHSUs' education. This study explored the topic from the professionals' perspective in the context of community mental health centres, which is a fresh view in the research literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest which types of support professionals perceive to be required for MHSUs to advance their studies. Knowledge of adequate forms of support can be applied in the mental health nursing practice to develop support measures for service users to advance in their studies. All levels of the community mental health centres should be aware of and adopt a recovery-oriented approach. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and the more active involvement of MHSUs in the design of their own rehabilitation process. Introduction Studies show the importance of providing support for mental health service users' (MHSUs') education. However, none of these studies explored this support in the community mental health centre setting. The range of MHSUs' educational activities identified in this study varied from participation in courses at the mental health centres to independent studies at different levels of education outside the centres. Aim (1) How do mental health professionals perceive the challenges that may limit service users' potential when they apply for, and complete, their education? (2) How do the professionals describe the methods of rehabilitation aimed at supporting the service users in achieving their educational goals? Method The data were collected from 14 mental health professionals using focus group interviews. Inductive content analysis was then performed. Results Professionals perceive that the predominance of disease and marginalization may be barriers to MHSUs' success in education. Strengthening the MHSUs' internal resources, creating a supportive environment with professional expertise available and service user-centred education appeared to support the MHSUs' educational achievements. Our findings confirm previous knowledge of a recovery-oriented approach to support MHSUs' education. However, professionals' views on this topic in the context of community mental health centres have not been investigated previously. Discussion Professionals perceive that a recovery-oriented approach to rehabilitation may support MHSUs in their educational efforts. Implications for practice A recovery-oriented approach should be adopted by all levels of the community mental health centres. MHSUs and professionals need to have a shared opinion on the definition of recovery orientation. This requires mutual discussion and a more active involvement of MHSUs in the design of their own rehabilitation process. © 2017 John Wiley & Sons Ltd.

Cash and counseling: a promising option for consumer direction of home- and community-based services and supports.

PubMed

Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen

2006-01-01

The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.

Peace corps partnered health services implementation research in global health: opportunity for impact.

PubMed

Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-09-01

There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community-Peace Corps-academic partnership approach to conduct local primary healthcare services implementation research. The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach, the contributions of each partner are as follows: the local community and health system leadership guides the work in consideration of local priorities and context; the Peace Corps provides logistical support, community expertise, and local trust; and the academic institutions offer professional technical and public health educational and training resources and research support. The Peace Corps offers the opportunity to enhance a community-academic partnership in LMICs through community-level guidance, logistical assistance, and research support for community based participatory primary health-care services implementation research that addresses local primary healthcare priorities.

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research.

PubMed

Goeman, Dianne; King, Jordan; Koch, Susan

2016-12-07

To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the 'SDN' model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Community Nursing Care of Chinese-Australian Cancer Patients: A Qualitative Study.

PubMed

McKenzie, Heather; Kwok, Cannas; Tsang, Heidi; Moreau, Elizabeth

2015-01-01

Providing quality care and support to cancer patients from minority cultures can challenge community nurses when language barriers and cultural complexities intersect with the need for complex care. This article reports on a qualitative study that explores interactions between community nurses and Chinese-Australian cancer patients. The research method focused on particular nurse-patient encounters and involved preencounter and postencounter interviews with the nurse, postencounter interviews with the patient, and observation of the encounters. Participants included community nurses, Chinese cancer patients being cared for at home, and their carers if present. Four themes were conceptualized: (1) the impact of language barriers on nurse-patient interactions, (2) patient understandings of the scope and objectives of healthcare services, (3) cultural complexities and sensitivities, and (4) valued care and support. The study demonstrates that, although many nurses do provide comprehensive, culturally competent care, language barriers can lead to task-oriented rather than comprehensive approaches, and other cultural complexities do have an impact on patient experiences and on the quality of nurse-patient interactions. Nevertheless, most patient participants experienced a feeling of security as a result of regular contact with a community nursing service. Cancer patients with complex care needs but limited English proficiency require support to negotiate complicated community services networks. Culturally competent community nurses can provide this support. The study highlights the need for continuing cultural competence education for community nurses and the importance of careful discharge planning to ensure continuity of care for this vulnerable patient group.

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research

PubMed Central

Goeman, Dianne; King, Jordan; Koch, Susan

2016-01-01

Objective To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. Setting An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. Participants People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Data collection and analysis Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Results Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the ‘SDN’ model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Conclusions Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services. PMID:27927662

Why Women Living in an Obstetric Care Underserved Area Do Not Utilize Their Local Hospital Supported by Korean Government for Childbirth.

PubMed

Kim, Jung-Eun; Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

2016-09-01

This study aimed to understand why mothers do not utilize the prenatal care and delivery services at their local hospital supported by the government program, the Supporting Program for Obstetric Care Underserved Area (SPOU). We conducted a focus group interview by recruiting four mothers who delivered in the hospital in their community (a rural underserved obstetric care area) and another four mothers who delivered in the hospital outside of the community. From the finding, the mothers were not satisfied with the quality of services that the community hospital provided, in terms of professionalism of the obstetric care team, and the outdated medical device and facilities. Also, the mothers believed that the hospital in the metropolitan city is better for their health as well as that of their babies. The mothers who delivered in the outside community hospital considered geographical closeness less than they did the quality of obstetric care. The mothers who delivered in the community hospital gave the reason why they chose the hospital, which was convenience and emergency preparedness due to its geographical closeness. However, they were not satisfied with the quality of services provided by the community hospital like the other mothers who delivered in the hospital outside of the community. Therefore, in order to successfully deliver the SPOU program, the Korean government should make an effort in increasing the quality of maternity service provided in the community hospital and improving the physical factors of a community hospital such as outdated medical equipment and facilities. Copyright © 2016. Published by Elsevier B.V.

Spinal Cord Injury Community Survey: Understanding the Needs of Canadians with SCI.

PubMed

Noreau, Luc; Noonan, Vanessa K; Cobb, John; Leblond, Jean; Dumont, Frédéric S

2014-01-01

There is a lack of literature regarding service needs of people with SCI living in the community. Better assessment of expressed and met and unmet needs would help in the development of effective service delivery. From a national SCI Community Survey in Canada, the aim was to identify the most critical service needs of people living in the community at least 1 year post discharge from rehabilitation and the support they received to meet their needs. Data were collected mainly through a secure Web site and encompassed demographics, personal and household income, an SCI severity measure, and an SCI community needs measure containing information on 13 SCI-related needs. A total of 1,549 persons with SCI (traumatic lesion, n = 1,137; nontraumatic lesion, n = 412) across Canada completed the survey. Most critical needs for community integration were expressed by a substantial proportion of survey participants, but significantly more expressed and met needs were reported by persons with a traumatic than a nontraumatic lesion. Personal and environmental characteristics influenced the probability of expressing and meeting needs (eg, severity of injury and household income). Help and support to meet expressed needs were received from government agencies, community organizations, and friends or family. Better assessment of expressed and met or unmet needs for services remains a challenge but will serve as a tool to optimize service delivery in the community. Environmental barriers to services, particularly the process of getting needs met and associated costs, remain an issue that requires a reconsideration of some aspects of access to services.

Clark County Community College Students: Highlights from a Survey of their Backgrounds, Activities, Ratings of Skills, Use of Support Services, and Educational Attainments.

ERIC Educational Resources Information Center

Friedlander, Jack

This series of 15 brief reports summarizes findings for a survey of 564 Clark County Community College students which was conducted in Spring 1981 to determine: (1) student characteristics and educational background; (2) student usage of campus support services; (3) student ratings of their abilities in eight academic skill areas; (4) the extent…

The Impact of the Student Support Services Program on the Retention of Students at Southeast Kentucky Community and Technical College

ERIC Educational Resources Information Center

Sundy, Carolyn Mitchell

2017-01-01

As retention becomes more of a key issue for community colleges, it is important that these institutions create an environment that is easy to navigate if they are to retain a greater percentage of their students. This study investigates the impact of the Student Support Services (SSS) program on the retention of students at Southeast Kentucky…

What older people want: evidence from a study of remote Scottish communities.

PubMed

King, Gerry; Farmer, Jane

2009-01-01

The growing proportions of older people in rural areas have implications for the provision of health and social care services. Older people are more likely to have complex health needs compared with other age groups, requiring a full range of primary, community and acute hospital services. The provision of services to older people in rural areas is challenged by diseconomies of scale, travel costs and difficulties in attracting staff. Policy-makers are requested to include the 'voice' of older people to help provide services that match needs and context. In spite of this, what older people want from health and social care services is a neglected area of investigation. The reported study was conducted in 2005/2006 as part of a European Union Northern Periphery Programme (EU NPP) project called Our Life as Elderly. Its aims were to explore the views of those aged 55 years and over and living in remote communities about current and future health and social care service provision for older people. Evidence was to be collected that could inform policy-makers about changing or improving service delivery. This article summarises emergent themes and considers their implications. The study selected two small remote mainland Scottish Highland communities for in-depth case study. Semi-structured interviews (n = 23), 10 'informal conversations' and 4 focus groups were held with community members aged 55 years and over, in order to provide different types of qualitative data and 'layers' of data to allow reflection. Data analysis was assisted by computerised data management software and performed using the 'framework analysis' approach. Participants did not consider themselves 'old' and expressed the need for independence in older age to be supported by services. Several aspects of services that were undergoing change or restructuring were identified, including arrangements for home care services, meals provision and technological support. Participants valued elements of the traditional model of care they had been receiving: these were local, personal emphasis and continuity. They were suspicious of new arrangements perceived to emphasise technical efficiency. Health and care services were described as inter-linked with other aspects of rural living, including transport and housing (which might have to be relinquished to pay for care). Proximity to family was desired for social and domestic support only; health and related support should be from generic service providers. Community members were involved in reciprocal help-giving of many types. The findings compare with results of other studies of older rural people internationally, and generic 'principles' of service derived could guide restructuring. There may be systemic challenges to empowering older people's 'voice' in designing sustainable rural services that stem from society's views of older people, attitudes of communities to collective roles and responsibilities, and the fragmented ways that services are sometimes provided.

75 FR 10199 - Schools and Libraries Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... schools' Internet access during non-operating hours. The Commission waived, on its own motion, through... have limited access to affordable Internet services for educational and job training opportunities... facilities and services supported by E-rate funding and increase community access to the Internet. Third, the...

Identification of Job Coach Competencies, Staff Roles and Agency Administrative Patterns. Summary Report from the Community-Based Supported Employment Symposium (St. Cloud, Minnesota, June 10-11, 1986).

ERIC Educational Resources Information Center

Minnesota Association for Rehabilitation, Education, and Training.

A symposium on community-based supported employment for developmentally disabled adults in Minnesota was attended by agency direct service staff who provide job training, executive directors and administrators of agencies, and personnel who refer clients to agencies providing supported work and other types of community-based training and…

Community Currency Trading Method through Partial Transaction Intermediary Process

NASA Astrophysics Data System (ADS)

Kido, Kunihiko; Hasegawa, Seiichi; Komoda, Norihisa

A community currency is local money that is issued by local governments or Non-Profit Organization (NPO) to support social services. The purpose of introducing community currencies is to regenerate communities by fostering mutual aids among community members. In this paper, we propose a community currency trading method through partial intermediary process, under operational environments without introducing coordinators all the time. In this method, coordinators perform coordination between service users and service providers during several months from the start point of transactions. After the period of coordination, participants spontaneously make transactions based on their trust area and a trust evaluation method based on the number of provided services and complaint information. This method is especially effective to communities with close social networks and low trustworthiness. The proposed method is evaluated through multi-agent simulation.

Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

PubMed Central

Ala-Nikkola, Taina; Pirkola, Sami; Kontio, Raija; Joffe, Grigori; Pankakoski, Maiju; Malin, Maili; Sadeniemi, Minna; Kaila, Minna; Wahlbeck, Kristian

2014-01-01

Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule—Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data, local data on unemployment rate, length of education, age of retirement, proportion of single households, alcohol sales and a composite mental health index were used as indicators of population mental health needs. Population size correlated strongly with service diversity, explaining 84% of the variance. Personnel resources did not associate with diversity or community orientation. The indicators of mental health services need did not have the expected association with quality and quantity of services. In terms of service organization, the results may support larger population bases, at least 150,000 adult inhabitants, when aiming for higher diversity. PMID:25153471

Illinois Community College System. Workforce Development Grant Report Business and Industry Services, Fiscal Year 2009

ERIC Educational Resources Information Center

Illinois Community College Board, 2009

2009-01-01

The Illinois Community College Board provided more than $3.3 million to community colleges during fiscal year 2009 to support local workforce and economic development services through their Business and Industry Centers. The workforce development activities conducted under this grant include customized job training on campus or on-site at a…

Building the Community Nexus: A Community Centered Approach to Planning and Design

ERIC Educational Resources Information Center

Bingler, Steven

2011-01-01

Recent research indicates that the goals (of producing management efficiencies to deliver community programs and infrastructure and more graduates) can be better achieved through a holistic model that supports the whole family and child by providing better access to wrap around services. Nexus planning is a process through which these services can…

Teaching Service Learning in the Geosciences: An On the Cutting Edge Workshop Report

NASA Astrophysics Data System (ADS)

Bruckner, M. Z.; Laine, E. P.; Mogk, D. W.; O'Connell, S.; Kirk, K. B.

2010-12-01

Service learning is an instructional method that combines community service and academic instruction within the context of an established academic course. It is a particularly effective approach that uses active and experiential learning to develop the academic skills required of a course of study and to simultaneously address authentic community needs. Service learning projects can energize and motivate students by engaging a sense of civic responsibility by working in concert with community partners. The geosciences provide abundant opportunities to develop service learning projects on topics related to natural hazards, resources, land use, water quality, community planning, public policy, and education (K-12 and public outreach). To explore the opportunities of teaching service learning in the geosciences, the On the Cutting Edge program convened an online workshop in February 2010. The goals of the workshop were to: 1) introduce the principles and practices of effective service learning instructional activities; 2) provide examples of successful service learning projects and practical advice about "what works;" 3) provide participants with the opportunity to design, develop, and refine their own service learning courses or projects; 4) develop collections of supporting resources related to the pedagogy of service learning; and 5) support a community of scholars interested in continued work on service learning in the geoscience curriculum. The workshop consisted of a series of web-based synchronous and asynchronous sessions, including presentations from experienced practitioners of service learning, panel discussions, threaded discussions, and editable web pages used to develop new material for the website. Time was also provided for small group and individual work and for participants to peer-review each others' service learning projects and to revise their own activities based on reviewer comments. Insights from the workshop were integrated into new web pages that can help others implement service learning projects in their own institutions and communities. Online resources developed by the workshop participants, conveners, and supporting staff include an assemblage of online and print resources, a searchable collection of peer-reviewed examples of service learning projects, a tutorial on using the "8-Block Model" to design and implement a service learning project, tips on finding service learning partners, advice on motivating students, departments and the community, and example assessment instruments. Faculty are encouraged to submit their own examples of additional service learning projects in the geosciences. The entire workshop program, resources and activities are available online at: http://serc.carleton.edu/NAGTWorkshops/servicelearning/index.html

Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services.

PubMed

Regan, Jemma L

2016-07-01

A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities. © The Author(s) 2014.

Ethics reflection groups in community health services: an evaluation study.

PubMed

Lillemoen, Lillian; Pedersen, Reidar

2015-04-17

Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

Community-managed Data Sharing, Curation, and Publication: SEN on SEAD

NASA Astrophysics Data System (ADS)

Martin, R. L.; Myers, J.; Hsu, L.

2017-12-01

While data publication in support of reuse and scientific reproducibility is increasingly being recognized as a key aspect of modern research practice, best practices are still to be developed at the level of scientific communities. Often, such practices are discussed in the abstract - as community standards for data plans or as requirements for yet-to-be-built software - with no clear path to community adoption. In contrast, the Sediment Experimentalist Network, supported through the National Science Foundation's (NSF) EarthCube initiative, has encouraged an iterative, practice-based approach within its community that has resulted in the publication of dozens of datasets, comprised of millions of files totaling more than 4 TB in size, and the documentation of more than 100 experimental procedures, instruments, and facilities, by multiple research teams. A key element of SEN's approach has been to leverage cloud-based data services that provide robust core capabilities with community-based management and customization capabilities. These services - data sharing, curation, and publication services developed through the NSF-supported Sustainable Environment - Actionable Data (SEAD) project and the wiki-based SEN Knowledge Base (KB) - have allowed the SEN team to ground discussions in reality and leverage the practical questions arising as researchers publish data to drive discussion and evolve towards better practices. In this presentation we summarize how SEN interacts with researchers, the best practices that have been developed, and the capabilities of SEAD and the SEN KB that support them. We also describe issues that have arisen in the community - related, for example, to recommended and required metadata, individual, project and community branding, and data version and derivation relationships - and describe how SEN's outreach activities, collaboration with the SEAD team, and the flexible design of the data services themselves have, in combination, been able to provide rapid incremental solutions to support researchers needs while also helping the community align with broader semantic and data publication standards. We conclude with thoughts on how this approach could be applied in other communities as a way to drive progress towards data reuse and reproducible research.

Community-Based Breastfeeding Support With the Tiger Babies Breastfeeding Support Tent.

PubMed

Lambert, Ann W; Harris, Laurie C; Wang, Chih-Hsuan; Tzeng, Shu-Wen

2018-04-01

The Tiger Babies Breastfeeding Support Tent was established by a baccalaureate nursing program in southeastern Alabama to increase community awareness of the importance of breastfeeding and to provide a clean, convenient, and private location for nursing mothers during community events. Local advertising was distributed before community events to promote awareness and support of the project. Survey results indicate that 80% of mothers who used the tent's services would recommend the tent to their friends and family members. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Creating Community: One Institution's Experience with Communities of Practice

ERIC Educational Resources Information Center

Heath, Sally; McDonald, Jeanette

2012-01-01

This article examines the use and benefits of communities of practice (CoPs) in academic settings. In the 2010-2011 academic year Teaching Support Services at Wilfrid Laurier University introduced four theme-based CoPs for faculty and academic support staff after a successful pilot initiative. This article explores our motivation for focusing our…

Organizing Self-Employment Programs: A Guide for Development Organizations.

ERIC Educational Resources Information Center

Rinehart, Eric L., Ed.; Lamb, Melissa, Ed.

This resource guide is intended to help communities that want to implement an entrepreneurship training program. Chapters I and II contain general advice for the planning process, such as how to assess need and community support, assess current services for entrepreneurs, select target clientele, develop a community support network, and identify…

Home and Community Based Services (HCBS) Waivers: A Nationwide Study of the States

ERIC Educational Resources Information Center

Rizzolo, Mary C.; Friedman, Carli; Lulinski-Norris, Amie; Braddock, David

2013-01-01

In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States (Braddock et al., 2011). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In…

The Direct Support Workforce in Community Supports to Individuals with Developmental Disabilities: Issues, Implications, and Promising Practices

ERIC Educational Resources Information Center

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to…

Development of Clinical Pharmacy in Switzerland: Involvement of Community Pharmacists in Care for Older Patients.

PubMed

Hersberger, Kurt E; Messerli, Markus

2016-03-01

The role of the community pharmacist in primary care has been undergoing change in Switzerland in parallel to international developments: it has become more clinically and patient oriented. Special services of community pharmacists to older patients taking long-term or multiple medications, discharged from hospitals or experiencing cognitive impairment or disability have been developed. These services require more clinical knowledge and skills from community pharmacists and are based on, for example, 'simple or intermediate medication reviews' focused primarily to improve medication adherence and rational drug use by a patient. Reflecting the new role of community pharmacies, this article describes the current services provided by community pharmacies in Switzerland, e.g., 'polymedication check', 'weekly pill organizer', and 'services for chronic patients', as well as new Swiss educational and reimbursement systems supporting development of these services. In the international context, involvement of community pharmacists in patient-oriented care is growing. This review summarizes positive and negative experiences from implementation of community pharmacy services in Switzerland and provides examples for the development of such services in other countries.

Service utilisation by carers of people with dementia in rural Victoria.

PubMed

Ervin, Kaye; Reid, Carol

2015-12-01

To explore the use of community and dementia-specific services by informal carers caring for someone with dementia in a rural setting. Carers of people with dementia were recruited through a variety of rural community services and invited to complete a survey related to the utilisation of community services. A total of 39 carers completed surveys. Despite 84% reporting use of the Aged Care Assessment Service and 61% reporting provision of printed information on the services available, less than half of the carers utilised commonly available support services. Only 46% received financial compensation for their carer role. Rural carers of care recipients with behavioural and psychological symptoms of dementia underutilise community services. Services that may assist with carer stress and depression and services that provide advice on the management of distressing behavioural and psychological symptoms of dementia were utilised by less than half of the carers surveyed. © 2014 AJA Inc.

Randomized Trial of the Family Intervention: Telephone Tracking-Caregiver for Dementia Caregivers: Use of Community and Healthcare Resources.

PubMed

Tremont, Geoffrey; Davis, Jennifer D; Ott, Brian R; Galioto, Rachel; Crook, Cara; Papandonatos, George D; Fortinsky, Richard H; Gozalo, Pedro; Bishop, Duane S

2017-05-01

To examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking-Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. Randomized, controlled trial. Academic medical center. Dyads (n = 250) of distressed informal dementia caregivers and care recipients. Caregivers were randomly assigned to receive the FITT-C (n = 133) or telephone support (TS; n = 117). Both groups received 16 telephone contacts from a master's-level therapist over 6 months. The FITT-C intervention provided psychoeducation, problem solving, and other directive approaches based on assessment of critical areas (e.g., mood, behavior, family functioning, social support). TS provided supportive therapeutic strategies. Outcome variables were caregiver report of community support service use, number of visits to the emergency department (ED) for caregivers and care recipients, and hospital stays for caregivers during the interventions. Intervention groups did not differ in demographic characteristics, use of support services, or use of healthcare resources at baseline. Caregivers who received the FITT-C used community support services at end of treatment significantly more than those receiving TS (P = .02). FITT-C caregivers had a significantly lower rate of ED visits (rate difference 9.5%, P = .048) and hospital stays (rate difference 11.4%, P = .01) over the 6-month course of the intervention than TS caregivers. Care recipient use of community or medical resources did not differ according to group. An entirely telephone-delivered intervention was effective in increasing caregiver engagement in community resources and reducing caregiver use of hospital-based healthcare resources. Results highlight the potential effect of FITT-C on healthcare use. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

PubMed

Doucette, William R; Kreling, David H; Schommer, Jon C; Gaither, Caroline A; Mott, David A; Pedersen, Craig A

2006-01-01

To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. Cross-sectional study. Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.

Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages.

PubMed

Lathren, Christine R; Sloane, Philip D; Hoyle, Joseph D; Zimmerman, Sheryl; Kaufer, Daniel I

2013-12-10

Primary care physicians routinely provide dementia care, but may lack the clinical skills and awareness of available resources to provide optimal care. We conducted a community-based pilot dementia training intervention designed to both improve clinical competency and increase utilization of local dementia care services. Physicians (N = 29) and affiliated staff (N = 24) participated in a one-day training program on dementia screening, diagnosis and management that included direct engagement with local support service providers. Questionnaires about their dementia care competency and referral patterns were completed before and 6 months after the training intervention. Physicians reported significantly higher overall confidence in their dementia care competency 6 months post-training compared to pre-training. The largest reported improvements were in their ability to educate patients and caregivers about dementia and making appropriate referrals to community care services. Participants also reported markedly increased use of cognitive screening tools in providing care. Community service providers recorded approximately 160 physician-initiated referrals over a 2 year-period post-training, compared to few beforehand. Combining a targeted physician practice-based educational intervention with community service engagement improves dementia care competency in clinicians and promotes linkages between clinical and community dementia care providers.

Peace Corps Partnered Health Services Implementation Research in Global Health: Opportunity for Impact

PubMed Central

Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-01-01

Background: There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community–Peace Corps–academic partnership approach to conduct local primary healthcare services implementation research. Discussion: The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach, the contributions of each partner are as follows: the local community and health system leadership guides the work in consideration of local priorities and context; the Peace Corps provides logistical support, community expertise, and local trust; and the academic institutions offer professional technical and public health educational and training resources and research support. Conclusion: The Peace Corps offers the opportunity to enhance a community-academic partnership in LMICs through community-level guidance, logistical assistance, and research support for community based participatory primary health-care services implementation research that addresses local primary healthcare priorities. PMID:25568819

Enhancing Schools’ Capacity to Support Children in Poverty: An Ecological Model of School-Based Mental Health Services

PubMed Central

Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.; Glisson, Charles

2013-01-01

School based mental health services for children in poverty can capitalize on schools’ inherent capacity to support development and bridge home and neighborhood ecologies. We propose an ecological model informed by public health and organizational theories to refocus school based services in poor communities on the core function of schools to promote learning. We describe how coalescing mental health resources around school goals includes a focus on universal programming, mobilizing indigenous school and community resources, and supporting core teaching technologies. We suggest an iterative research–practice approach to program adaptation and implementation as a means toward advancing science and developing healthy children. PMID:18581225

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Generating demand and community support for sexual and reproductive health services for young people: A review of the Literature and Programs.

PubMed

Kesterton, Amy J; Cabral de Mello, Meena

2010-09-24

This review investigates the effectiveness of interventions aimed at generating demand for and use of sexual and reproductive health (SRH) services by young people; and interventions aimed at generating wider community support for their use. Reports and publications were found in the peer-reviewed and grey literature through academic search engines; web searches; the bibliographies of known conference proceedings and papers; and consultation with experts. The studies were reviewed against a set of inclusion criteria and those that met these were explored in more depth. The evidence-base for interventions aimed at both generating demand and community support for SRH services for young people was found under-developed and many available studies do not provide strong evidence. However, the potential of several methods to increase youth uptake has been demonstrated, this includes the linking of school education programs with youth friendly services, life skills approaches and social marketing and franchising. There is also evidence that the involvement of key community gatekeepers such as parents and religious leaders is vital to generating wider community support. In general a combined multi-component approach seems most promising with several success stories to build on. Many areas for further research have been highlighted and there is a great need for more rigorous evaluation of programmes in this area. In particular, further evaluation of individual components within a multi-component approach is needed to elucidate the most effective interventions.

Generating demand and community support for sexual and reproductive health services for young people: A review of the Literature and Programs

PubMed Central

2010-01-01

Background This review investigates the effectiveness of interventions aimed at generating demand for and use of sexual and reproductive health (SRH) services by young people; and interventions aimed at generating wider community support for their use. Methods Reports and publications were found in the peer-reviewed and grey literature through academic search engines; web searches; the bibliographies of known conference proceedings and papers; and consultation with experts. The studies were reviewed against a set of inclusion criteria and those that met these were explored in more depth. Results The evidence-base for interventions aimed at both generating demand and community support for SRH services for young people was found under-developed and many available studies do not provide strong evidence. However, the potential of several methods to increase youth uptake has been demonstrated, this includes the linking of school education programs with youth friendly services, life skills approaches and social marketing and franchising. There is also evidence that the involvement of key community gatekeepers such as parents and religious leaders is vital to generating wider community support. In general a combined multi-component approach seems most promising with several success stories to build on. Conclusions Many areas for further research have been highlighted and there is a great need for more rigorous evaluation of programmes in this area. In particular, further evaluation of individual components within a multi-component approach is needed to elucidate the most effective interventions. PMID:20863411

EnviroAtlas - Metrics for Austin, TX

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://enviroatlas.epa.gov/EnviroAtlas). The layers in this web service depict ecosystem services at the census block group level for the community of Austin, Texas. These layers illustrate the ecosystems and natural resources that are associated with clean air (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_CleanAir/MapServer); clean and plentiful water (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_CleanPlentifulWater/MapServer); natural hazard mitigation (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_NaturalHazardMitigation/MapServer); climate stabilization (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_ClimateStabilization/MapServer); food, fuel, and materials (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_FoodFuelMaterials/MapServer); recreation, culture, and aesthetics (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_RecreationCultureAesthetics/MapServer); and biodiversity conservation (https://enviroatlas.epa.gov/arcgis/rest/services/Communities/ESC_ATX_BiodiversityConservation/MapServer), and factors that place stress on those resources. EnviroAtlas allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the conterminous United States as well as de

What do clients expect of community care and what are their needs? The Community care for the Elderly: Needs and Service Use Study (CENSUS).

PubMed

Harrison, Fleur; Low, Lee-Fay; Barnett, Anna; Gresham, Meredith; Brodaty, Henry

2014-09-01

To investigate the relationship between objectively assessed care needs and expectations for care of older people and their carers, before commencement of community care services. Cross-sectional research on 55 community-dwelling older adults and carers, recruited after receiving approval for government-subsidised community care services. Care needs and expectations of care were assessed at interview. Participants' and carers' expectations for their pending community care package did not correspond with unmet participant needs. Instead, expectations corresponded with met needs, that is those for which they already received help, with the exception of expectations of domestic support and personal care. Participants' unmet needs were predominantly in social and recreational activities, eating, and physical and mental health. As community care in Australia becomes consumer-directed by 2015, care services will need to empower clients and carers through education about their needs and available services, as part of the assessment and service negotiation process. © 2013 ACOTA.

Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitation.

PubMed

Skipworth, J; Humberstone, V

2002-01-01

To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated.

Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

PubMed

Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

2017-04-10

There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

PubMed Central

Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

2017-01-01

Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

47 CFR 54.601 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... teaching hospital or medical school; (ii) Community health center or health center providing health care to migrants; (iii) Local health department or agency; (iv) Community mental health center; (v) Not-for-profit... SERVICE Universal Service Support for Health Care Providers § 54.601 Eligibility. (a) Health care...

Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study.

PubMed

Sandhu, Sima; Priebe, Stefan; Leavey, Gerard; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Shepherd, Geoff; Killaspy, Helen

2017-07-11

Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their aims and outcomes or how they are regarded by staff and the clients. We interviewed 30 staff and 30 clients from the three main types of supported accommodation in England (residential care, supported housing, floating outreach) to explore their perspectives on the purpose of these services, and the components of care considered most helpful. The interviews were coded and analysed using thematic analysis. There were generally consistent understandings amongst clients and staff across service types on the goals and purposes of supported accommodation services as: building independence and confidence; supporting people with their mental health; and providing safety and stability. We also noted a competing theme of anxiety about the continuity of support when clients move on from a service. Themes on the experience of what aided effective practice centred on: the supportive presence of others; incremental steps to progress; working together to avoid deskilling and dependency; feeling known and personally understood; tailoring support for social and community engagement; and building confidence through encouragement. The findings provide an understanding of the commonalities in service approach, and goals of clients in these services, as well as the facilitators of goal attainment. However, they also highlight a common tension between providing safe and supportive living environments, whilst also promoting independence and facilitating rehabilitative change.

Redesigning community mental health services for urban children: Supporting schooling to promote mental health.

PubMed

Atkins, Marc S; Shernoff, Elisa S; Frazier, Stacy L; Schoenwald, Sonja K; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-10-01

This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities. (c) 2015 APA, all rights reserved).

An Evaluation of a Behavioural Support Team for Adults with a Learning Disability and Behaviours That Challenge from a Multi-Agency Perspective

ERIC Educational Resources Information Center

Christopher, Rose; Horsley, Sarah

2016-01-01

The Dudley Behavioural Support Team (BST) was set up based on Positive Behavioural Support (PBS) principles to support individuals with behaviours that challenge. The Winterbourne Review emphasises the importance of developing high-quality specialist community services and the Ensuring Quality Services (Local Government Association & NHS…

Survey of rehabilitation support for children 0-15 years in a rural part of Kenya.

PubMed

Bunning, Karen; Gona, Joseph K; Odera-Mung'ala, Victor; Newton, Charles R; Geere, Jo-Anne; Hong, Chia Swee; Hartley, Sally

2014-01-01

Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.

Lessons learned from community-based participatory research: establishing a partnership to support lesbian, gay, bisexual and transgender ageing in place.

PubMed

Wright, Leslie A; King, Diane K; Retrum, Jessica H; Helander, Kenneth; Wilkins, Shari; Boggs, Jennifer M; Portz, Jennifer Dickman; Nearing, Kathryn; Gozansky, Wendolyn S

2017-06-01

Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN). A case study approach was employed to describe the partnership development process by reflecting on past meeting minutes, progress reports and interviews with SUSTAIN's partners. Key partnering practices utilized by SUSTAIN included (i) development of a shared commitment and vision; (ii) identifying partners with intersecting spheres of influence in multiple communities of identity (ageing services, LGBT, health research); (iii) attending to power dynamics (e.g. equitable sharing of funds); and (iv) building community capacity through reciprocal learning. Although the partnership dissolved after 4 years, it served as a successful catalyst to establish community programming to support ageing in place for LGBT seniors. Multi-sector stakeholder involvement with capacity to connect communities and use frameworks that formalize equity was key to establishing a high-trust CBPR partnership. However, lack of focus on external forces impacting each partner (e.g. individual organizational strategic planning, community funding agency perspectives) ultimately led to dissolution of the SUSTAIN partnership even though implementation of community programming was realized. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

Building the Case: Changing Consumer Perceptions of the Value of Expanded Community Pharmacist Services.

PubMed

Steckowych, Kathryn; Smith, Marie; Spiggle, Susan; Stevens, Andrew; Li, Hao

2018-01-01

The role of the community pharmacist has traditionally been a medication dispenser; however, community pharmacists' responsibilities must expand to include more direct patient care services in order to transform primary care practice. Use case-based scenarios to (1) determine factors that contribute to positive and negative consumer perceptions of expanded community pharmacist patient care roles, (2) identify facilitators and barriers that contribute to consumer perceptions of the value of expanded community pharmacist patient care services, and (3) develop a successful approach and strategies for increasing consumer advocacy for the value of expanded community pharmacist patient care services. Two consumer focus groups used scenario-based guided discussions and Likert scale questionnaires to elicit consumer reactions, facilitators, and barriers to expanded community pharmacist services. Convenience, timeliness, and accessibility were common positive reactions across all 3 scenarios. Team approach to care and trust were viewed as major facilitators. Participant concerns included uncertainty about pharmacist training and qualifications, privacy, pharmacists' limited bandwidth to accept new tasks, and potential increased patient costs. Common barriers to service uptake included a lack of insurance payment and physician preference to provide the services. Consumer unfamiliarity with non-traditional community pharmacist services is likely an influencer of consumers' hesitancy to utilize such services; therefore, an opportunity exists to engage consumers and advocacy organizations in supporting expanded community pharmacist roles. This study can inform consumers, advocates, community pharmacists, primary care providers, and community-based organizations on methods to shape consumer perceptions on the value of community pharmacist expanded services.

Cluster randomized controlled trial of a peer support program for people with diabetes: study protocol for the Australasian peers for progress study

PubMed Central

2012-01-01

Background Well managed diabetes requires active self-management in order to ensure optimal glycaemic control and appropriate use of available clinical services and other supports. Peer supporters can assist people with their daily diabetes self-management activities, provide emotional and social support, assist and encourage clinical care and be available when needed. Methods A national database of Australians diagnosed with type 2 diabetes is being used to invite people in pre-determined locations to participate in community-based peer support groups. Peer supporters are self-identified from these communities. All consenting participants receive diabetes self-management education and education manual prior to randomization by community to a peer support intervention or usual care. This multi-faceted intervention comprises four interconnected components for delivering support to the participants. (1) Trained supporters lead 12 monthly group meetings. Participants are assisted to set goals to improve diabetes self-management, discuss with and encourage each other to strengthen linkages with local clinical services (including allied health services) as well as provide social and emotional support. (2) Support through regular supporter-participant or participant-participant contact, between monthly sessions, is also promoted in order to maintain motivation and encourage self-improvement and confidence in diabetes self-management. (3) Participants receive a workbook containing diabetes information, resources and community support services, key diabetes management behaviors and monthly goal setting activity sheets. (4) Finally, a password protected website contains further resources for the participants. Supporters are mentored and assisted throughout the intervention by other supporters and the research team through attendance at a weekly teleconference. Data, including a self-administered lifestyle survey, anthropometric and biomedical measures are collected on all participants at baseline, 6 and 12 months. The primary outcome is change in cardiovascular disease risk using the UKPDS risk equation. Secondary outcomes include biomedical, quality of life, psychosocial functioning, and other lifestyle measures. An economic evaluation will determine whether the program is cost effective. Discussion This manuscript presents the protocol for a cluster randomized controlled trial of group-based peer support for people with type 2 diabetes in a community setting. Results from this trial will contribute evidence about the effectiveness of peer support in achieving effective self-management of diabetes. Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR); ACTRN12609000469213 PMID:23035666

Moving towards an enhanced community palliative support service (EnComPaSS): protocol for a mixed method study.

PubMed

Arris, Steven M; Fitzsimmons, Deborah A; Mawson, Susan

2015-04-30

The challenge of an ageing population and consequential increase of long term conditions means that the number of people requiring palliative care services is set to increase. One UK hospice is introducing new information and communication technologies to support the redesign of their community services; improve experiences of existing patients; and allow efficient and effective provision of their service to more people. Community Palliative Care Nurses employed by the hospice will be equipped with a mobile platform to improve communication, enable accurate and efficient collection of clinical data at the bedside, and provide access to clinical records at the point of care through an online digital nursing dashboard. It is believed that this will ensure safer clinical interventions, enable delegated specialist care deployment, support the clinical audit of patient care and improve patient safety and patient/carer experience. Despite current attempts to evaluate the implementation of such technology into end of life care pathways, there is still limited evidence supporting the notion that this can be sustained within services and implemented to scale. This study presents an opportunity to carry out a longitudinal evaluation of the implementation of innovative technology to provide evidence for designing more efficient and effective community palliative care services. A mixed methods approach will be used to understand a wide range of organisational, economic, and patient-level factors. The first stage of the project will involve the development of an organisational model incorporating proposed changes resulting from the introduction of new novel mobile technologies. This model will guide stage two, which will consist of gathering and analysing primary evidence. Data will be collected using interviews, focus groups, observation, routinely collected data and documents. The implementation of this new approach to community-based palliative care delivery will require significant changes to established working patterns. This new service delivery model is being developed by the Hospice in collaboration with a team of international academic, industry, and clinical commissioning service improvement specialists. The findings from this initial evaluation will provide valuable baseline evidence regarding the delivery of palliative and end-of-life care services.

Oakland Unified School District Community Schools: Understanding Implementation Efforts to Support Students, Teachers, and Families

ERIC Educational Resources Information Center

Fehrer, Kendra; Leos-Urbel, Jacob

2015-01-01

In 2010, Oakland Unified School District (OUSD) launched an initiative to transform all district schools into full service community schools. The community school design provides integrated supports to students and fosters a school climate conducive to academic, social, and emotional learning. Interventions span in-school and out-of-school time,…

Community Satisfaction: Implications for Army Communities

DTIC Science & Technology

1990-08-01

1954) hierarchical theory of motivation, hypothesize that a hierarchy of community services exists, such that basic human needs must be provided for...help in an emergency (Ahlbrandt, 1984). Neighbors 13 may provide socioemotional support, which is positively associated with neighborhood satisfaction...Saroson & B. R. Sarason (Eds.), Social .support: Theory , research and applications. Boston: Martinus Nijhoff. Baldassare, M. (1979). Residential crowding

Tax Strategies for Community Economic Development.

ERIC Educational Resources Information Center

Pryde, Paul, Jr.

Critical to the success of current efforts to reform and restructure education and other community supports and services to improve the lives of children and their families is the way in which they are financed. This report of The Finance Project focuses on ways of using tax policies to help build strong local communities that can support families…

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEVELOPMENTAL DISABILITIES PROGRAM THE UNIVERSITY AFFILIATED PROGRAMS § 1388.6 Program criteria—services and... training setting within the community including the university. Direct service projects may involve...

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEVELOPMENTAL DISABILITIES PROGRAM THE UNIVERSITY AFFILIATED PROGRAMS § 1388.6 Program criteria—services and... training setting within the community including the university. Direct service projects may involve...

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEVELOPMENTAL DISABILITIES PROGRAM THE UNIVERSITY AFFILIATED PROGRAMS § 1388.6 Program criteria—services and... training setting within the community including the university. Direct service projects may involve...

Public/Private Partnership--A Cost Effective Model for Child Day Care Services.

ERIC Educational Resources Information Center

Alisberg, Helene R.

Trends suggest that 11 million children in the United States will need day care services by 1995. Presently, corporations provide child care support through subsidies to low income employees or through community facilities, parent education, and information and referral (I & R) services. Such support results in reduced rates of absenteeism and…

78 FR 78358 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... with a seamless network of supportive services to help them complete high school or postsecondary... education (IHE); (2) Support pregnant and parenting teens at high schools and community service centers; (3) Improve services for pregnant women who are victims of domestic violence, sexual violence, sexual assault...

Support needs of breast-feeding women: views of Australian midwives and health nurses.

PubMed

McLelland, Gayle; Hall, Helen; Gilmour, Carole; Cant, Robyn

2015-01-01

to explore the views of midwives and maternal-child health nurses regarding factors that influence breast feeding initiation and continuation, focusing on how support for women could be improved to increase breast feeding duration. a focus group study. hospital or domiciliary (home-visiting) midwives and community-based maternal and child health (MCH) nurses in one region of Victoria, Australia. twelve MCH nurses and five midwives who provided supportive services to women in the immediate postnatal period attended one of three audio-recorded focus groups. Thematic findings were identified. four key themes were: 'Guiding women over breast-feeding hurdles', 'Timing, and time to care'; 'Continuity of women's care' and 'Imparting professional knowledge'. Given the a pattern of hospital discharge of mother and infant on day one or day two after birth, participants thought the timing of immediate postnatal breast-feeding support was critical to enable women to initiate and continue breast feeding. Community-based MCH nurses reported time gaps in uptake of new mother referrals and time-pressured face-to-face consultations. Both groups perceived barriers to continuity of women's care. health services subscribe to the Baby Friendly Health Initiative and government policies which support breast feeding, however providers described time pressures and a lack of continuity of women's care, including during transition from hospital to community services. there is a need to examine administration of service delivery and how domiciliary and community nurses can collaborate to establish and maintain supportive relationships with breast feeding women. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Mind-Body Building Equation.

ERIC Educational Resources Information Center

Dryfoos, Joy

2000-01-01

Full-service community schools combine three concepts--mind, body, and building--into an integrated approach placing quality education and comprehensive support services at one site. The DeWitt Wallace-Reader's Digest Fund is helping schools and communities replicate 4 such programs at 60 sites in 20 U.S. cities. (MLH)

The Bosom Buddy Project: A Breastfeeding Support Group Sponsored by the Indiana Black Breastfeeding Coalition for Black and Minority Women in Indiana.

PubMed

Friesen, Carol A; Hormuth, Laura J; Curtis, Terry J

2015-11-01

In 2012, the Indiana Black Breastfeeding Coalition (IBBC) used grant funds to increase participation in the Bosom Buddy Project, an original breastfeeding support group that pairs breastfeeding mothers with trained mentors. Resources for local organizations that support breastfeeding are extremely limited, making it difficult to expand programs and services. This article describes a variety of strategies used by the IBBC to expand programs and services. These activities provide a template for other community-based organizations that wish to provide culturally sensitive breastfeeding support in their community. © The Author(s) 2015.

'The government cannot do it all alone': realist analysis of the minutes of community health committee meetings in Nigeria.

PubMed

Abimbola, Seye; Molemodile, Shola K; Okonkwo, Ononuju A; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra L

2016-04-01

Since the mid-1980s, the national health policy in Nigeria has sought to inspire community engagement in primary health care by bringing communities into partnership with service providers through community health committees. Using a realist approach to understand how and under what circumstances the committees function, we explored 581 meeting minutes from 129 committees across four states in Nigeria (Lagos, Benue, Nasarawa and Kaduna). We found that community health committees provide opportunities for improving the demand and supply of health care in their community. Committees demonstrate five modes of functioning: through meetings (as 'village square'), reaching out within their community (as 'community connectors'), lobbying governments for support (as 'government botherers'), inducing and augmenting government support (as 'back-up government') and taking control of health care in their community (as 'general overseers'). In performing these functions, community health committees operate within and through the existing social, cultural and religious structures of their community, thereby providing an opportunity for the health facility with which they are linked to be responsive to the needs and values of the community. But due to power asymmetries, committees have limited capacity to influence health facilities for improved performance, and governments for improved health service provision. This is perhaps because national guidelines are not clear on their accountability functions; they are not aware of the minimum standards of services to expect; and they have a limited sense of legitimacy in their relations with sub-national governments because they are established as the consequence of a national policy. Committees therefore tend to promote collective action for self-support more than collective action for demanding accountability. To function optimally, community health committees require national government or non-government organization mentoring and support; they need to be enshrined in law to bolster their sense of legitimacy; and they also require financial support to subsidise their operation costs especially in geographically large communities. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Informal and formal support among community-dwelling Japanese American elders living alone in Chicagoland: an in-depth qualitative study.

PubMed

Lau, Denys T; Machizawa, Sayaka; Doi, Mary

2012-06-01

A key public health approach to promote independent living and avoid nursing home placement is ensuring that elders can obtain adequate informal support from family and friends, as well as formal support from community services. This study aims to describe the use of informal and formal support among community-dwelling Nikkei elders living alone, and explore perceived barriers hindering their use of such support. We conducted English and Japanese semi-structured, open-ended interviews in Chicagoland with a convenience sample of 34 Nikkei elders age 60+ who were functionally independent and living alone; 9 family/friends; and 10 local service providers. According to participants, for informal support, Nikkei elders relied mainly on: family for homemaking and health management; partners for emotional and emergency support; friends for emotional and transportation support; and neighbors for emergency assistance. Perceived barriers to informal support included elders' attitudinal impediments (feeling burdensome, reciprocating support, self-reliance), family-related interpersonal circumstances (poor communication, distance, intergenerational differences); and friendship/neighbor-related interpersonal situations (difficulty making friends, relocation, health decline/death). For formal support, Nikkei elders primarily used adult day care/cultural programs for socializing and learning and in-home care for personal/homemaking assistance and companionship. Barriers to formal support included attitudinal impediments (stoicism, privacy, frugality); perception of care (incompatibility with services, poor opinions of in-home care quality); and accessibility (geographical distance, lack of transportation). In summary, this study provides important preliminary insights for future community strategies that will target resources and training for support networks of Nikkei elders living alone to maximize their likelihood to age in place independently.

42 CFR 441.404 - Minimum protection requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... receiving community supported living arrangements services are protected from neglect, physical and sexual abuse, and financial exploitation; (b) Providers of community supported living arrangements services— (1) Do not use individuals who have been convicted of child or client abuse, neglect, or mistreatment, or...

Dementia RED (Respect Empathy Dignity): Collaborating to build dementia supportive communities in North Wales--reporting on a pilot project (innovative practice).

PubMed

Chalk, Annabel; Page, Sean

2016-03-01

There is increasing interest in developing dementia supportive communities world wide. Dementia RED (Respect Empathy Dignity) is a unique example from North Wales which is based on the twin concepts of people living with dementia as citizens in their community and developing 'bottom up' rather than 'top down' approaches to dementia supportive communities. Most people with dementia prefer to live at home thus making community connectivity key to maintaining healthy relationships and wellbeing. For those living with dementia, the community plays a pivotal role in providing value, meaning, purpose and acceptance. Building dementia supportive communities helps to raise awareness about dementia in the community through engagement and from identifying champions in the locality to voice issues. Dementia RED is an initiative and service which helps to develop such a philosophy in creating a dementia supportive community. © The Author(s) 2014.

Individual Placement and Support: a community mental health center approach to vocational rehabilitation.

PubMed

Becker, D R; Drake, R E

1994-04-01

Individual Placement and Support (IPS) is a vocational rehabilitation intervention for people with severe mental disabilities. IPS draws from components and philosophies of several other models. Employment specialists, who are part of the community mental health center team, provide services in the community. IPS emphasizes client preferences, rapid job finding, continuous assessment, competitive employment, integrated work settings, and follow-along supports. Initial research on IPS shows favorable results.

Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAP-registered pharmacies: pharmacists' role in reducing racial/ethnic disparities in influenza vaccinations in New York City.

PubMed

Crawford, Natalie D; Blaney, Shannon; Amesty, Silvia; Rivera, Alexis V; Turner, Alezandria K; Ompad, Danielle C; Fuller, Crystal M

2011-02-01

New York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39-2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.

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

PubMed Central

2009-01-01

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

Can specially trained community care workers effectively support patients and their families in the home setting at the end of life?

PubMed

Poulos, Roslyn G; Harkin, Damian; Poulos, Christopher J; Cole, Andrew; MacLeod, Rod

2018-03-01

Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs). An evaluation of the service was undertaken, focussing on the self-reported impact of the service on family carers (FCs), with triangulation of findings from community palliative care teams and CCWs. Service evaluation data were obtained through postal surveys and/or qualitative interviews with FCs, community palliative care teams and CCWs. FCs also reported the experience of their loved one based on 10 items drawn from the Quality of Death and Dying Questionnaire (QODD). Thematic analysis of surveys and interviews found that the support provided by CCWs was valued by FCs for: enabling choice (i.e. to realise end-of-life care in the home); providing practical assistance ("hands-on"); and for emotional support and reassurance. This was corroborated by community palliative care teams and CCWs. Responses by FCs on the QODD items indicated that in the last week of life, effective control of symptoms was occurring and quality of life was being maintained. This study suggests that satisfactory outcomes for patients and their families who wish to have end-of-life care in the home can be enabled with the additional support of specially trained CCWs. A notable benefit of the PCHSP model, which provided specific palliative care vocational training to an existing community care workforce, was a relatively rapid increase in the palliative care workforce across the state. © 2017 John Wiley & Sons Ltd.

Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

PubMed Central

Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-01-01

Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

Recovery-oriented service provision and clinical outcomes in assertive community treatment.

PubMed

Kidd, Sean A; George, Lindsey; O'Connell, Maria; Sylvestre, John; Kirkpatrick, Helen; Browne, Gina; Odueyungbo, Adefowope O; Davidson, Larry

2011-01-01

While the term "recovery" is routinely referenced in clinical services and health policy, few studies have examined the relationship between recovery-oriented service provision and client outcomes. The present study was designed to examine the relationship between recovery-orientation of service provision for persons with severe mental illnesses and outcomes in Assertive Community Treatment (ACT). Client, family, staff, and manager ratings of service recovery-orientation and outcomes across a range of service utilization and community functioning indicators were examined among 67 ACT teams in Ontario, Canada. Significant associations were found between ratings of recovery-oriented service provision and better outcomes in the domains of legal involvement, hospitalization days, education involvement, and employment. Results were not uniformly positive or consistent, however, across stakeholder Recovery Self-Assessment (RSA) ratings or outcomes. These findings provide some preliminary support for an association between recovery-oriented service delivery for persons with severe mental illnesses and better outcomes. In line with the current practice commentary, this association would suggest the importance of evaluating and cultivating recovery-oriented values and practices in ACT contexts. This is a particularly salient point given that ACT standards minimally address key domains of recovery-oriented service provision. Further study is required, however, to determine if these findings apply to the implementation of ACT in other jurisdictions or generalize to other community support programs.

The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

PubMed

Glisson, Charles; Schoenwald, Sonja K

2005-12-01

This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee.

The DLESE Community Services Center

NASA Astrophysics Data System (ADS)

Geary, E.; Aivazian, B.; Manduca, C.; Mogk, D.

2003-12-01

The DLESE Community Services Center (DCSC) is one of several centers recently funded by the National Science Foundation to promote greater and more effective use of Digital Library resources. The primary goals of the DCSC are to: (1) increase the current resource user and contributor base to include greater numbers of K-12, informal, and college educators and students, (2) diversify the DLESE user and contributor base to include rich and robust representation of ethnic, cultural, and differently-abled groups, (3) improve the ability of users and contributors to easily find, adapt, and use high quality digital resources in their classrooms, laboratories, and communities and (4) demonstrate how DLESE can support community activity addressing issues in geoscience education. During the course of the next three years we will: (a) solicit, create, and disseminate "exemplars" that highlight effective digital resource use in a variety of diverse educational settings, (b) continue to support and promote on-line DLESE community services, and (c) work to develop a DLESE ambassadors outreach program involving educators, scientists, and students working across the Earth, space, and environmental sciences. Collaborations with the DLESE Evaluation and Data Centers, collection builders, the DLESE Program Center staff, as well as diverse audience groups will be a key focus of our efforts. We invite you to join us as we work to build and support the next generation of digital services and resources for educators and students at all levels.

A Case Study That Examines the Community School Model in Elementary School Settings in West Tennessee

ERIC Educational Resources Information Center

Clark, LaWanda M.

2016-01-01

If schools are to succeed, children must be provided with more support than a school can accomplish alone (Barbour et al., 2001). The need to involve community in the educational process to offer services that make students successful and to have these services within the school building are all critical aspects of the community school model…

Granting authority to a new policy. A community benefit services policy becomes part of the general business strategy.

PubMed

Karibo, J

1994-05-01

Bon Secours Health System's new strategic plan and community benefit services policy integrates the planning, budgeting, evaluating, and reporting of community benefit services into management processes at the same level of authority as other operational activities. The strategic plan of Bon Secours Health System, headquartered in Marriottsville, MD, documents the system's mission, operating principles, vision, and five goals, one of which is to improve the communities' health status. The community benefit services operating policy requires that the Bon Secours Health System chief executive officer (CEO) and each local system CEO and nursing home administrator form a multidisciplinary local work group to be responsible for community benefit services. Each local work group assesses the needs of its community within the framework of the annual planning process. Determining what services are needed and how to deliver them is relatively easy. The difficult task is determining which of the many needs to address. What a community lacks may be the result of poor or inadequate public policy. For example, its priority may not be healthcare. In these situations healthcare providers may be best able to serve the community by providing indirect support to social service providers or by advocating for change. The community benefit services operating policy provides a standard approach to match the community's priority needs with the institution's resources and produce a measurable improvement in health status.

Deinstitutionalisation and Community Living: Progress, Problems and Priorities

ERIC Educational Resources Information Center

Mansell, Jim

2006-01-01

Background: Deinstitutionalisation of services for people with intellectual disabilities has become a focus of disability policy in many countries. Research for the most part supports this strategy. However, outcomes are not uniformly better for everyone who moves to community living. This paper explores reasons for variability in service quality…

Increasing Student Success: An Interview with Edward A. Morante.

ERIC Educational Resources Information Center

Spann, Milton G.; Calderwood, Barbara J.

1998-01-01

Presents an interview with Edward Morante, Dean of Student Services and Learning Resources at College of the Desert (California), regarding the needs of high-risk community college students. Morante focuses on assessment, placement, basic-skills courses, student-support services, the learning-community concept, student involvement, and evaluation,…

"It Starts out with Little Things": An Exploration of Urban Adolescents' Support-Seeking Strategies in the Context of School

ERIC Educational Resources Information Center

Brion-Meisels, Gretchen

2016-01-01

Background: Student support systems have become a permanent structure in most U.S. public schools, responsible for ensuring equal access to support services. Typically utilized before special education is deemed necessary, these supports often include a range of school- and community-based services such as tutors, mentors, out-of-school time…

Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

PubMed

Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of individual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that explored their experiences of intervention implementation and delivery. Twenty-nine staff members from completer pharmacies returned exit surveys and interviews were conducted with 30 staff from completer and non-completer pharmacies. Descriptive analyses of quantitative data and thematic analyses of qualitative data were used to compare completers and non-completers. Baseline similarities included numbers of general and mental health prescriptions dispensed and established professional services. However, there was greater prevalence of diabetes management, opioid substitution services, and relationships with mental health services in completer pharmacies. Key facilitators for completers included pharmacy owner/manager support, staff buy-in and involvement, intervention flexibility, recruitment immediately following training, integration of intervention with existing services, changes to workflow, and regular consumer contact. Key barriers for both groups included lack of pharmacy owner/manager support or staff buy-in, time constraints, privacy limitations and pilot project associated paperwork. Insights into factors that underpinned successful intervention implementation and delivery should inform effective strategies for similar future studies and allocation of pharmacy mental health service delivery resources. Copyright © 2017 Elsevier Inc. All rights reserved.

Service implications from a comparison of the evidence on the effectiveness and a survey of provision in England and Wales of COPD specialist nurse services in the community.

PubMed

Candy, Bridget; Taylor, Stephanie J C; Ramsay, Jean; Esmond, Glenda; Griffiths, Chris J; Bryar, Rosamund M

2007-05-01

Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of mortality worldwide and is a burden on healthcare resources. Therefore, implementing the right care model(s) for patients with COPD is a priority. Nurses, particularly those with specialist roles, are often the principal health professionals involved in new service models. for patients in the community with COPD are increasing in many countries. Two main types of initiatives have been evaluated; those designed to transfer acute care out of hospital and into the community, and those offering chronic disease management. The extent and nature of such specialist services in the UK and internationally are unknown. To present the results of the first survey of specialist nurse service provision for patients in the community with COPD in England and Wales. To combine the survey findings with systematic review evidence to explore to what extent provision is supported by evidence of effectiveness. A postal survey of respiratory healthcare professionals undertaken concurrently with a review of the evidence of the effectiveness of nurse COPD services (review findings are reported fully elsewhere). Two hundred and thirty four specialist nurse services were identified; 71% involved chronic disease management, of which 47% also provided acute care. Seventeen per cent of services involved acute care only. The review identified evidence to support the provision of acute services but data on chronic disease management services are sparse and there is currently little evidence to support these services. Those interventions that have been evaluated to date differed from many of the services provided. This study identifies a considerable mismatch between existing evidence around effectiveness and services provision for patients with COPD. It clearly highlights the need for greater interaction between what happens in practice and research. This is an issue that has relevance across all healthcare practice, both nationally and internationally.

Medicaid--It's Not Just about Income!

ERIC Educational Resources Information Center

Mercado, Denise

2007-01-01

Medicaid Waivers are crucial to the community life of individuals with significant disabilities and their families. In a nutshell, Medicaid Waivers prevent institutionalization by providing the support individuals with significant disabilities need to live in the communities of their choice. These supports include Personal Care services and…

Psychological Community Integration of Individuals With Serious Mental Illness.

PubMed

Pahwa, Rohini; Kriegel, Liat

2018-06-01

As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.

Semantic Catalog of Things, Services, and Data to Support a Wind Data Management Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephan, E. G.; Elsethagen, T. O.; Berg, L. K.

The purpose of this paper is to discuss how community vocabularies and linked open data best practices are being used to seamlessly link things, data, and off the shelf services to support scientific offshore wind energy research for the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy (EERE) Wind and Water Power Program. This is largely made possible by leveraging collaborative advances in the Internet of Things (IoT), Semantic Web, Linked Services, Linked Open Data (LOD), and RDF vocabulary communities, which provide the foundation for our design. By adapting these linked community best practices, we designed amore » wind characterization data management facility capable of continually collecting, processing, and preservation of in situ and remote sensing instrume« less

Washington's Can Do Kids.

ERIC Educational Resources Information Center

Washington State Office of Community Development, Olympia.

Conceived as a state-supported community-sponsored program for families, strengthened by business and service organization support, and designed to work with local educational, child care, and social service agencies, Washington State's Early Childhood Education and Assistance Program (ECEAP, pronounced e-cap) provides a "whole child"…

Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

PubMed

Rebeiro Gruhl, K L; Kauppi, C; Montgomery, P; James, S

2012-01-01

Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.

42 CFR 51c.404 - Grant evaluation and award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY... feasibility of its providing all of such enumerated services by the end of the period of support under section... the requirements of § 51c.304 by the end of the period of support under section 330(d)(1)(B) of the...

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

PubMed

Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

2015-07-22

Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive community -primary health care services. At present, however, pre-release planning is not always available, especially for Aboriginal inmates who are more likely to be on remand or in custody for less than six months.

Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.

PubMed

Noureldin, Marwa; Hass, Zachary; Abrahamson, Kathleen; Arling, Greg

2017-09-04

Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls. Fifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p < .05). Within the context of a state-implemented transition program, findings highlight the importance of supports/services in mitigating against medication-related risk of falling post NH discharge. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers.

PubMed

Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy

2011-06-24

Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.

A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia.

PubMed

Nik, Jah; Lai, Pauline Siew Mei; Ng, Chirk Jenn; Emmerton, Lynne

2016-08-30

Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.

What does dependency on community mental health services mean? A conceptual review with a systematic search.

PubMed

Bonavigo, Tommaso; Sandhu, Sima; Pascolo-Fabrici, Elisabetta; Priebe, Stefan

2016-04-01

Although community mental health services aim to support patients' autonomy and independence, they have repeatedly been criticised for making patients dependent. Yet, it remains often unclear what exactly is meant with dependency in this context. This review aimed to identify the meaning of the term dependency on community services in the literature. A systematic search and conceptual review of papers where dependency is used in the context of community mental health services. Narrative synthesis was used to identify thematic concepts linked to dependency in these settings. Fifteen papers met the inclusion criteria. The analysis identified five different concepts of dependency on community mental health services: dislocation from the outside world; inflexibility and lack of freedom; obligation as resentment or appreciation; living with or without meaningful activities; and security. The findings suggest that, distinct from the exclusively negative connotation of the term dependency in a conventional medical context, dependency on community mental health services contains both negative and positive aspects. The different aspects might guide the future evaluation of the care provided in such services.

Structured decision making as a method for linking quantitative decision support to community fundamental objectives

EPA Science Inventory

Decision support intended to improve ecosystem sustainability requires that we link stakeholder priorities directly to quantitative tools and measures of desired outcomes. Actions taken at the community level can have large impacts on production and delivery of ecosystem service...

Condition of Iowa Community Colleges, 2005

ERIC Educational Resources Information Center

Iowa Department of Education, 2006

2006-01-01

Iowa's 15 Community Colleges offer thousands of credit and non-credit courses. The 2005 "Condition of Iowa Community Colleges" report will review Iowa Community College programs and related services. The report is supported by Management Information System (MIS) data, as reported by Iowa Community Colleges to the Iowa Department of…

Strategic Management Lessons from Valencia, Clackamas, and Coastline Community Colleges.

ERIC Educational Resources Information Center

Kelley, Douglas

1983-01-01

Cites five strategic management factors accounting for the achievements in serving adult and community needs at three community colleges: presidential and board support; the organizational status given to community service programs; performance of change agent roles; diversity of needs assessment and community involvement methods; and favorable…

Newcomers health in Brantford and the counties of Brant, Haldimand and Norfolk: perspectives of newcomers and service providers.

PubMed

Sethi, Bharati

2013-10-01

The Canadian government's plan to support a balanced distribution of immigrants throughout the nation has contributed to newcomers' dispersion to small town communities and rural areas. However, very little work has examined the health experiences of immigrants settling in smaller urban and rural regions. Even less literature exists on the perspectives of service providers working with newcomers in Canada's urban-rural communities. This paper focuses on a part of a larger Community-based study on 'Newcomer Settlement and Integration in Education, Training, Employment, Health and Social Support' in Brantford--a middle-sized urban/rural region in Ontario, Canada--and discusses the findings in the health domain. Data were generated from 212 service providers and 237 newcomers using both qualitative and quantitative research tools. Newcomers identified several barriers in accessing mental and/or physical health services including lack of culturally appropriate services and discrimination. The striking differences between newcomers' and service providers' responses to the survey questionnaires bring to light cultural variations between the newcomers' and the service providers' perceptions of 'health'. The findings reinforce the need for including newcomers in developing more inclusive and culturally-appropriate health services and programs.

The People's College & the Street People: Community Colleges & Community Development (Part One of Two).

ERIC Educational Resources Information Center

O'Banion, Terry; Gillett-Karam, Rosemary

1996-01-01

Argues that, despite the provision of community-based educational services, community colleges do not play a key role in social change in their communities. Reviews the history of community development in the colleges, suggesting that original goals were designed to be noncontroversial. Discusses increasing foundation support to address community…

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

PubMed Central

Antezana, Ligia; Scarpa, Angela; Valdespino, Andrew; Albright, Jordan; Richey, John A.

2017-01-01

Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings. PMID:28473784

European grid services for global earth science

NASA Astrophysics Data System (ADS)

Brewer, S.; Sipos, G.

2012-04-01

This presentation will provide an overview of the distributed computing services that the European Grid Infrastructure (EGI) offers to the Earth Sciences community and also explain the processes whereby Earth Science users can engage with the infrastructure. One of the main overarching goals for EGI over the coming year is to diversify its user-base. EGI therefore - through the National Grid Initiatives (NGIs) that provide the bulk of resources that make up the infrastructure - offers a number of routes whereby users, either individually or as communities, can make use of its services. At one level there are two approaches to working with EGI: either users can make use of existing resources and contribute to their evolution and configuration; or alternatively they can work with EGI, and hence the NGIs, to incorporate their own resources into the infrastructure to take advantage of EGI's monitoring, networking and managing services. Adopting this approach does not imply a loss of ownership of the resources. Both of these approaches are entirely applicable to the Earth Sciences community. The former because researchers within this field have been involved with EGI (and previously EGEE) as a Heavy User Community and the latter because they have very specific needs, such as incorporating HPC services into their workflows, and these will require multi-skilled interventions to fully provide such services. In addition to the technical support services that EGI has been offering for the last year or so - the applications database, the training marketplace and the Virtual Organisation services - there now exists a dynamic short-term project framework that can be utilised to establish and operate services for Earth Science users. During this talk we will present a summary of various on-going projects that will be of interest to Earth Science users with the intention that suggestions for future projects will emerge from the subsequent discussions: • The Federated Cloud Task Force is already providing a cloud infrastructure through a few committed NGIs. This is being made available to research communities participating in the Task Force and the long-term aim is to integrate these national clouds into a pan-European infrastructure for scientific communities. • The MPI group provides support for application developers to port and scale up parallel applications to the global European Grid Infrastructure. • A lively portal developer and provider community that is able to setup and operate custom, application and/or community specific portals for members of the Earth Science community to interact with EGI. • A project to assess the possibilities for federated identity management in EGI and the readiness of EGI member states for federated authentication and authorisation mechanisms. • Operating resources and user support services to process data with new types of services and infrastructures, such as desktop grids, map-reduce frameworks, GPU clusters.

42 CFR 441.353 - Supporting documentation required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... that are maintained by the agency and by providers of services to support financial accountability, information regarding how the State meets the requirement for financial accountability, and an explanation of... 1915(d) home and community-based waiver services. If the State has an approved Medicaid Management...

Rehabilitation Prevocational Support Services. Program Outline.

ERIC Educational Resources Information Center

Musgrove, Ann

This outline decribes the Rehabilitation Prevocational Support Service program at Northwest Community College (Alabama), designed to help prepare selected students for occupational training programs or job placement and to enhance their academic level. Students are assigned to individualized learning modules based on pretesting by a variety of…

Leveraging Globus to Support Access and Delivery of Scientific Data

NASA Astrophysics Data System (ADS)

Cram, T.; Schuster, D.; Ji, Z.; Worley, S. J.

2015-12-01

The NCAR Research Data Archive (RDA; http://rda.ucar.edu) contains a large and diverse collection of meteorological and oceanographic observations, operational and reanalysis outputs, and remote sensing datasets to support atmospheric and geoscience research. The RDA contains greater than 600 dataset collections which support the varying needs of a diverse user community. The number of RDA users is increasing annually, and the most popular method used to access the RDA data holdings is through web based protocols, such as wget and cURL based scripts. In the year 2014, 11,000 unique users downloaded greater than 1.1 petabytes of data from the RDA, and customized data products were prepared for more than 45,000 user-driven requests. In order to further support this increase in web download usage, the RDA has implemented the Globus data transfer service (www.globus.org) to provide a GridFTP data transfer option for the user community. The Globus service is broadly scalable, has an easy to install client, is sustainably supported, and provides a robust, efficient, and reliable data transfer option for the research community. This presentation will highlight the technical functionality, challenges, and usefulness of the Globus data transfer service for accessing the RDA data holdings.

Community for All Is Possible: Promoting Home and Community Life at Community Vision, Inc.

ERIC Educational Resources Information Center

Walker, Pam

This report on Community Vision, Inc. is part of a series documenting innovative supports for community living for adults with severe disabilities. Community Vision was created as an alternative to facility-based services in Oregon that would intentionally focus on providing inclusive community living for those with the most severe disabilities…

CDDIS: NASA's Archive of Space Geodesy Data and Products Supporting GGOS

NASA Technical Reports Server (NTRS)

Noll, Carey; Michael, Patrick

2016-01-01

The Crustal Dynamics Data Information System (CDDIS) supports data archiving and distribution activities for the space geodesy and geodynamics community. The main objectives of the system are to store space geodesy and geodynamics related data and products in a central archive, to maintain information about the archival of these data,to disseminate these data and information in a timely manner to a global scientific research community, and provide user based tools for the exploration and use of the archive. The CDDIS data system and its archive is a key component in several of the geometric services within the International Association of Geodesy (IAG) and its observing systemthe Global Geodetic Observing System (GGOS), including the IGS, the International DORIS Service (IDS), the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS), and the International Earth Rotation and Reference Systems Service (IERS). The CDDIS provides on-line access to over 17 Tbytes of dataand derived products in support of the IAG services and GGOS. The systems archive continues to grow and improve as new activities are supported and enhancements are implemented. Recently, the CDDIS has established a real-time streaming capability for GNSS data and products. Furthermore, enhancements to metadata describing the contents ofthe archive have been developed to facilitate data discovery. This poster will provide a review of the improvements in the system infrastructure that CDDIS has made over the past year for the geodetic community and describe future plans for the system.

Links between social environment and health care utilization and costs.

PubMed

Brault, Marie A; Brewster, Amanda L; Bradley, Elizabeth H; Keene, Danya; Tan, Annabel X; Curry, Leslie A

2018-01-01

The social environment influences health outcomes for older adults and could be an important target for interventions to reduce costly medical care. We sought to understand which elements of the social environment distinguish communities that achieve lower health care utilization and costs from communities that experience higher health care utilization and costs for older adults with complex needs. We used a sequential explanatory mixed methods approach. We classified community performance based on three outcomes: rate of hospitalizations for ambulatory care sensitive conditions, all-cause risk-standardized hospital readmission rates, and Medicare spending per beneficiary. We conducted in-depth interviews with key informants (N = 245) from organizations providing health or social services. Higher performing communities were distinguished by several aspects of social environment, and these features were lacking in lower performing communities: 1) strong informal support networks; 2) partnerships between faith-based organizations and health care and social service organizations; and 3) grassroots organizing and advocacy efforts. Higher performing communities share similar social environmental features that complement the work of health care and social service organizations. Many of the supportive features and programs identified in the higher performing communities were developed locally and with limited governmental funding, providing opportunities for improvement.

Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

PubMed

Gao, Xing; He, Yao; Hu, Hongpu

2017-01-01

Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

EarthConnections: Integrating Community Science and Geoscience Education Pathways for More Resilient Communities.

NASA Astrophysics Data System (ADS)

Manduca, C. A.

2017-12-01

To develop a diverse geoscience workforce, the EarthConnections collective impact alliance is developing regionally focused, Earth education pathways. These pathways support and guide students from engagement in relevant, Earth-related science at an early age through the many steps and transitions to geoscience-related careers. Rooted in existing regional activities, pathways are developed using a process that engages regional stakeholders and community members with EarthConnections partners. Together they connect, sequence, and create multiple learning opportunities that link geoscience education and community service to address one or more local geoscience issues. Three initial pilots are demonstrating different starting points and strategies for creating pathways that serve community needs while supporting geoscience education. The San Bernardino pilot is leveraging existing academic relationships and programs; the Atlanta pilot is building into existing community activities; and the Oklahoma Tribal Nations pilot is co-constructing a pathway focus and approach. The project is using pathway mapping and a collective impact framework to support and monitor progress. The goal is to develop processes and activities that can help other communities develop similar community-based geoscience pathways. By intertwining Earth education with local community service we aspire to increase the resilience of communities in the face of environmental hazards and limited Earth resources.

Pause...Before Rushing In: Examining Motivations to Help in Trauma Impacted Communities Internationally

ERIC Educational Resources Information Center

Streets, Barbara Faye; Nicolas, Guerda; Wolford, Karen

2015-01-01

International service learning courses, cultural immersion projects, and international disaster response teams have provided valuable aid, services, supplies and programs to trauma-impacted communities across the globe. Many colleges and universities support global learning and the creation of global citizens, and this ethic is reflected in many…

Student Management and Human Intelligence Skills Enhanced through Community Service

ERIC Educational Resources Information Center

Wilson, Stefanie Denise

2012-01-01

Based on years of human intelligence research conducted by Howard Gardner and results from a quantitative research study supporting Gardner's research collected from a sample of 205 faculty within the United States, the researcher examined students that are actively engaged in community service experiences and their approaches to reframing their…

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)

Supporting Veteran Transitions to the Academic Setting: VA on Campus

ERIC Educational Resources Information Center

O'Connor, Ashley; Herbst, Ellen; McCaslin, Shannon; Armstrong, Keith; Leach, Bridget; Jersky, Brandina

2018-01-01

In this case study, we assessed academic functioning, service satisfaction, and needs of student veterans at a community college who had accessed the Veterans Health Administration (VHA) Student Veteran Health Program (SVHP) (n = 36). The SVHP provides outreach and behavioral health services directly on a large community college campus to overcome…

The impact of nursing students on the health-related quality of life and perceived social support of a rural population in Ecuador: effects of a service-based learning course.

PubMed

Walcott, Rebecca L; Murcia, Angela M; Berry, Gloria M; Juna, Christian F; Roldós, María Isabel; Corso, Phaedra S

2018-02-02

Students seeking degrees in healthcare in Ecuador participate in community improvement projects and provide free health services under the supervision of faculty health professionals. The aim of this study is to determine the impact of a community-based intervention delivered by nursing students on health-related quality of life (HRQoL) and perceived social support of a rural population in Ecuador. A quasi-experimental non-equivalent control group design study was conducted in two rural communities in Tumbaco, Ecuador. Families from one rural community were invited to participate in the intervention, receiving 8 weekly home visits from nursing students. Families from a neighboring community were similarly recruited as wait-list controls. One member of each family was consented into the study; the final sample included 43 intervention participants and 55 control participants. HRQoL and perceived social support were assessed before and after the intervention in both groups. The SF-12 was used to measure HRQoL, including eight domain scores and two composite scores, and the Interpersonal Support Evaluation List was used as an indicator of perceived social support. Difference-in-differences (DD) analyses were conducted to mitigate the effects of any baseline differences in the non- equivalent control group design. When compared to the control group, the intervention group realized significant improvements in the physical component summary score of the SF-12 (4.20, p < 0.05) and the physical function domain of the SF-12 (4.92, p < 0.05). There were no statistically significant differences for any other components of the SF-12 or in the measure of perceived social support. Nursing students completing their rural service rotation have the potential to improve the health-related quality of life of rural residents in Ecuador. Future research should continue to examine the impact of service-based learning on recipient populations.

Developing services to support parents caring for a technology-dependent child at home.

PubMed

Kirk, S; Glendinning, C

2004-05-01

A group of children with complex health care needs have emerged as a result of medical advances and government policies emphasizing the community as the arena for care. Some of these children remain dependent on the medical technology that enabled them to survive and require care of a complex and intensive nature to be carried out by their parents at home. To explore the experiences of families caring at home for a technology-dependent child; to examine their needs for practical and other support; and to examine how far services are currently meeting these needs. Methods In-depth interviews were conducted with the parents of 24 technology-dependent children and with 44 health, social care and other professionals. Services in the community were not sufficiently developed to support this group of families. Major problems were identified in the purchasing and provision of both short-term care/home support services and specialist equipment/therapies in the community. Service provision could be poorly planned and co-ordinated at an operational level and few families had a designated key worker. Parents felt that professionals did not always recognize either the emotional costs entailed in providing care of this nature or their expertise in caregiving. Information-giving to parents was often described as poor and participants reported that hospital professionals failed to negotiate the transfer of caregiving responsibility to parents. Services need to work in partnership with families and with each other at both strategic and operational levels, to develop integrated and co-ordinated services that can meet the needs of this group of families.

20 CFR 641.535 - What services must grantees and sub-recipients provide to participants?

Code of Federal Regulations, 2011 CFR

2011-04-01

... capabilities, aptitudes, needs for supportive services, occupational preferences, training needs, potential for... safe and healthy working conditions at their community service employment worksites (OAA § 502(b)(1)(J...

Engaging the Refugee Community of Greater Western Sydney

ERIC Educational Resources Information Center

Naidoo, Loshini

2010-01-01

This paper discusses the community engagement program, "Refugee Action Support" (RAS) at the University of Western Sydney. RAS is a partnership program between the Australian Literacy and Numeracy Foundation, The NSW Department of Education and Training and the university. The Refugee Action Support program prepares pre-service teachers…

Tailored tobacco dependence support for mental health patients: a model for inpatient and community services.

PubMed

Parker, Camilla; McNeill, Ann; Ratschen, Elena

2012-12-01

Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings and to assess its impact, as well as barriers and facilitators to implementation. An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals. Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the United Kingdom's largest Mental Health Trust. Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on implementation barriers/facilitators. A total of 110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers) and 57 community (of unknown number of community smokers, as recording of smoking status is not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to: (i) trust policy, systems and procedures, (ii) staff knowledge and attitudes and (iii) illness-related factors. Despite the strong anti-smoking climate in the United Kingdom, including a law requiring smoke-free policies in mental health settings, establishing a smoking cessation treatment service for people with mental illness proved difficult, due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Analysis of Contemporary Contingency Contracting Educational Resources

DTIC Science & Technology

2010-11-29

Iraq and Afghanistan by providing base operations support (e.g., food and housing); communication services; tactical and nontactical vehicle...334, mentioned earlier, are widely accessible to all acquisition communities across the DoD. MN 3318 is exclusively taught through the NPS, and the...peacekeeping missions, and humanitarian relief efforts. The services provided include base operations support (e.g., food and housing), communication services

Analysis of Contemporary Contingency Contracting Educational Resources

DTIC Science & Technology

2010-12-01

Afghanistan by providing base operations support (e.g., food and housing); communication services; tactical and nontactical vehicle maintenance...Contingency Contracting Handbook on which it is based) and CON 334, mentioned earlier, are widely accessible to all acquisition communities across the DoD...missions, and humanitarian relief efforts. The services provided include base operations support (e.g., food and housing), communication services

Supporting Shared Resource Usage for a Diverse User Community: the OSG Experience and Lessons Learned

NASA Astrophysics Data System (ADS)

Garzoglio, Gabriele; Levshina, Tanya; Rynge, Mats; Sehgal, Chander; Slyz, Marko

2012-12-01

The Open Science Grid (OSG) supports a diverse community of new and existing users in adopting and making effective use of the Distributed High Throughput Computing (DHTC) model. The LHC user community has deep local support within the experiments. For other smaller communities and individual users the OSG provides consulting and technical services through the User Support area. We describe these sometimes successful and sometimes not so successful experiences and analyze lessons learned that are helping us improve our services. The services offered include forums to enable shared learning and mutual support, tutorials and documentation for new technology, and troubleshooting of problematic or systemic failure modes. For new communities and users, we bootstrap their use of the distributed high throughput computing technologies and resources available on the OSG by following a phased approach. We first adapt the application and run a small production campaign on a subset of “friendly” sites. Only then do we move the user to run full production campaigns across the many remote sites on the OSG, adding to the community resources up to hundreds of thousands of CPU hours per day. This scaling up generates new challenges - like no determinism in the time to job completion, and diverse errors due to the heterogeneity of the configurations and environments - so some attention is needed to get good results. We cover recent experiences with image simulation for the Large Synoptic Survey Telescope (LSST), small-file large volume data movement for the Dark Energy Survey (DES), civil engineering simulation with the Network for Earthquake Engineering Simulation (NEES), and accelerator modeling with the Electron Ion Collider group at BNL. We will categorize and analyze the use cases and describe how our processes are evolving based on lessons learned.

Better Together: Expanding Rural Partnerships to Support Families

ERIC Educational Resources Information Center

Shaklee, Harriet; Bigbee, Jeri; Wall, Misty

2012-01-01

Chronic shortages of health, social service, and mental health professionals in rural areas necessitate creative partnerships in support of families. Cooperative extension professionals in Family and Consumer Sciences and community health nurses, who can bring critical skills to human services teams, are introduced as trusted professionals in…

Faces of Neglect.

ERIC Educational Resources Information Center

Dubin, Bettina Adelberg; And Others

The family is the primary source of support and caregiving for the frail, dependent elder, providing emotional support, logistical services, supplemental finances, and the link to the outside community for the homebound elder. The caregiving systems of 84 of Texas's Adult Protective Services' (APS) cases were examined. The definition of neglect…

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

PubMed

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

2017-07-01

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

Flexibility in community pharmacy: a qualitative study of business models and cognitive services.

PubMed

Feletto, Eleonora; Wilson, Laura K; Roberts, Alison S; Benrimoj, Shalom I

2010-04-01

To identify the capacity of current pharmacy business models, and the dimensions of organisational flexibility within them, to integrate products and services as well as the perceptions of viability of these models. Fifty-seven semi-structured interviews were conducted with community pharmacy owners or managers and support staff in 30 pharmacies across Australia. A framework of organisational flexibility was used to analyse their capacity to integrate services and perceptions of viability. Data were analysed using the method of constant comparison by two independent researchers. The study found that Australian community pharmacies have used the four types of flexibility to build capacity in distinct ways and react to changes in the local environment. This capacity building was manifested in four emerging business models which integrate services to varying degrees: classic community pharmacy, retail destination pharmacy, health care solution pharmacy and networked pharmacy. The perception of viability is less focused on dispensing medications and more focused on differentiating pharmacies through either a retail or services focus. Strategic flexibility appeared to offer pharmacies the ability to integrate and sustainably deliver services more successfully than other types, as exhibited by health care solution and networked pharmacies. Active support and encouragement to transition from being dependent on dispensing to implementing services is needed. The study showed that pharmacies where services were implemented and showed success are those strategically differentiating their businesses to become focused health care providers. This holistic approach should inevitably influence the sustainability of services.

Oversight on Community Services Administration, Child Abuse Prevention and Treatment, and Adoption Opportunities, and Native American Programs Act. Hearing before the Subcommittee on Aging, Family and Human Services of the Committee on Labor and Human Resources. United States Senate, Ninety-Seventh Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

Oversight hearings were conducted on April 23, 1981 in reference to social service block grants for the Community Services Administration, child abuse prevention and treatment and adoption programs, and Native American Programs Act. Testimonies for support of block grants advocated ability of States to decide how program resources can best be…

A qualitative study exploring community pharmacists' awareness of, and contribution to, self-care support in the management of long-term conditions in the United Kingdom.

PubMed

Ogunbayo, Oladapo J; Schafheutle, Ellen I; Cutts, Christopher; Noyce, Peter R

2015-01-01

Self-care support refers to activities aimed at educating, training and empowering patients with skills and ability to manage [and monitor] their long-term conditions (LTCs). While self-care support by health care professionals has emerged as a distinct concept in the management of LTCs, evidence of community pharmacy's contribution is sparse. The aim was to explore community pharmacy's contribution to self-care support of LTCs. The objectives were to explore how community pharmacists conceptualize self-care support of LTCs and how they operationalize the core elements of this in their practice. Semi-structured interviews were conducted with community pharmacists in England (n = 12) and Scotland (n = 12). A framework consisting of the core elements of self-care support (information and advice; skills training and support; technology; support networks; and collaborative care planning) was developed from the literature and was used to structure the interviews and analysis. Analysis was done thematically using the interpretative phenomenological analysis technique. The three main themes that emerged were conceptualization; operationalization of the core elements; and barriers to providing self-care support. Participants conceptualized self-care of LTCs as patients taking responsibility for their own health, performing activities that improved their LTCs and that enabled them to become more independent in managing their LTCs. Their views on self-care support did not reflect this conceptual understanding but was described primarily as providing patients with information and advice rather than actively supporting them. Participants' views of operationalizing the core elements of self-care support was found to be medicines focused, opportunistic and dependent on the services they provided, rather than being patient-centered and proactive. The barriers to providing self-care support of LTCs in community pharmacy were described as priority accorded to dispensing activities, the structure of the community pharmacy contract, lack of incentives to provide self-care support and patients' expectations and lack of awareness of community pharmacy's role in LTCs management. Community pharmacists' theoretical understanding of self-care was not reflected in the ways that they portrayed their contributions to self-care support. The current ways in which community pharmacy delivers its services for patient care may need to be re-configured in order to fit into the holistic self-care support paradigm. Copyright © 2015 Elsevier Inc. All rights reserved.

45 CFR 1388.6 - Program criteria-services and supports.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., integration and inclusion of individuals with developmental disabilities and their families. (b) UAP community... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON DEVELOPMENTAL DISABILITIES, DEVELOPMENTAL DISABILITIES PROGRAM THE UNIVERSITY AFFILIATED PROGRAMS § 1388.6 Program criteria—services and...

Toward Rural Prosperity: A State Policy Framework in Support of Rural Community Colleges. Policy Paper.

ERIC Educational Resources Information Center

Chesson, J. Parker, Jr.; Rubin, Sarah

In six policy areas, states can better equip rural community colleges to serve their communities. In the area of economic and community development, states can use rural community colleges to promote community development efforts and service learning and to provide small business assistance and entrepreneurship education. States can improve access…

Toward a Community School: A Model for Organizing Community Based Educational Support Services. Publication Series No. 10.

ERIC Educational Resources Information Center

Bartelt, David W.

This paper focuses on how to develop a community-based educational intervention when community apathy is present, or where the isolation between school and community makes partnership more difficult. The key elements for this model are three steps: (1) determining the school-community relationship, establishing that a condition of isolation…

Community outreach library services in the UK: a case study of Wirral Hospital NHS Trust (WHNT).

PubMed

Dowse, Frances Maria; Sen, Barbara

2007-09-01

The study evaluates the Community Outreach Library Service at Wirral Hospital National Health Service Trust (WHNT). It considers the information seeking behaviour and information needs of primary care staff, and service effectiveness in meeting those needs. A literature review established the current context and areas of best practice. The investigative case study used postal questionnaires to 250 primary care staff and an interview with the Community Outreach Librarian. Themes emerged from the literature regarding information seeking behaviour, information needs, and meeting user needs through effective service delivery. Outreach services have value in terms of improving information skills and providing services at point of need. Time is a major constraint for both users and service providers. Investment is needed from appropriate funding sources to support the provision and marketing of outreach library services. Librarians benefit from sharing best practice. The continued evaluation of outreach library services is recommended.

Technical support for Life Sciences communities on a production grid infrastructure.

PubMed

Michel, Franck; Montagnat, Johan; Glatard, Tristan

2012-01-01

Production operation of large distributed computing infrastructures (DCI) still requires a lot of human intervention to reach acceptable quality of service. This may be achievable for scientific communities with solid IT support, but it remains a show-stopper for others. Some application execution environments are used to hide runtime technical issues from end users. But they mostly aim at fault-tolerance rather than incident resolution, and their operation still requires substantial manpower. A longer-term support activity is thus needed to ensure sustained quality of service for Virtual Organisations (VO). This paper describes how the biomed VO has addressed this challenge by setting up a technical support team. Its organisation, tooling, daily tasks, and procedures are described. Results are shown in terms of resource usage by end users, amount of reported incidents, and developed software tools. Based on our experience, we suggest ways to measure the impact of the technical support, perspectives to decrease its human cost and make it more community-specific.

Philanthropic Donor Perspectives on Supporting Nursing Excellence in a Community Hospital.

PubMed

Fickley, Sharon K; Mishler, Ray R; Black, Amelia S; DeGuzman, Pam B

2016-11-01

The purpose of this research is to explore donors' perspectives on support of nursing excellence in a community hospital. Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals. Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis. Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received. This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.

Older adults' home- and community-based care service use and residential transitions: a longitudinal study.

PubMed

Chen, Ya-Mei; Berkowitz, Bobbie

2012-08-10

As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults' use of home- and community-based services and their residential transitions. The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults' residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Older adults' use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults' use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Older adults' differing HCBS use patterns may be the key to explaining older adults' transitions. Attention to older adults' HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships.

Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

PubMed Central

2012-01-01

Background As Home-and Community-Based Services (HCBS), such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and community-based services and their residential transitions. Methods The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults’ residential status at the three follow-up interviews, four residential transitions were tracked: (1) Community-Community-Community (CCC: Resided in community during the entire study period); (2) Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3); (3) Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3); (4) Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.). Results Older adults’ use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults’ use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS) and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other services, such as senior center services or meal services, were associated with different directions in residential transition, such as CIC and CII respectively. Conclusions Older adults’ differing HCBS use patterns may be the key to explaining older adults’ transitions. Attention to older adults’ HCBS use patterns is recommended for future practice. However, this was an exploratory study and the analyses cannot establish causal relationships. PMID:22877416

45 CFR 2516.710 - What are the limits on the use of funds?

Code of Federal Regulations, 2010 CFR

2010-10-01

... NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Funding Requirements § 2516.710 What... to pay any stipend, allowance, or other financial support to any participant in a service-learning...

45 CFR 2516.710 - What are the limits on the use of funds?

Code of Federal Regulations, 2011 CFR

2011-10-01

... NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Funding Requirements § 2516.710 What... to pay any stipend, allowance, or other financial support to any participant in a service-learning...

Achieving Results through Community School Partnerships: How District and Community Leaders Are Building Effective, Sustainable Relationships

ERIC Educational Resources Information Center

Blank, Martin J.; Jacobson, Reuben; Melaville, Atelia

2012-01-01

A community school is a place and a set of partnerships connecting a school, the families of students, and the surrounding community. A community school is distinguished by an integrated focus on academics, youth development, family support, health and social services, and community development. The community school strategy is central to efforts…

An evaluation of a multi-site community pharmacy-based chronic obstructive pulmonary disease support service.

PubMed

Wright, David; Twigg, Michael; Barton, Garry; Thornley, Tracey; Kerr, Clare

2015-02-01

Chronic obstructive pulmonary disease (COPD) is a progressive chronic condition that can be effectively managed by smoking-cessation, optimising prescribed therapy and providing treatment to prevent chest infections from causing hospitalisation. The government agenda in the UK is for community pharmacists to become involved in chronic disease management, and COPD is one area where they are ideally located to provide a comprehensive service. This study aims to evaluate the effect of a community pharmacy-based COPD service on patient outcomes. Patients in one UK location were recruited over a 10-week period to receive a community pharmacy-based COPD support service consisting of signposting to or provision of smoking-cessation service, therapy optimisation and recommendation to obtain a rescue pack containing steroid and antibiotic to prevent hospitalisation as a result of chest infection. Data were collected over a 6-month period for all recruited patients. Appropriate clinical outcomes, patient reported medication adherence, quality of life and National Health Service (NHS) resource utilisation were measured. Three hundred six patients accessed the service. Data to enable comparison before and after intervention was available for 137 patients. Significant improvements in patient reported adherence, utilisation of rescue packs, quality of life and a reduction in routine general practitioner (GP) visits were identified. The intervention cost was estimated to be off-set by reductions in the use of other NHS services (GP and accident and emergency visits and hospital admissions). Results suggest that the service improved patient medicine taking behaviours and that it was cost-effective. © 2014 Community Pharmacy Futures. International Journal of Pharmacy Practice published by. John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

An evaluation of a family planning mobile job aid for community health workers in Tanzania.

PubMed

Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

2016-07-01

The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016 Elsevier Inc. All rights reserved.

Decentralizing provision of mental health care in Sri Lanka.

PubMed

Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

2017-04-01

In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

"A Treasure Chest of Service": The Role of Toy Libraries within Play Policy in Wales

ERIC Educational Resources Information Center

Powell, Robat; Seaton, Nia

2007-01-01

Since the first toy libraries opened in the 1960s and 1970s to support families of children with special educational needs, they have expanded to serve broader communities. Toy libraries do more than lend toys: they can provide family support services and specialist support to families with children with special educational needs, benefit…

Implementation of a pharmacogenetic management service for postmyocardial infarction care in a community pharmacy.

PubMed

Bright, D R; Kisor, D F; Smith, A; Conaway, M; Yu, M

2015-08-01

The purpose of this study was to pilot a multisite, proof-of-concept model where community pharmacists could engage patients and physicians to provide pharmacogenetic (PGt) testing and clinical decision support. Patients with history of acute myocardial infarction and percutaneous coronary intervention with no prior history of CYP2C19 testing. Four community pharmacies provided pharmacogenetic testing and medication therapy management services to 30 patients, resulting in eight recommendations for antiplatelet therapy adjustment. Pharmacists involved in the study were able to facilitate antiplatelet therapy adjustments based on PGt data regardless of baseline antiplatelet drug selection. Whereas prior literature largely revolved around PGt management in the inpatient setting, this project supports the involvement of the community pharmacist in making PGt-based recommendations.

Supporting Individuals with Autism Spectrum Disorder in Recreation

ERIC Educational Resources Information Center

Coyne, Phyllis; Fullerton, Ann

2004-01-01

This book was developed to assist recreation service providers, as well as families, to understand strategies for supporting individuals with ASD in community and school recreation programs. The ideas have many practical uses in generic and specialized recreation programs. A variety of audiences, including teachers, recreation service providers,…

75 FR 61180 - Notice of Availability of Funds and Solicitation for Grant Applications (SGA) for YouthBuild Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... and training opportunities; opportunities for meaningful work and service to their communities; and... support, and their plan for providing education, skills training, and leadership development services to... cannot be used to support occupational skills training other than construction. Programs may offer...

Myth and reality in the rural health service crisis: facing up to community responsibilities.

PubMed

Amundson, B

1993-01-01

Rural communities, rural advocacy organizations, and policy makers persist in perpetuating two serious but related misconceptions, namely: (1) The continuing deterioration of health services in most rural communities is primarily the result of forces and factors outside of the communities themselves, and (2) the solution to reverse this deterioration will come mainly from changes in reimbursement and other types of public policy initiatives. Overemphasis on the role of external factors has created a serious imbalance in programs, resources, and policy efforts, including those supported by the NRHA, resulting in inadequate national efforts and resources to foster community-based solutions. Suggested solutions include: (1) application by communities of a proven set of principles for organizing and developing local health services, and (2) creation of a national network to promote such community-based solutions.

A National Analysis of Medicaid Home and Community Based Services Waivers for People With Intellectual and Developmental Disabilities: FY 2015.

PubMed

Friedman, Carli

2017-10-01

Medicaid Home and Community Based Services (HCBS) 1915(c) waivers are the largest source of funding for the long term services and supports of people with intellectual and developmental disabilities (IDD). National-level analyses of HCBS IDD waivers are crucial because of the large variance across states, the recent CMS rule and regulation changes (CMS 2249-F/2296-F), and the ever changing economic and political landscape. Therefore, the aim of this study was to examine state waiver priorities for people with IDD. In FY 2015, 111 waivers projected spending $25.6 billion for approximately 630,000 people with IDD. The services with the most funding were residential habilitation, supports to live in one's own home, and day habilitation. However, our analysis revealed large discrepancies across states and services.

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Eligibility. 441.510 Section 441.510 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Home and Community-Based Attendant Services and Supports Stat...

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Eligibility. 441.510 Section 441.510 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Home and Community-Based Attendant Services and Supports Stat...

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Eligibility. 441.510 Section 441.510 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Home and Community-Based Attendant Services and Supports Stat...

45 CFR 2516.100 - What is the purpose of school-based service-learning programs?

Code of Federal Regulations, 2012 CFR

2012-10-01

... school-based service-learning programs is to promote service-learning as a strategy to support high...-learning programs? 2516.100 Section 2516.100 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility...

45 CFR 2516.100 - What is the purpose of school-based service-learning programs?

Code of Federal Regulations, 2013 CFR

2013-10-01

... school-based service-learning programs is to promote service-learning as a strategy to support high...-learning programs? 2516.100 Section 2516.100 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility...

45 CFR 2516.100 - What is the purpose of school-based service-learning programs?

Code of Federal Regulations, 2014 CFR

2014-10-01

... school-based service-learning programs is to promote service-learning as a strategy to support high...-learning programs? 2516.100 Section 2516.100 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility...

Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2017-09-01

Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues, social life, education, work and financial issues. © 2016 Nordic College of Caring Science.

Community Coordinated Modeling Center (CCMC): Using innovative tools and services to support worldwide space weather scientific communities and networks

NASA Astrophysics Data System (ADS)

Mendoza, A. M.; Bakshi, S.; Berrios, D.; Chulaki, A.; Evans, R. M.; Kuznetsova, M. M.; Lee, H.; MacNeice, P. J.; Maddox, M. M.; Mays, M. L.; Mullinix, R. E.; Ngwira, C. M.; Patel, K.; Pulkkinen, A.; Rastaetter, L.; Shim, J.; Taktakishvili, A.; Zheng, Y.

2012-12-01

Community Coordinated Modeling Center (CCMC) was established to enhance basic solar terrestrial research and to aid in the development of models for specifying and forecasting conditions in the space environment. In achieving this goal, CCMC has developed and provides a set of innovative tools varying from: Integrated Space Weather Analysis (iSWA) web -based dissemination system for space weather information, Runs-On-Request System providing access to unique collection of state-of-the-art solar and space physics models (unmatched anywhere in the world), Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and recently Mobile apps (iPhone/Android) to view space weather data anywhere to the scientific community. The number of runs requested and the number of resulting scientific publications and presentations from the research community has not only been an indication of the broad scientific usage of the CCMC and effective participation by space scientists and researchers, but also guarantees active collaboration and coordination amongst the space weather research community. Arising from the course of CCMC activities, CCMC also supports community-wide model validation challenges and research focus group projects for a broad range of programs such as the multi-agency National Space Weather Program, NSF's CEDAR (Coupling, Energetics and Dynamics of Atmospheric Regions), GEM (Geospace Environment Modeling) and Shine (Solar Heliospheric and INterplanetary Environment) programs. In addition to performing research and model development, CCMC also supports space science education by hosting summer students through local universities; through the provision of simulations in support of classroom programs such as Heliophysics Summer School (with student research contest) and CCMC Workshops; training next generation of junior scientists in space weather forecasting; and educating the general public about the importance and impacts of space weather effects. Although CCMC is organizationally comprised of United States federal agencies, CCMC services are open to members of the international science community and encourages interagency and international collaboration. In this poster, we provide an overview of using Community Coordinated Modeling Center (CCMC) tools and services to support worldwide space weather scientific communities and networks.;

Community Partners' Perspectives of Community-University Partnerships that Support Service-Learning

ERIC Educational Resources Information Center

Witchger Hansen, Anne Marie

2010-01-01

Community partner voices are important to understand because they provide the contexts in which occupational therapy students meet course objectives by applying clinical reasoning theory and developing clinical reasoning skills in a natural context (Witchger-Hansen et al., 2007; Provident, et al., 2011). To sustain these community-university…

Community Connections. Time Warner Community Responsibility Report, 1998-2000.

ERIC Educational Resources Information Center

Owens, Jane; Stein, Carol

This report highlights efforts by Time Warner personnel to strengthen community connections through various programs and services aimed at supporting: education, the arts, volunteerism, diversity, and business-community action. The report is divided into sections focusing on each of these areas. The first section, Education, describes programs…

The Influence of Parental Support on the Community Service Learning Experiences of American College Students

ERIC Educational Resources Information Center

Seider, Scott

2012-01-01

This mixed methods study considered the relationship between the civic development of college students participating in the Serve Program at Ignatius University and the influence of these students' parents. The Serve Program is a community service learning program that combines coursework in philosophy and theology with a year-long service…

Rural psychiatric services. A collaborative model.

PubMed Central

Kaufmann, I. M.

1993-01-01

Psychiatric services are difficult to obtain in rural communities because few psychiatrists practise outside urban centres. Family physicians who are willing to develop their skills with the support of their psychiatrist colleagues could alleviate this problem. This article describes a community mental health clinic where a family physician acts as psychiatric consultant. Images p1958-a p1961-a PMID:8219844

Effecting Successful Community Re-Entry: Systems of Care Community Based Mental Health Services

ERIC Educational Resources Information Center

Estes, Rebecca I.; Fette, Claudette; Scaffa, Marjorie E.

2005-01-01

The need for system reform for child and adolescent mental health services, long recognized as a vital issue, continues to challenge mental health professionals. While past legislation has not adequately addressed the issues, the 2003 President's New Freedom Commission may begin to reorient mental health systems toward recovery. Supported by this…

Using Interactions among In-Service Music Teachers in a Graduate Programme for Teacher Support

ERIC Educational Resources Information Center

Shin, Jihae

2018-01-01

The purpose of this study was to examine interactions among in-service music teachers in a graduate music teacher education programme using Wenger, McDermott, and Snyder's [2002. "Cultivating Communities of Practice: A Guide to Managing Knowledge." Boston, MA: Harvard Business School Press] Communities of Practice (CoPs) framework. The…

Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia.

PubMed

Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F

2014-09-01

Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.

The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice.

PubMed

Adams, Alex J; Dering-Anderson, Allison; Klepser, Michael E; Klepser, Donald

2018-05-01

Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

A Pilot Study of Early Intervention for Families with Children with or at Risk of an Intellectual Disability in Northern Malawi

ERIC Educational Resources Information Center

Kelly, Aine; Ghalaieny, Theresa; Devitt, Catherine

2012-01-01

In low-income rural communities, access to early intervention and support services is restricted and resources needed to support children and families are limited. The aim of this study was to explore the role of local nonprofessional women, recruited as community home visitors (CHVs), to assist trained professionals in supporting parents with…

Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda.

PubMed

Banek, Kristin; Nankabirwa, Joaniter; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah; Taaka, Lilian; Chandler, Clare I R; Staedke, Sarah G

2015-05-01

In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, we interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs' work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. All questionnaires and knowledge assessments were analysed. Summary contact sheets were made for each of the 100 interviews and 35 were chosen for full transcription and analysis. CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to 'becoming someone important', with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly complex forms, are to become the solution to improving access to primary health care, greater attention to what motivates individuals, and ways to strengthen health system support are required. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

Taking Our Seat at the Table: Community Cancer Survivorship.

PubMed

Polo, Katie M; Smith, Caitlin

Cancer survivors are at risk for occupational performance issues related to activities of daily living, instrumental activities of daily living, work, and social and community participation. Occupational therapy practitioners can address these performance issues by offering services within existing community cancer survivorship programs that focus on adaptive and compensatory strategies to facilitate meaningful lifestyles and optimize health and well-being. Occupational therapy services do not currently exist at these community sites, nor are occupational therapy practitioners recognized as providers in existing community cancer survivorship programs. Recognition of practitioners' distinct value in cancer survivorship, advocacy for occupational therapy services in the community, development of supporting documentation for occupational therapy's role in community survivorship, and research on the efficacy of interventions in community cancer survivorship are needed to expand occupational therapy's role with this growing population. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Quality of Life and Unmet Need in People with Psychosis in the London Borough of Haringey, UK

PubMed Central

Lambri, Maria; Chakraborty, Apu; Leavey, Gerard; King, Michael

2012-01-01

Objectives. Deinstitutionalization of long-term psychiatric patients produced various community-based residential care facilities. However, inner-city areas have many patients with severe mental illness (SMI) as well as deprivation, unemployment, and crime. This makes meeting their community needs complex. We undertook a needs assessment of service provision and consonance between service users' evaluation of need and by care workers. Design. Cross-sectional study with random sample of SMI service users in four housing settings: rehabilitation units; high-supported; medium-supported; low-supported housing. Setting. London Borough of Haringey. Outcome Measures. 110 SMI service users and 110 keyworkers were interviewed, using Camberwell Assessment of Need; SF-36; Lancashire Quality-of-Life profile; demographic and clinical information. Results. People in “low-support” and “high-support” housing had similar symptom scores, though low support had significantly lower quality of life. Quality of life was positively predicted by self-reported mental-health score and negatively predicted by unmet-need score in whole sample and in medium-support residents. Residents' and care-workers' assessments of need differed considerably. Conclusions. Although patients' housing needs were broadly met, those in low-supported housing fared least well. Attendance to self-reported mental health and unmet social needs to quality of life underpins planning of residential services for those with SMI. Social and personal needs of people in supported housing may be underestimated and overlooked; service providers need to prioritise these if concept of “recovery” is to advance. PMID:23213300

Understanding the Dynamic System of Terrorist-Government Interaction

DTIC Science & Technology

2003-03-01

organizations out of support or for services rendered (Department of State, 2002:65; Wallace, 2003:2). However, financial support does not have to be in...America’s critical infrastructure encompasses a large number of sectors[:]” agriculture, food, water, public health, emergency services , government...military, international law enforcement community, or the U.S. or international intelligence services (Department of State, 2002:vii-xiii). In fact

Enriched and Inspired: Service Pathways to College Success

ERIC Educational Resources Information Center

Barnett, Lynn; Jeandron, Carol

2009-01-01

With support from the U.S. Department of Education and advice from an external panel of experts, the American Association of Community Colleges (AACC) published a book that described disability support practices and programs designed to help community college students with disabilities reach their fullest potential. The book was an outgrowth of a…

Deliberate-Fire: An Account of Organizational Transformation in Onondaga Community Living, Syracuse, New York.

ERIC Educational Resources Information Center

O'Brien, John

From April 11-14, 1995, the Onondaga Community Living (OCL) organization hosted a team of five visitors sponsored by Syracuse University's Center on Human Policy. OCL provides services to empower and individually support people with developmental disabilities. In investigating the organization's move toward the provision of individual supports in…

A Case for Expanded School-Community Partnerships in Support of Positive Youth Development

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Stetler, E. Gwyn; Midle, Theresa

2006-01-01

This article discusses the results of two studies exploring the status of partnerships between schools and community organizations. In the first study, 90 teachers, administrators, and support service staff reported that the most common type of partnership involved youth development organizations, mental health providers, parents and residents,…

After the Visit: An Overview of Government and Community Programs Supporting Children with Medical Complexity.

PubMed

Olson, Kaitlyn B

2017-05-04

The optimal care of children with medical complexity (CMC) requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States. It outlines the educational rights of children with disabilities and offers practical tips for collaborating with Early Intervention and the public school system. The article also provides an overview of financial assistance programs, respite care services, and support groups that are beneficial to CMC and their families.

Exploring the Benefits of Respite Services to Family Caregivers: Methodological Issues and Current Findings

PubMed Central

Zarit, Steven H.; Liu, Yin; Bangerter, Lauren R.; Rovine, Michael J.

2017-01-01

Objectives There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Method Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Results Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. Conclusion An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite. PMID:26729467

Exploring the benefits of respite services to family caregivers: methodological issues and current findings.

PubMed

Zarit, Steven H; Bangerter, Lauren R; Liu, Yin; Rovine, Michael J

2017-03-01

There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite.

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

PubMed

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

PubMed

Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

2018-02-01

Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

Extreme Heat and Health: Perspectives from Health Service Providers in Rural and Remote Communities in South Australia

PubMed Central

Williams, Susan; Bi, Peng; Newbury, Jonathan; Robinson, Guy; Pisaniello, Dino; Saniotis, Arthur; Hansen, Alana

2013-01-01

Among the challenges for rural communities and health services in Australia, climate change and increasing extreme heat are emerging as additional stressors. Effective public health responses to extreme heat require an understanding of the impact on health and well-being, and the risk or protective factors within communities. This study draws on lived experiences to explore these issues in eleven rural and remote communities across South Australia, framing these within a socio-ecological model. Semi-structured interviews with health service providers (n = 13), and a thematic analysis of these data, has identified particular challenges for rural communities and their health services during extreme heat. The findings draw attention to the social impacts of extreme heat in rural communities, the protective factors (independence, social support, education, community safety), and challenges for adaptation (vulnerabilities, infrastructure, community demographics, housing and local industries). With temperatures increasing across South Australia, there is a need for local planning and low-cost strategies to address heat-exacerbating factors in rural communities, to minimise the impact of extreme heat in the future. PMID:24173140

An Exploration of Factors that Effect the Implementation of Peer Support Services in Community Mental Health Settings.

PubMed

Mancini, Michael A

2018-02-01

This study explored the integration of peer services into community mental health settings through qualitative interviews with peer-providers and non-peer mental health workers. Results show peer job satisfaction was contingent upon role clarity, autonomy, and acceptance by non-peer coworkers. Mental health workers reported the need for organizational support for peer services and guidance about how to utilize peers, negotiate their professional boundaries and accommodate their mental health needs. Effective peer integration requires organizational readiness, staff preparation and clear policies and procedures. Consultation from consumer-based organizations, enhanced professional competencies, and professional development and career advancement opportunities for peers represent important resources.

A Linked Fusion of Things, Services, and Data to Support a Collaborative Data Management Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephan, Eric G.; Elsethagen, Todd O.; Wynne, Adam S.

The purpose of this paper is to illustrate the use of semantic technologies and approaches to seamlessly link things, services, and data in the proposed design of a scientific offshore wind energy research for the U.S. Department of Energy Wind and Water Technology Office of the Office of Energy Efficiency and Renewable Energy (EERE). By adapting linked community best practices, we were able to design a collaborative facility supporting both operational staff and end users that incorporates off-the-shelf components and overcome traditional barriers between devices, resulting data, and processing services. This was made largely possible through complementary advances in themore » Internet of Things (IoT), semantic web, Linked Services, and Linked Data communities, which provide the foundation for our design.« less

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries

PubMed Central

BERNHARDT, ANTONIA K.; BERGER, GREGORY; LEE, JAMES A.; REUTER, KEVIN; DAVANZO, JOAN; MONTGOMERY, ANNE; DOBSON, ALLEN

2016-01-01

Policy Points: At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with “activities of daily living.” Available services fail to match frail elders’ needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs.The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long‐term care costs, and declining family caregiver availability portend gaps in badly needed services.The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. Context The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better‐coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. Methods The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. Findings The simulation projected third‐year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. Conclusions The MediCaring Communities financial simulation demonstrates that better care at lower cost for frail elderly Medicare beneficiaries is possible within current financing levels. Long‐term success of the initiative will require reinvestment of Medicare savings to bolster nonmedical supportive services in the community. Successful implementation will necessitate waiving certain regulations and developing new infrastructure in pilot communities. This financial simulation methodology will help leadership in other communities to project fiscal performance. Since the MediCaring Communities model also achieves the Centers for Medicare and Medicaid Services' vision for care for frail elders (better care, healthier people, smarter spending) and since these reforms can proceed with limited waivers from Medicare, willing communities should explore implementation and share best practices about how to achieve fundamental service delivery changes that can meet the challenges of a much older population in the 21st century. PMID:27378581

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

PubMed

Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

2016-09-01

At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The MediCaring Communities financial simulation demonstrates that better care at lower cost for frail elderly Medicare beneficiaries is possible within current financing levels. Long-term success of the initiative will require reinvestment of Medicare savings to bolster nonmedical supportive services in the community. Successful implementation will necessitate waiving certain regulations and developing new infrastructure in pilot communities. This financial simulation methodology will help leadership in other communities to project fiscal performance. Since the MediCaring Communities model also achieves the Centers for Medicare and Medicaid Services' vision for care for frail elders (better care, healthier people, smarter spending) and since these reforms can proceed with limited waivers from Medicare, willing communities should explore implementation and share best practices about how to achieve fundamental service delivery changes that can meet the challenges of a much older population in the 21st century. © 2016 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

Beyond the biomedical: community resources for mental health care in rural Ethiopia.

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

Background The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. Method We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. Results The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. Discussion The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention. PMID:25962075

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery

PubMed Central

Wittman, Fried; Jee, Babette; Polcin, Douglas L.; Henderson, Diane

2014-01-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting – building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city – function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research. PMID:25328377

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

PubMed

Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

2014-07-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

Provider and consumer perspectives of community mental health services: Implications for consumer-driven care.

PubMed

Kelly, Erin L; Davis, Lisa; Mendon, Sapna; Kiger, Holly; Murch, Lezlie; Pancake, Laura; Giambone, Leslie; Brekke, John S

2018-05-03

Public mental health services in the community are broad and continue to expand to address the multiple issues faced by those with serious mental illnesses. However, few studies examine and contrast how helpful consumers and providers find the spectrum of services. The present study examines the services at community mental health service clinics (CMHCs) from the perspectives of providers and consumers. There were 351 consumers and 147 providers from 15 CMHCs who rated and ranked the helpfulness of 24 types of common services. All of the agencies were participating in a Practice-Based Research Network (PBRN). Social support was the highest rated service by both types of respondents, and the creation of a welcoming environment was the highest ranked service by both. There were also areas of disagreement. Consumers identified traditional mental health services (individual therapy and medication services) as being most helpful to them whereas providers selected longer-term services that promote self-reliance (e.g., securing housing, and promoting self-sufficiency) as the most helpful. Understanding how consumers and providers perceive the range of CMHC services provided in usual care is important to develop new targets for intervention. A welcoming milieu and providing social support appear important to both, but significant differences exist between these groups regarding other aspects of services. This holds implications for the design and implementation of consumer-driven services. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS)

PubMed Central

Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

2016-01-01

Objectives To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Design Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. Setting North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Participants Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. Interventions NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Main outcome measures Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. Results NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014–7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. Conclusions NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a structured framework to evaluate and redesign the service with the aim to improve effectiveness and efficiency. PMID:27566629

A. C. C. Fact Book: A Statistical Profile of Allegany Community College and the Community It Serves.

ERIC Educational Resources Information Center

Andersen, Roger C.

This document is intended to be an authoritative compilation of frequently referenced basic facts concerning Allegany Community College (ACC) in Maryland. It is a statistical profile of ACC and the community it serves, divided into six sections: enrollment, students, faculty, community, support services, and general college related information.…

20 CFR 641.545 - What supportive services may grantees/subgrantees provide to participants?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Services... transportation; health care and medical services; special job-related or personal counseling; incidentals such as work shoes, badges, uniforms, eyeglasses, and tools; child and adult care; temporary shelter; and...

Implementing oral chemotherapy services in community pharmacies: a qualitative study of chemotherapy nurses' and pharmacists' views.

PubMed

Butt, Farida; Ream, Emma

2016-05-01

Changes in health-care provision have led to cancer patients being offered oral chemotherapy in the community. Three levels of oral chemotherapy services have been proposed (levels 1, 2 and 3) with community pharmacies playing differing roles within them. This study aims to explore health-care professionals' views on oral chemotherapy services being delivered by community pharmacies and to gain insights into the barriers, facilitators and training/knowledge needs of community pharmacists with respect to providing them. Qualitative semi-structured interviews were conducted with a purposive sample of three chemotherapy nurses, five oncology pharmacists and five community pharmacists. Data were analysed thematically using Framework Analysis. Findings for level 1 and 2 services included uncertainty on community pharmacists' professional responsibilities, the expertise of GPs in prescribing oral chemotherapy and the training and competency of community pharmacists. The lack of patient information, care and support provision was emphasised for all the models. Although level 1 was achievable in current practice, level 2 was considered the safest option, while level 3 was ideal but risky option. For all levels, training and education for community pharmacists and inter-professional issues were facilitators to oral chemotherapy services. The service environment, dispensing process-related constraints (access to blood test results and protocols) were significant barriers for levels 2 and 3. Advanced communication skills, patient education and counselling were identified as key areas for education and training for community pharmacists. The study suggests there are significant concerns and challenges associated with community pharmacies implementing any of the proposed levels of oral chemotherapy services. Educational and training opportunities for community pharmacists and the careful development of safe infrastructures will be essential in the future planning and implementation of any community pharmacy oral chemotherapy service. © 2015 Royal Pharmaceutical Society.

Organisational strategies and midwives' readiness to provide care for out of hospital births: an analysis from the birthplace organisational case studies.

PubMed

McCourt, Christine; Rayment, Juliet; Rance, Susanna; Sandall, Jane

2012-10-01

the objective of the Birthplace in England Case Studies was to explore the organisational and professional issues that may impact on the quality and safety of labour and birth care in different birth settings: Home, Freestanding Midwifery Unit, Alongside Midwifery Unit or Obstetric Unit. This analysis examines the factors affecting the readiness of community midwives to provide women with choice of out of hospital birth, using the findings from the Birthplace in England Case Studies. organisational ethnographic case studies, including interviews with professionals, key stakeholders, women and partners, observations of service processes and document review. a maximum variation sample of four maternity services in terms of configuration, region and population characteristics. All were selected from the Birthplace cohort study sample as services scoring 'best' or 'better' performing in the Health Care Commission survey of maternity services (HCC 2008). professionals and stakeholders (n=86), women (64), partners (6), plus 50 observations and 200 service documents. each service experienced challenges in providing an integrated service to support choice of place of birth. Deployment of community midwives was a particular concern. Community midwives and managers expressed lack of confidence in availability to cover home birth care in particular, with the exception of caseload midwifery and a 'hub and spoke' model of care. Community midwives and women's interviews indicated that many lacked home birth experience and confidence. Those in midwifery units expressed higher levels of support and confidence. maternity services need to consider and develop models for provision of a more integrated model of staffing across hospital and community boundaries. Copyright © 2012 Elsevier Ltd. All rights reserved.

Indigenous health: effective and sustainable health services through continuous quality improvement.

PubMed

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

The role of the bilingual/bicultural worker in dementia education, support and care.

PubMed

Boughtwood, Desiree; Shanley, Christopher; Adams, Jon; Santalucia, Yvonne; Kyriazopoulos, Helena; Rowland, Jeffrey; Pond, Dimity

2013-01-01

Members of minority populations often have difficulty knowing about and accessing dementia services. One of the strategies used to promote access is the employment of bilingual/bicultural workers (sometimes referred to as multicultural, link or outreach workers). This study involved interviews with 24 bilingual/bicultural workers in south western Sydney, Australia to gain a better understanding of their role within the dementia field. Seven themes emerged: importance of working with family; process of building trust when moving between two cultures; importance of understanding the culture; self-care and culture; flexibility of their role; linking community members; and linking communities to mainstream services. Bilingual/bicultural workers play a significant and complex role in supporting individuals and families within their community who are affected by dementia. The significance of their role needs to be more clearly acknowledged in the development of policy, further research and service provision within the dementia field.

The role of the neonatal nurse practitioner in the community hospital level I nursery.

PubMed

Hatch, Julie

2012-01-01

Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country's Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP's experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

Roles and Functions of Community Health Workers in Primary Care.

PubMed

Hartzler, Andrea L; Tuzzio, Leah; Hsu, Clarissa; Wagner, Edward H

2018-05-01

Community health workers have potential to enhance primary care access and quality, but remain underutilized. To provide guidance on their integration, we characterized roles and functions of community health workers in primary care through a literature review and synthesis. Analysis of 30 studies identified 12 functions (ie, care coordination, health coaching, social support, health assessment, resource linking, case management, medication management, remote care, follow-up, administration, health education, and literacy support) and 3 prominent roles representing clusters of functions: clinical services, community resource connections, and health education and coaching. We discuss implications for community health worker training and clinical support in primary care. © 2018 Annals of Family Medicine, Inc.

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

PubMed

Linton, Julie M; Stockton, Maria Paz; Andrade, Berta; Daniel, Stephanie

2018-01-01

Positive parenting programs, developmental support services, and evidence-based home visiting programs can effectively provide parenting support and improve health and developmental outcomes for at-risk children. Few models, however, have integrated referrals for on-site support and home visiting programs into the provision of routine pediatric care within a medical home. This article describes an innovative approach, through partnership with a community-based organization, to deliver on-site and home visiting support services for children and families within and beyond the medical home. Our model offers a system of on-site services, including parenting, behavior, and/or development support, with optional intensive home visiting services. Assessment included description of the population served, delineation of services provided, and qualitative identification of key themes of the impact of services, illustrated by case examples. This replicable model describes untapped potential of the pediatric medical home as a springboard to mitigate risk and optimize children's health and development.

Breastfeeding Counseling, Barriers and Facilitators of Lactation in the Military Community

DTIC Science & Technology

1998-05-01

of Defense This work was supported by the Uniformed Services University of the Health Sciences Protocol No. THE06139-01. The opinions or assertions...Organization (1989). Protecting, promoting, and supporting breastfeeding : The special role of maternity services Switzerland: WHO/UNICEF. 64 APPENDICES...method. However, the literature shows that many health care providers do not actively endorse and support breastfeeding in their practices. This

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... law) including infants, children, youth, adolescents, and young adults. Community-based services... child development, family budgeting, coping with stress, health, and nutrition; and (6) Case management... otherwise to enhance child development. Family support services may include: (1) Services, including in-home...

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... law) including infants, children, youth, adolescents, and young adults. Community-based services... child development, family budgeting, coping with stress, health, and nutrition; and (6) Case management... otherwise to enhance child development. Family support services may include: (1) Services, including in-home...

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... law) including infants, children, youth, adolescents, and young adults. Community-based services... child development, family budgeting, coping with stress, health, and nutrition; and (6) Case management... otherwise to enhance child development. Family support services may include: (1) Services, including in-home...

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... law) including infants, children, youth, adolescents, and young adults. Community-based services... child development, family budgeting, coping with stress, health, and nutrition; and (6) Case management... otherwise to enhance child development. Family support services may include: (1) Services, including in-home...

Using intensive case management to reduce violence by mentally ill persons in the community.

PubMed

Dvoskin, J A; Steadman, H J

1994-07-01

Aggressive and intensive case management and a comprehensive array of community support services are the keys to reducing the risk of violence by people with serious mental illness in the community. The authors describe the elements of intensive case management for potentially violent clients, including use of individual case managers responsible for small caseloads, 24-hour availability of case managers, and strong linkages to agencies providing mental health services, substance abuse treatment, and social services as well as to the criminal justice system. They summarize the results of three recent studies of intensive case management programs suggesting that this intervention is effective in reducing clients' dangerousness in the community. They discuss cultural and human resource issues that affect planning of intensive case management services. Intensive case managers need to be "boundary spanners" with the training, experience, and personality to bridge the often-broad gap between human service and criminal justice systems.

Evaluation and delivery of domestic animal health services in remote communities in the Northwest Territories: A case study of status and needs

PubMed Central

Brook, Ryan K.; Kutz, Susan J.; Millins, Caroline; Veitch, Alasdair M.; Elkin, Brett T.; Leighton, Ted

2010-01-01

Domestic animal health services are supplied to communities in Canada’s Northwest Territories (NT) in diverse ways, including private veterinary practices in 2 of 33 communities, and by mail-order, fly-in, free clinics, and a government-coordinated lay vaccinator program in some of the other 31 communities. We evaluated delivery, needs, and potential uptake of domestic animal health services in the Sahtu Settlement Area, NT by offering free clinics for 225 dogs in 2008 and 2009; and administered questionnaires to 42 dog owners and 67 students in 2008. Owners indicated that 20% of dogs were neutered, 37% had had rabies vaccinations, and 29% had been dewormed. Physical examination of dogs demonstrated that 54% were “thin” and 4% were “emaciated.” Owners and youth showed a range of attitudes toward dogs and supported improved domestic animal health services. Future services need to build on existing programs and collaborate with communities to ensure relevance, ownership, and sustainability. PMID:21197203

Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

DTIC Science & Technology

2013-01-01

a need for a more formal flow of information from the military to the civilian community about troop deployments and reintegration. In the five...Interviewees also offered a mixed assessment of how information about available supports and services is communicated to service members and their...and military parents. This team serves as a conduit of information between the community and the installation, addresses questions with changes of

Facebook and the Final Practicum: The Impact of Online Peer Support in the Assistant Teacher Program

ERIC Educational Resources Information Center

Paris, Lisa F.; Boston, Julie; Morris, Julia

2015-01-01

Australian pre-service teachers (PST) frequently report feeling isolated and vulnerable during the high stakes Assistant Teacher Program (ATP) final practicum. Mentoring and online learning communities have been shown to offer effective support during periods in which pre-service and beginning teachers feel challenged. As social media…

Service Learning: Connecting Higher Education and Civil Society--Are We Meeting the Challenge?

ERIC Educational Resources Information Center

Naidoo, B.; Devnarain, B.

2009-01-01

The decline in civic participation, dwindling support for social services and deficits in state budgets, has created a climate in which higher education, supported by several policies, has to make a commitment to contribute to the reconstruction and development of society by linking academic programmes to community-based priorities (Campbell…

The development of supported employment services for people with mental illness: local experience in Hong Kong.

PubMed

Chiu, Frank P.F.

2000-01-01

Before the 1960s in Hong Kong, specialized vocational services for people with mental illness were very limited, and sheltered workshop seemed to be the only option for their future vocational placement at that time. As discussed in the literature, there are still many shortcomings of the sheltered workshop model, that brings us to the emergence of another community-based vocational service: Supported Employment. Unlike traditional vocational services, the concept of supported employment emphasizes the placing of the clients into integrated work environments and then providing on-going support and work-related skills training in the job post. Though supported employment services help many clients to sustain a job in the competitive market, many service barriers and problems still remain unsolved. These service barriers and problems will be discussed in this article, and suggestions will be made.

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

PubMed

Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

2017-01-01

Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

Strengthening partnerships between Black Churches and HIV service providers in the United States.

PubMed

Obong'o, Christopher O; Pichon, Latrice C; Powell, Terrinieka W; Williams, Andrea L

2016-09-01

Across the United States, Black Churches play a significant role among the Black community and are increasingly being used to deliver Human Immunodeficiency Virus (HIV) prevention services. This study sought to investigate HIV service providers' strategies for strengthening partnerships with churches to deliver HIV prevention services. Using a community-based participatory research approach, an HIV coalition and an academic institution formed a partnership to address the study aim. Individual interviews (n = 16) were conducted with providers from medical institutions and HIV social support agencies. A thematic analysis focusing on recommendations for addressing the challenges and benefits of partnership with churches for HIV services was conducted. Participants' interest in and intention to work with churches, as well as their comfort level discussing sexual health-related topics with religious congregations, was high. Four themes emerged to highlight the different perspectives of service providers' recommendations for addressing challenges and strengthening partnerships with churches to deliver HIV services including: (1) carefully selecting churches and HIV services to provide, (2) gaining "buy-in" and support of church leadership, (3) taking advantage of conflict with church doctrine, and (4) choosing appropriate delivery strategies. Study findings demonstrate that although challenges exist, heath service providers in this region of the United States may be interested in addressing HIV among faith communities. Study findings also provide concrete solutions to previously documented barriers to HIV prevention in Black Churches. Such information will benefit researchers and practitioners seeking to expand effective HIV prevention efforts with Black Churches in communities who bear a disproportionate burden of HIV infections.

The Intelcities Community of Practice: The Capacity-Building, Co-Design, Evaluation, and Monitoring of E-Government Services

ERIC Educational Resources Information Center

Deakin, Mark; Lombardi, Patrizia; Cooper, Ian

2011-01-01

The paper examines the IntelCities Community of Practice (CoP) supporting the development of the organization's capacity-building, co-design, monitoring, and evaluation of e-government services. It begins by outlining the IntelCities CoP and goes on to set out the integrated model of electronically enhanced government (e-government) services…

Child Participation and Family Engagement with Early Childhood Education and Care Services in Disadvantaged Australian Communities

ERIC Educational Resources Information Center

Grace, Rebekah; Bowes, Jennifer; Elcombe, Emma

2014-01-01

To support national policy initiatives in early childhood education and to determine reasons for low enrolment in services from families in disadvantaged areas, the authors investigated the views and practices of 101 families from disadvantaged communities. Families with a child aged 3-5 years were recruited from urban, rural and remote areas of…

Community of Inquiry Development in a Blended Learning Course for In-Service Teachers

ERIC Educational Resources Information Center

Theodosiadou, Dimitra; Konstantinidis, Angelos; Pappos, Christos; Papadopoulos, Nikos

2017-01-01

The paper presents the course design and evaluation methods of an online community of inquiry that is developed in a blended learning training course for in-service teachers working in public K-6 schools in Greece. The course content is about digital storytelling, its educational value, and the use of supportive web 2.0 tools for developing…

Community Supports for People Labeled by Both the Mental Retardation and the Mental Health Systems.

ERIC Educational Resources Information Center

Knoll, James; Racino, Julie Ann

The paper addresses issues in providing community services for people with both mental retardation and emotional or behavioral disorders. First, it explores the meaning often found at the root of the often elusive definition of dual diagnosis concluding that this has become a catch-all category for people who present existing service systems with…

Community Education: A Community Planning Process Guide.

ERIC Educational Resources Information Center

Wiglesworth, Bill, Comp.

Designed to assist in the planning of community education and services, this booklet offers an argument in support of as well as step-by-step implementation instructions for a 2-day planning process. Following a discussion of the advantages of cooperative planning, the community planning process is outlined. Examined next are the reasons why a…

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey.

PubMed

Wibowo, Yosi; Parsons, Richard; Sunderland, Bruce; Hughes, Jeffery

2015-10-01

Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Community pharmacies in a developing country setting (Surabaya, Indonesia). A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. A response rate of 60% was achieved. Dispensing (100%) and education on how to use medications (72.6%) were common current pharmacy practices. More than 50% of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6%) and common/important adverse effects (25.7%)], education on exercise (36.5%), education on diet (47.7%), and monitoring medication compliance (27.9%). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

Providing HIV-related services in China for men who have sex with men.

PubMed

Cheng, Weibin; Cai, Yanshan; Tang, Weiming; Zhong, Fei; Meng, Gang; Gu, Jing; Hao, Chun; Han, Zhigang; Li, Jingyan; Das, Aritra; Zhao, Jinkou; Xu, Huifang; Tucker, Joseph D; Wang, Ming

2016-03-01

In China, human immunodeficiency virus (HIV) care provided by community-based organizations and the public sector are not well integrated. A community-based organization and experts from the Guangzhou Center for Disease Control and Prevention developed internet-based services for men who have sex with men, in Guangzhou, China. The internet services were linked to clinical services offering HIV testing and care. The expanding HIV epidemic among men who have sex with men is a public health problem in China. HIV control and prevention measures are implemented primarily through the public system. Only a limited number of community organizations are involved in providing HIV services. The programme integrated community and public sector HIV services including health education, online HIV risk assessment, on-site HIV counselling and testing, partner notification, psychosocial care and support, counting of CD4+ T-lymphocytes and treatment guidance. The internet can facilitate HIV prevention among a subset of men who have sex with men by enhancing awareness, service uptake, retention in care and adherence to treatment. Collaboration between the public sector and the community group promoted acceptance by the target population. Task sharing by community groups can increase access of this high-risk group to available HIV-related services.

Small Business Training Models for Community Growth.

ERIC Educational Resources Information Center

Jellison, Holly M., Ed.

Nine successful community college programs for small business management training are described in this report in terms of their college and economic context, purpose, offerings, delivery modes, operating and marketing strategies, community outreach, support services, faculty and staff, evaluation, and future directions. The model programs are…

The mobilization of community resources to support long-term addiction recovery.

PubMed

White, William L

2009-03-01

Models of addiction treatment that view the sources and solutions to severe alcohol and other drug (AOD) problems as rooted within the vulnerability and resiliency of each individual stand in marked contrast to models that focus on the ecology of AOD problem development and resolution via complex interactions between individuals, families, and communities. An integration of the latter model into mainstream addiction treatment would necessitate a reconstruction of the treatment-community relationship and new approaches to community resource development and mobilization. Such an integration would redefine core addiction treatment services and to whom, by whom, when, where, and for how long such services are delivered. This article draws on historical and contemporary events in the history of addiction treatment and recovery in the United States to illuminate the relationship between recovery and community. Principles and strategies that could guide the development and mobilization of community resources to support the long-term recovery of individuals and families are identified.

Gerontological Social Work Student-Delivered Respite: A Community-University Partnership Pilot Program.

PubMed

Washington, Tiffany R; Tachman, Jacqueline A

2017-01-01

This study describes a community-university partnership to support a gerontological social work student-delivered respite program, the Houseguest Program (Houseguest). Houseguest was designed using a community-engaged scholarship model of integrating research, teaching, and service. Houseguest was piloted with a small group of community-dwelling, coresiding dementia caregivers and care recipients. We examined caregivers' experiences with student-delivered respite using qualitative data analysis. Thematic analysis produced 8 themes: (a) respite from full time caregiving role, (b) information on caregiving strategies, (c) no-cost supportive services, (d) opportunity for care recipients to socialize, (e) tailored activities for care recipients, (f) rapport-building between students and family dyad, (g) reciprocity between students and family dyad, and (h) program continuation. We conclude with a proposed community-engaged scholarship model for dementia caregiving. Through a community-university partnership, Houseguest reduced the impact of caregiver burden and created an opportunity for students to serve families affected by dementia through respite and tailored activities.

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

PubMed Central

Zeigler, Bernard P.; Redding, Sarah; Leath, Brenda A.; Carter, Ernest L.; Russell, Cynthia

2016-01-01

Introduction: The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Pathways Community HUB Model and Formalization: Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. Requirements for Data Architecture to Support the Pathways Community HUB Model: The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Problems with Quality of Data Extracted from the CHAP Database: Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Implementation of Features: Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Discussion: Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Conclusions and Recommendations: Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health. PMID:26870743

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints.

PubMed

Baum, Frances E; Legge, David G; Freeman, Toby; Lawless, Angela; Labonté, Ronald; Jolley, Gwyneth M

2013-05-10

The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services' responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse "dilemmatic space" in their work. The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health's recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study's findings.

Family Life and the Impact of Previous and Present Residential and Day Care Support for Children with Major Cognitive and Behavioural Challenges: A Dilemma for Services and Policy

ERIC Educational Resources Information Center

Brown, R. I.; Geider, S.; Primrose, A.; Jokinen, N. S.

2011-01-01

Introduction: Since the development of inclusion and integration, parents have increasingly become the major, and sometimes the only, carers of their children with disabilities. Many families speak of stress and frustration with service and community support, and some have turned to residential and specialised day care services to overcome…

The Emergence of a Human Services Cooperative to Support Families and Young Adults with Disabilities: Implications for Disability Services and Supports

ERIC Educational Resources Information Center

Shogren, Karrie A.; Forber-Pratt, Anjali J.; Nittrouer, Christine; Aragon, Steven R.

2013-01-01

This paper documents the experiences of a group of parents who came together to form a human service cooperative in their local community to address the needs of their adult children with intellectual and developmental disabilities. Each parent felt that their child's needs were not (or could not be) met by existing providers. Parent leaders who…

A Statewide Service Learning Network Ignites Teachers and Students.

ERIC Educational Resources Information Center

Monsour, Florence

Service learning, curriculum-linked community service, has proved remarkably effective in igniting students' desire to learn. In 1997, the Wisconsin Partnership in Service Learning was initiated as a cross-disciplinary, cross-institutional endeavor. Supported by a grant from Learn and Serve America, the partnership created a network throughout…

A Drug and Alcohol Aftercare Service: Linking Adolescents, Families and Schools.

ERIC Educational Resources Information Center

Fertman, Carl I.; Toca, Olivia A.

1988-01-01

Describes first-year service process and implementation evaluation of aftercare service for adolescents who had completed drug and alcohol treatment programs. Results showed that aftercare service, developed cooperatively by schools and community agencies to support and link adolescents, parents, and schools during adolescents' recovery, helped…

Facts and Faith: A Status Report on Youth Service.

ERIC Educational Resources Information Center

Lewis, Anne C.

Research supports the value of youth service, but indicates concerns about the diminishing interest of young people in giving of themselves. New justifications for community service include the following: (1) documentation of the educational value of service; (2) greater understanding of environmental and human needs; and (3) greater understanding…

The Impact of a Volunteer Postpartum Doula Program on Breastfeeding Success: A Case Study.

PubMed

Cattelona, Georg'ann; Friesen, Carol A; Hormuth, Laura J

2015-11-01

Bloomington Area Birth Services (BABS), centered in Bloomington, Indiana, is a community-based program that provides comprehensive education and support for new breastfeeding mothers, infants, family members, and the community by working together with local hospitals, midwives, obstetricians, pediatric offices, and social service agencies to create a seamless continuity of care for families. To help with continuity of care in the community, BABS established a volunteer doula program (birth and postpartum), allowing BABS to combine the services of a community lactation center with birth and postpartum doulas. This article describes the volunteer doula program and highlights one client's story in an effort to encourage and motivate other communities to focus their limited dollars on the development of a volunteer doula program. © The Author(s) 2015.

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-01-01

Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users’ control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Conclusions Regardless of providers’ portal use, service users’ control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users’ autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). PMID:28465277

Job Designs: A Community Based Program for Students with Emotional and Behavioral Disorders.

ERIC Educational Resources Information Center

Lehman, Constance

1992-01-01

The Job Designs Project, a 3-year federally funded project, provides students (ages 16-22) at an Oregon residential treatment center for youth with emotional and behavioral disorders with supported paid employment in the community. The project has provided job supported employment services to 36 students working in such positions as restaurant bus…

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

PubMed

McVilly, K; Webber, L; Paris, M; Sharp, G

2013-08-01

Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Advancing Long Tail Data Capture and Access Through Trusted, Community-Driven Data Services at the IEDA Data Facility

NASA Astrophysics Data System (ADS)

Lehnert, K. A.; Carbotte, S. M.; Ferrini, V.; Hsu, L.; Arko, R. A.; Walker, J. D.; O'hara, S. H.

2012-12-01

Substantial volumes of data in the Earth Sciences are collected in small- to medium-size projects by individual investigators or small research teams, known as the 'Long Tail' of science. Traditionally, these data have largely stayed 'in the dark', i.e. they have not been properly archived, and have therefore been inaccessible and underutilized. The primary reason has been the lack of appropriate infrastructure, from adequate repositories to resources and support for investigators to properly manage their data, to community standards and best practices. Lack of credit for data management and for the data themselves has contributed to the reluctance of investigators to share their data. IEDA (Integrated Earth Data Applications), a NSF-funded data facility for solid earth geoscience data, has developed a comprehensive suite of data services that are designed to address the concerns and needs of investigators. IEDA's data publication service registers datasets with DOI and ensures their proper citation and attribution. IEDA is working with publishers on advanced linkages between datasets in the IEDA repository and scientific online articles to facilitate access to the data, enhance their visibility, and augment their use and citation. IEDA's investigator support ranges from individual support for data management to tools, tutorials, and virtual or face-to-face workshops that guide and assist investigators with data management planning, data submission, and data documentation. A critical aspect of IEDA's concept has been the disciplinary expertise within the team and its strong liaison with the science community, as well as a community-based governance. These have been fundamental to gain the trust and support of the community that have lead to significantly improved data preservation and access in the communities served by IEDA.

Activities of Intellectual Disability Clinical Nurse Specialists in Ireland.

PubMed

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services.

PubMed

Okumura, Megumi J; Saunders, Mara; Rehm, Roberta S

2015-01-01

Youth and young adults with special healthcare needs (YASHCN) experience challenges during transition from pediatric to adult care. Prior studies have not examined how community and healthcare resources can work together to assist YASHCN in transitioning from child-focused care and services to adult-oriented providers. The aim of this study was to develop a theoretical understanding of how family, healthcare providers and community supports can assist YASHCN during the transition from pediatric to adult healthcare and services. We conducted 41 semi-structured interviews with YASHCN aged 16-25, their family members and healthcare and community providers. We focused our interviews on support mechanisms, both within the traditional healthcare system, and those available in the community. Using grounded theory methods, we performed a multi-step analysis process. The theoretical code "Transition Advocacy" was developed from the data. This theoretical perspective arose from three major categories, which were developed in the analysis: "Fighting for healthcare", "Obtaining resources", and "Getting ready to transition". Transition Advocacy consists of the presence of, or need for, a healthcare "advocate" who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. The "advocate" role was performed by family members, healthcare or agency professionals, or sometimes the YASHCN themselves. If advocates were identified, youth were more likely to obtain needed services. Parents, health providers, and community agencies are potentially well-poised to assist transitioning YASHCN. Efforts to encourage development of strong advocacy skills will facilitate better transitions for YASHCN. Copyright © 2015 Elsevier Inc. All rights reserved.

The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services

PubMed Central

Okumura, Megumi; Saunders, Mara; Rehm, Roberta S.

2015-01-01

Background Youth and young adults with special healthcare needs (YASHCN) experience challenges during transition from pediatric to adult care. Prior studies have not examined how community and healthcare resources can work together to assist YASHCN in transitioning from child-focused care and services to adult-oriented providers. Objective To develop a theoretical understanding of how family, healthcare providers and community supports can assist YASHCN during the transition from pediatric to adult healthcare and services. Design/Methods We conducted 41 semi-structured interviews with YASHCN aged 16-25, their family members and healthcare and community providers. We focused our interviews on support mechanisms, both within the traditional healthcare system, and those available in the community. Using grounded theory methods, we performed a multi-step analysis process. Results The theoretical code “Transition Advocacy” was developed from the data. This theoretical perspective arose from three major categories, which were developed in the analysis: “Fighting for healthcare”, “Obtaining resources”, and “Getting ready to transition”. Transition Advocacy consists of the presence of, or need for, a healthcare ”advocate”’ who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. The ”advocate” role was performed by family members, healthcare or agency professionals, or sometimes the YASHCN themselves. If advocates were identified, youth were more likely to obtain needed services. Conclusions Parents, health providers, and community agencies are potentially well-poised to assist transitioning YASHCN. Efforts to encourage development of strong advocacy skills will facilitate better transitions for YASHCN. PMID:26228309

Community action research track: Community-based participatory research and service-learning experiences for medical students.

PubMed

Gimpel, Nora; Kindratt, Tiffany; Dawson, Alvin; Pagels, Patti

2018-04-01

Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences. This article provides an overview of CART and reports the program impact based on students' participation, preliminary evaluations and accomplishments. CART is an optional 4‑year service-learning experience for medical students interested in community health. The curriculum includes a coordinated longitudinal program of electives, community service-learning and lecture-based instruction. From 2009-2015, 146 CART students participated. Interests in public health (93%), community service (73%), primary care (73%), CBPR (60%) and community medicine (60%) were the top reasons for enrolment. Significant improvements in mean knowledge were found when measuring the principles of CBPR, levels of prevention, determining health literacy and patient communication strategies (all p's < 0.05). Most students (73%) were satisfied with CART. Projects were disseminated by at least 65 posters and four oral presentations at local, national and international professional meetings. Six manuscripts were published in peer-reviewed journals. CART is an innovative curriculum for training future physicians to be community-responsive physicians. CART can be replicated by other medical schools interested in offering a longitudinal CBPR and service-learning track in an urban metropolitan setting.

US Religious Congregations' Programming to Support Veterans: A Mixed Methods Study.

PubMed

Derose, Kathryn Pitkin; Haas, Ann; Werber, Laura

2016-06-01

Religious congregations may be well equipped to address veterans' reintegration needs, but little is known about the prevalence and nature of such support. We conducted a mixed methods study using nationally representative congregational survey data and in-depth interviews with congregational leaders. Overall, 28% of congregations nationally reported having programming to support veterans and positive, independent predictors included: community context (county veteran presence, high-poverty census tract, rural compared to urban location); congregational resources (more adult attendees, having a paid employee that spent time on service programs); and external engagement (assessing community needs, collaboration, and social service participation). Qualitative interviews revealed a range of activities, including attending to spiritual issues, supporting mental, physical and social well-being, and addressing vocational, legal, financial, and material needs.

Secrecy inhibits support: A grounded theory of community perspectives of women suffering from obstetric fistula, in Kenya.

PubMed

Lavender, T; Wakasiaka, S; McGowan, L; Moraa, M; Omari, J; Khisa, W

2016-11-01

this study aimed to gain understanding of the views of community members in relation to obstetric fistula. a qualitative, grounded theory approach was adopted. Data were collected using in-depth interviews with 45 community members. The constant comparison method enabled generation of codes and subsequent conceptualisations, from the data. participants were from communities served by two hospitals in Kenya; Kisii and Kenyatta. Interviews took place either in the home, place of work, or hospital. the core category (central concept) is 'secrecy hinders support'. This was supported by three themes: 'keeping fistula hidden', 'treatment being a lottery' and 'multiple barriers to support.' These themes represent the complexities around exposure of individual fistula sufferers and the impact that lack of information and women's status can have on treatment. Keeping fistula secret reinforces uncertainties around fistula, which in itself fuels myths and ignorance regarding causes and treatments. Lack of openness, at an individual level, prevents support being sought or offered. A multi-layered strategy is required to support women with fistula. At a societal level, the status of women in LMIC countries needs elevation to a level that provides equity in health services. At a national level, laws need to protect vulnerable women from mistreatment as a direct result of fistula. Furthermore, resources should be available to ensure provision of timely management, as part of routine services. At community level, awareness and education is required to actively engage members to support women locally. Peer support before and after fistula repair may be beneficial, but requires further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Battered Agency Syndrome: The Challenge to Agencies Serving Low-Income Communities.

ERIC Educational Resources Information Center

Reed, Diane; Lally, J. Ronald; Quiett, Douglas

Community-based social service agencies working in low-income communities increasingly function with inadequate support and encounter numerous oppressive external and internal conditions that compromise organizational and staff well-being. Working with many such agencies, WestEd identified stressors that included funding problems, unrealistic…

Structured decision making as a framework for linking quantitative decision support to community values

EPA Science Inventory

Community-level decisions can have large impacts on production and delivery of ecosystem services, which ultimately affects community well-being. But engaging stakeholders in a process to explore these impacts is a significant challenge. The principles of Structured Decision Ma...

12 CFR 1282.14 - Special Affordable Housing Goal.

Code of Federal Regulations, 2010 CFR

2010-01-01

...”) Insurance Program, 12 U.S.C. 1715z-20; mortgages guaranteed under the Rural Housing Service's Single Family...-going, sustainable efforts to ensure that additional loans that meet the goal are originated. (iv... of the Community Support Program; or (B) Community development credit unions; community development...

Optimizing care transitions: the role of the community pharmacist

PubMed Central

Melody, Karleen T; McCartney, Elizabeth; Sen, Sanchita; Duenas, Gladys

2016-01-01

Transitions of care (TOC) refer to the movement of patients across institutions, among providers, between different levels of care, and to and from home. Medication errors that occur during TOC have the potential to result in medical complications that are serious for the patient and costly to the health care system. Positive outcomes have been demonstrated when pharmacists are involved in providing TOC services, including reducing preventable adverse drug reactions, medication-related problems, and rehospitalizations, as well as improving the discharge process. This review explores TOC models involving community pharmacy practice, the current impact of pharmacist interventions in TOC, and patient satisfaction with TOC services provided by community pharmacists. Common barriers and potential solutions to TOC services provided in the community pharmacy, such as patient identification, information gathering, standardization of services, administrative support, reimbursement, and time restraints, are also discussed. PMID:29354539

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

PubMed

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

2011-01-01

Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward' section was proposed as a way to begin addressing certain issues that were raised by community members. This article explores the continuum of community members' perspectives that range from interest and enthusiasm to hesitancy and concern. One participant reported personal experience with using telemental health and found the approach helpful in increasing her comfort in the therapeutic situation. In addition, concerns relating to appropriateness and safety were voiced. A variety of advantages (eg facilitation of disclosure, increased access to services, usefulness) and disadvantages or concerns (eg interference with capacity building, concerns about privacy) are reported and discussed. Following a coding procedure, a descriptive quantitative analysis demonstrated that 47% of the participants were categorized as having a positive response toward telemental health, 32% as having a negative response, and 21% as being neutral or undecided. Valuing Indigenous knowledge can help us understand community members' experiences of and concerns with telemental health and inform more successful and appropriate initiatives. With the invaluable support of the KO Telemedicine co-authors, we offer ways forward to address concerns identified by the community members. Most importantly, any ways forward for community telemental health initiatives need to be community driven and community led.

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

75 FR 78875 - White House Council for Community Solutions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... Service (CNCS) to support the social innovation and civic participation agenda of the Domestic Policy... problems; and (e) honoring and highlighting the work of leaders in service and social innovation who are...

20 CFR 664.440 - What are supportive services for youth?

Code of Federal Regulations, 2010 CFR

2010-04-01

... section 101(46), may include the following: (a) Linkages to community services; (b) Assistance with transportation; (c) Assistance with child care and dependent care; (d) Assistance with housing; (e) Referrals to...

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

PubMed Central

2013-01-01

Background The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Methods Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. Results While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services’ responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse “dilemmatic space” in their work. Conclusions The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health’s recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study’s findings. PMID:23663304

Peer advocacy in a personalized landscape: The role of peer support in a context of individualized support and austerity.

PubMed

Power, Andrew; Bartlett, Ruth; Hall, Edward

2016-06-01

Whilst personalization offers the promise of more choice and control and wider participation in the community, the reality in the United Kingdom has been hampered by local council cuts and a decline in formal services. This has left many people with intellectual disabilities feeling dislocated from collective forms of support (Needham, 2015). What fills this gap and does peer advocacy have a role to play? Drawing on a co-researched study undertaken with and by persons with intellectual disabilities, we examined what role peer advocacy can play in a context of reduced day services, austerity and individualized support. The findings reveal that peer advocacy can help people reconnect in the face of declining services, problem-solve issues and informally learn knowledge and skills needed to participate in the community. We argue that peer advocacy thus offers a vital role in enabling people to take up many of the opportunities afforded by personalization. © The Author(s) 2016.

A hybrid supported employment program for persons with schizophrenia in Japan.

PubMed

Fuller, T R; Oka, M; Otsuka, K; Yokoyama, N; Liberman, R P; Niwa, S I

2000-07-01

INTRODUCTION BY THE COLUMN EDITORS: Because the mental health system in Japan has emphasized hospital-based treatment (1), patients with schizophrenia often remain institutionalized for long periods, even after their symptoms have stabilized. In addition, the introduction of modern community-based methods of treatment and rehabilitation was delayed by an antipsychiatry movement in the 1970s and the ascendance of a reductionistic biological approach to services (2). Lack of adequate outpatient services and community residential care in Japan has been a serious obstacle to destigmatization of mental disorders and has contributed to the heavy burden and stress experienced by families of mentally ill persons (3). More than 80 percent of patients discharged from mental hospitals return to live with their families, who are ill prepared to provide the supportive services required for community tenure. Involvement in work activities can facilitate community reentry for people with serious and persistent mental illness because employment displaces symptoms, provides structure and meaning in daily life, offers socialization with peers, and permits workers to earn income for shelter and food. In this issue's Rehab Rounds column, the authors describe an innovative vocational rehabilitation program for patients with schizophrenia that was designed to overcome obstacles to discharge and community adjustment. The program at Yabuki Prefecture Psychiatric Hospital, in the northern prefecture of Fukushima, Japan, has been successful in training patients for competitive work while capitalizing on the importance of work in Japanese culture and its traditionally supportive employer-employee relationships. The program is termed "hybrid" because it combines elements of transitional employment with supported employment (4).

Community pharmacists' attitudes and opinions towards supplying clozapine.

PubMed

Gan, Yuh-Lin; O'Reilly, Claire L

2018-06-23

Background Clozapine is very effective for treatment-resistant schizophrenia, but its use has been limited due to the risk of agranulocytosis. From July 2015, clozapine has been accessible from Australian community pharmacies following regulatory changes, but pharmacists' attitudes towards these changes remain unknown. Objective To explore pharmacists' perspectives and experiences in supplying clozapine. Setting Australian community pharmacists. Methods A cross-sectional study with a mixed methods approach involving two phases. An online survey containing Likert-type and open-response questions was distributed to community pharmacists (n = 134) via ClopineCentral™ (clozapine monitoring system). Participants were then invited to participate in semi-structured telephone interviews (n = 12) regarding clozapine supply. Quantitative data were statistically analysed, while qualitative responses were thematically content-analysed. Main outcome measures Pharmacists' responses to surveys and interviews. Results Community pharmacists were supportive towards supplying clozapine as it increased access for consumers. Better patient-pharmacist relationships and holistic care approach were identified to benefit both consumers and pharmacists. Pharmacists reported to be confident (89.6%), have adequate support (73.1%), knowledge (86.6%) and skills (93.3%) in dispensing clozapine. Training and support received facilitated pharmacists' roles, whereas administrative issues, especially in obtaining valid haematology results, posed challenges. Educational and technical improvements were suggested to improve service provision. Conclusion Community pharmacists welcomed the regulatory changes positively and were confident in supporting consumers taking clozapine. Despite challenges present, benefits and facilitators identified supported the feasibility of this service in community pharmacies. Future research should explore other aspects of clozapine supply, such as attitudes of other stakeholders, to improve current supply systems.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services.

PubMed

Ewen, Heidi H; Washington, Tiffany R; Emerson, Kerstin G; Carswell, Andrew T; Smith, Matthew Lee

2017-03-22

Background: The majority of older adults prefer to remain in their homes, or to "age-in-place." To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results : When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions : Findings suggest that older adults' residential environment is associated with their health status and HCBS utilization. Building upon the Person-Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

PubMed Central

Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

2017-01-01

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place. PMID:28327507

The Lindsay Leg Club: supporting the NHS to provide leg ulcer care.

PubMed

McKenzie, Morag

2013-06-01

Public health services will need to cope with additional demands due to an ageing society and the increasing prevalence of chronic conditions. Lower-limb ulceration is a long-term, life-changing condition and leg ulcer management can be challenging for nursing staff. The Lindsay Leg Club model is a unique partnership between community nurses, members and the local community, which provides quality of care and empowerment for patients with leg ulcers, while also supporting and educating nursing staff. The Leg Club model works in accord with core themes of Government and NHS policy. Patient feedback on the Leg Club model is positive and the Leg Clubs provide a service to members which is well accepted by patients, yet is more economically efficient than the traditional district nursing practice of home visits. Lindsay Leg Clubs provide a valuable support service to the NHS in delivering improved quality of care while improving efficiency.

Latest Community Coordinated Modeling Center (CCMC) services and innovative tools supporting the space weather research and operational communities.

NASA Astrophysics Data System (ADS)

Mendoza, A. M. M.; Rastaetter, L.; Kuznetsova, M. M.; Mays, M. L.; Chulaki, A.; Shim, J. S.; MacNeice, P. J.; Taktakishvili, A.; Collado-Vega, Y. M.; Weigand, C.; Zheng, Y.; Mullinix, R.; Patel, K.; Pembroke, A. D.; Pulkkinen, A. A.; Boblitt, J. M.; Bakshi, S. S.; Tsui, T.

2017-12-01

The Community Coordinated Modeling Center (CCMC), with the fundamental goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research, has been serving as an integral hub for over 15 years, providing invaluable resources to both space weather scientific and operational communities. CCMC has developed and provided innovative web-based point of access tools varying from: Runs-On-Request System - providing unprecedented global access to the largest collection of state-of-the-art solar and space physics models, Integrated Space Weather Analysis (iSWA) - a powerful dissemination system for space weather information, Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and Mobile apps to view space weather data anywhere to the scientific community. In addition to supporting research and performing model evaluations, CCMC also supports space science education by hosting summer students through local universities. In this poster, we will showcase CCMC's latest innovative tools and services, and CCMC's tools that revolutionized the way we do research and improve our operational space weather capabilities. CCMC's free tools and resources are all publicly available online (http://ccmc.gsfc.nasa.gov).

[Variability in the implementation of health-promoting community activities in Spain].

PubMed

March, S; Soler, M; Miller, F; Montaner, I; Pérez Jarauta, M J; Ramos, M

2014-01-01

To describe the variability in the application of community activities (CA) promoting health, in support received, in training, and in evaluation of the participation of professionals, administration and social partners in these. Survey to key informants identified in each region with the help of the Spanish Society of Family and Community Medicine. The questionnaire included a definition of a health promotion community activity. The study was conducted in 2008. There was variability in community activities by region. The most involved professionals are nurses and social workers. Most of the regions (15 of 17) offer training in these issues to their professionals, especially in health education. It is less frequent to offer training to family medicine residents (10 of 17 regions) and to the different nursing specialties (6 of 17). The main institutional support comes from primary health care management, regional health services, municipalities, and public health services, and non-institutional support from scientific societies, civic associations and NGOs. On the evaluation of the involvement of different organizations and institutions in these activities, the only entities receiving pass grades were NGOs (3 out of 5) and primary health care (2.5 out of 5). There is a high variability in the ways of supporting and promoting community activities in each region and consequently in their dissemination and implementation by primary health care teams. Nurses and social workers are key players in this process.

Using peer support groups to enhance community integration of veterans in transition.

PubMed

Drebing, Charles E; Reilly, Erin; Henze, Kevin T; Kelly, Megan; Russo, Anthony; Smolinsky, John; Gorman, Jay; Penk, Walter E

2018-05-01

Peer support groups, also known as "self-help groups," provide a unique tool for helping veterans working through the military-to-civilian transition to achieve higher levels of social support and community integration. The number and variety of community-based peer support groups has grown to the point that there are now more visits to these groups each year than to mental health professionals. The focus of these groups on the provision of social support, the number and variety of groups, the lack of cost, and their availability in the community make them a natural transition tool for building community-based social support. A growing literature suggests that these groups are associated with measurable improvements in social support, clinical symptoms, self-efficacy and coping. For clinical populations, the combination of peer support groups and clinical care results in better outcomes than either alone. Given this evidence, we suggest clinical services use active referral strategies to help veterans engage in peer support groups as a means of improving community reintegration and clinical outcomes. Finally, suggestions for identifying appropriate peer support groups and assisting with active referrals are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

PubMed Central

2010-01-01

Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations. PMID:21138584

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand.

PubMed

Ameratunga, Shanthi; Abel, Sally; Tin Tin, Sandar; Asiasiga, Lanuola; Milne, Sharon; Crengle, Sue

2010-12-07

Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations.

Using Cloud-Computing Applications to Support Collaborative Scientific Inquiry: Examining Pre-Service Teachers' Perceived Barriers to Integration

ERIC Educational Resources Information Center

Donna, Joel D.; Miller, Brant G.

2013-01-01

Technology plays a crucial role in facilitating collaboration within the scientific community. Cloud-computing applications, such as Google Drive, can be used to model such collaboration and support inquiry within the secondary science classroom. Little is known about pre-service teachers' beliefs related to the envisioned use of collaborative,…

Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS).

PubMed

Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

2016-08-26

To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a structured framework to evaluate and redesign the service with the aim to improve effectiveness and efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Implementation of Quality Management in Core Service Laboratories

PubMed Central

Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

2010-01-01

CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.

Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

PubMed

Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

2017-06-01

As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer patients regard psycho-oncology services as a highly reasonable and beneficial addition to medical care. In light of insufficient local coverage with services, difficulties with seamless referrals constitute a major challenge for physicians. Apart from emphasizing the effectiveness of psycho-oncology services and proactive attitudes toward the assessment of unmet needs, future policies should focus on the integration of medical and psychosocial follow-up of cancer survivors, especially in rural areas. © AlphaMed Press 2017.

End-of-Life Care and Dying: Issues Raised by Staff Supporting Older People with Intellectual Disability in Community Living Services

ERIC Educational Resources Information Center

Wiese, Michele; Stancliffe, Roger J.; Balandin, Susan; Howarth, Glennys; Dew, Angela

2012-01-01

Background: The aim of this study was to explore the current status of end-of-life care and dying of people with intellectual disability based on the experiences of staff in community living services. Materials and Methods: Focus groups and individual interviews were conducted, guided by grounded theory methodology. Results: The current status of…

Schools as Community Hubs: Integrating Support Services to Drive Educational Outcomes. A Series of Discussion Papers on Building Healthy Neighborhoods. No. 3

ERIC Educational Resources Information Center

Horn, Michael B.; Freeland, Julia; Butler, Stuart M.

2015-01-01

Effective approaches to the problems of struggling neighborhoods--from health to school success and poverty--require the focused use of integrated strategies. Consistent with this, community schools and many charter schools now function as hubs, helping to deliver a range of services beyond education in order to prepare their students to learn and…

Developmental Services for Children with HIV Infection.

ERIC Educational Resources Information Center

Crocker, Allen C.

1989-01-01

The special developmental needs of young children with congenital HIV (Human Immunodeficiency Virus) infection require evaluation, training, therapy, and other supports. Such services should be guided by developmentalists in a child study center in close alliance with medical, educational, and community service providers. Concerns about the…

The Impact of Current Economic Crisis on Community Colleges

ERIC Educational Resources Information Center

Okpala, Comfort O.; Hopson, Linda; Okpala, Amon O.

2011-01-01

The focus of the study was to examine the impact of the recession on (1) community college funding, (2) community college student support services, and (3) on student enrollment. This study relied on data from document analysis and interview of community college personnel and students. The current crisis has resulted in a steep budget reduction to…

Educating for Community Change: Higher Education's Proposed Role in Community Transformation through the Federal Promise Neighborhood Policy

ERIC Educational Resources Information Center

Hudson, Elizabeth

2013-01-01

This study investigated a federal comprehensive community initiative, the Promise Neighborhood initiative, in order to understand higher education community engagement in an embedded context. Promise Neighborhood programs aim to create a place-based system of family and education services that can support youth from early childhood through college…

"It was the whole picture" a mixed methods study of successful components in an integrated wellness service in North East England.

PubMed

Cheetham, M; Van der Graaf, P; Khazaeli, B; Gibson, E; Wiseman, A; Rushmer, R

2018-03-22

A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of 'active ingredients' at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

Adopting a Sustainable Community of Practice Model when Developing a Service to Support Patients with Epidermolysis Bullosa (EB): A Stakeholder-Centered Approach.

PubMed

Gowran, Rosemary Joan; Kennan, Avril; Marshall, Siobhán; Mulcahy, Irene; Ní Mhaille, Sile; Beasley, Sarah; Devlin, Mark

2015-02-01

Epidermolysis bullosa (EB) is a rare, genetic skin condition that is complicated, distressing, and painful and permeates every aspect of patients' lives. Support services are essential for meeting the primary needs of patients and families living with EB; however, provision is challenged by many complex issues. In collaboration with the patient organization DEBRA Ireland, this research conducted an in-depth analysis of Irish healthcare support services for EB, with a view to moving towards an improved and sustainable care pathway. A sustainable community of practice model (SCOP), as a core construct provided a simplified framework when studying this complex system. The research utilized mixed methods, comprising individual interviews, questionnaires, and a participatory action research workshop based on a soft systems approach. The study engaged patients, family members, service providers, and policy developers. Findings emphasized that the complexities of life with EB are more than 'skin deep'. The lived experience of stakeholders revealed many levels of emotion, both positive and heart-rending. Despite the positive efforts of specialists in this field, inadequacies to meet the primary needs of people with EB, such as bandages-fundamental for survival-were highlighted. Participants reported challenges relating to understanding patients' needs, access to consistent services within hospitals and the community, time constraints, and the strong emotions evoked by this severe and rare disease. The study identified several areas that can be targeted to bring about improvements in meeting primary needs. Education and research at public, policy, and practice levels need to be prioritized. It is imperative that citizens move beyond an awareness that EB exists and demonstrate a consciousness about the importance of advocating and enabling seamless and sustainable support services through collective action.

The Arctic Cooperative Data and Information System: Data Management Support for the NSF Arctic Research Program (Invited)

NASA Astrophysics Data System (ADS)

Moore, J.; Serreze, M. C.; Middleton, D.; Ramamurthy, M. K.; Yarmey, L.

2013-12-01

The NSF funds the Advanced Cooperative Arctic Data and Information System (ACADIS), url: (http://www.aoncadis.org/). It serves the growing and increasingly diverse data management needs of NSF's arctic research community. The ACADIS investigator team combines experienced data managers, curators and software engineers from the NSIDC, UCAR and NCAR. ACADIS fosters scientific synthesis and discovery by providing a secure long-term data archive to NSF investigators. The system provides discovery and access to arctic related data from this and other archives. This paper updates the technical components of ACADIS, the implementation of best practices, the value of ACADIS to the community and the major challenges facing this archive for the future in handling the diverse data coming from NSF Arctic investigators. ACADIS provides sustainable data management, data stewardship services and leadership for the NSF Arctic research community through open data sharing, adherence to best practices and standards, capitalizing on appropriate evolving technologies, community support and engagement. ACADIS leverages other pertinent projects, capitalizing on appropriate emerging technologies and participating in emerging cyberinfrastructure initiatives. The key elements of ACADIS user services to the NSF Arctic community include: data and metadata upload; support for datasets with special requirements; metadata and documentation generation; interoperability and initiatives with other archives; and science support to investigators and the community. Providing a self-service data publishing platform requiring minimal curation oversight while maintaining rich metadata for discovery, access and preservation is challenging. Implementing metadata standards are a first step towards consistent content. The ACADIS Gateway and ADE offer users choices for data discovery and access with the clear objective of increasing discovery and use of all Arctic data especially for analysis activities. Metadata is at the core of ACADIS activities, from capturing metadata at the point of data submission to ensuring interoperability , providing data citations, and supporting data discovery. ACADIS metadata efforts include: 1) Evolution of the ACADIS metadata profile to increase flexibility in search; 2) Documentation guidelines; and 3) Metadata standardization efforts. A major activity is now underway to ensure consistency in the metadata profile across all archived datasets. ACADIS is embarking on a critical activity to create Digital Object Identifiers (DOI) for all its holdings. The data services offered by ACADIS focus on meeting the needs of the data providers, providing dynamic search capabilities to peruse the ACADIS and related cyrospheric data repositories, efficient data download and some special services including dataset reformatting and visualization. The service is built around of the following key technical elements: The ACADIS Gateway housed at NCAR has been developed to support NSF Arctic data coming from AON and now broadly across PLR/ARC and related archives: The Arctic Data Explorer (ADE) developed at NSIDC is an integral service of ACADIS bringing the rich archive from NSIDC together with catalogs from ACADIS and international partners in Arctic research: and Rosetta and the Digital Object Identifier (DOI) generation scheme are tools available to the community to help publish and utilize datasets in integration and synthesis and publication.

Community Relations - Public Affairs - Personal Staff - Joint Staff - The

Science.gov Websites

Report National Commission of the Future of the Army White Papers I am the Guard ARNG Media ARNG Public Public Affairs Executive Support Services Legislative Liaison Special Staff Directorate of Management : Public Affairs : Community Relations Community Relations The National Guard Bureau Civic Engagement

Moving from Survival to Fulfillment: A Planning Framework for Community Schools

ERIC Educational Resources Information Center

Shaia, Wendy E.; Finigan-Carr, Nadine

2018-01-01

Community schooling is an effective tool for combating the effects of poverty by integrating academic, social service, health, and economic supports for students, families, and community members. But this is complex work, requiring extraordinarily careful planning and assessment. This article suggests a planning framework that can help community…

A Cluster Analysis of Support Networks of Older People with Severe Intellectual Impairment.

ERIC Educational Resources Information Center

Moss, Steve; Hogg, James

1989-01-01

The report describes a demographic survey of 122 people with severe intellectual impairment over 50 years of age in a British community. Seven relatively independent clusters were identified: contact with relatives, community activities, community independence, friendship, service pathways, geriatrics/mobility, and physical treatment. (Author/DB)

What Motivates the Community College Rogue Trustee?

ERIC Educational Resources Information Center

O'Banion, Terry

2009-01-01

Approximately 6500 elected or appointed trustees govern local community colleges in 36 states. The great majority of these trustees are extraordinary citizens motivated by the opportunity to provide service to their communities and to their colleges. On occasion, a trustee emerges whose motivations do not support the common good; some of these…

Supporting Latino Community College Students: An Investment in Our Economic Future

ERIC Educational Resources Information Center

Santiago, Deborah A.; Stettner, Andrew

2013-01-01

Most Latino students who enroll in college begin at community colleges. This paper highlights how "Excelencia" in Education ("Excelencia"), Single Stop USA, and innovative community colleges across the country are making smart changes in their student services that are helping thousands of Latino students access millions of…

Engaging in School-Led Multisectoral Collaboration: Implications to Agroforestry Promotion in the Philippine Uplands

ERIC Educational Resources Information Center

Landicho, Leila D.; Cabahug, Rowena D.; De Luna, Catherine C.

2009-01-01

The Agroforestry Support Program for Empowering Communities Towards Self-Reliance (ASPECTS) was conceived to develop a model of two-stage approach in agroforestry promotion by capacitating the upland communities to establish community-managed agroforestry extension services, while strengthening the agroforestry education programs of the three…

Hispanic/Latino Natural Support Systems. CSAP Implementation Guide.

ERIC Educational Resources Information Center

Acosta, Annie; Hamel, Vicki

This guide is intended to share knowledge about the Hispanic/Latino community with Center for Substance Abuse Prevention (CSAP) grant recipients and to help them develop effective prevention services responsive to the communities they serve. The guide: (1) highlights specific characteristics of the Hispanic and Latino communities that affect…

Foundations and Comprehensive Community Initiatives: The Challenges of Partnership. Discussion Paper.

ERIC Educational Resources Information Center

Brown, Prudence; Garg, Sunil

Against a backdrop of increasing localization of responsibilities for human services and community development, and in a climate of diminished resources for these activities, foundations have explored the comprehensive community initiative (CCI) as a strategy to direct support toward improved well-being for children and families. This discussion…

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

PubMed

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

2017-08-30

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

The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: a systematic literature review.

PubMed

Henderson, Saras; Kendall, Elizabeth; See, Laurenne

2011-05-01

Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities. © 2011 Blackwell Publishing Ltd.

Transitional Support for Adults with Severe Mental Illness: Critical Time Intervention and Its Roots in Assertive Community Treatment

ERIC Educational Resources Information Center

Herman, Daniel B.

2014-01-01

Professional social workers and other mental health providers have for many years been involved in delivering treatment and support services focused on the needs of adults with severe mental illnesses living in the community. While some models have evolved largely through practice experience, others have developed through research paradigms in…

A Policy Framework for Joint Use: Enabling and Supporting Community Use of K-12 Public School Facilities

ERIC Educational Resources Information Center

Filardo, Mary; Vincent, Jeffrey M.

2014-01-01

Joint use of public school facilities is a complex but manageable approach to efficiently enhancing the services and programs available to students and supporting the community use of public schools. Building upon on our 2010 paper titled "Joint Use of Public Schools: A Framework for a New Social Contract," this paper identifies the…

Improving Student Outcomes via Comprehensive Supports: Three-Year Outcomes from CUNY's Accelerated Study in Associate Programs (ASAP)

ERIC Educational Resources Information Center

Kolenovic, Zineta; Linderman, Donna; Karp, Melinda Mechur

2013-01-01

Community colleges are grappling with low rates of degree completion and transfer. The City University of New York's (CUNY) Accelerated Study in Associate Programs (ASAP) aims to improve graduation rates by providing a range of comprehensive support services to community college students in select majors. Using student-unit record data, we…

Two Years of Case Management: Final Findings from the Communities in Schools Random Assignment Evaluation

ERIC Educational Resources Information Center

Parise, Leigh M.; Corrin, William; Granito, Kelly; Haider, Zeest; Somers, Marie-Andrée; Cerna, Oscar

2017-01-01

While high school graduation rates are on the rise nationwide, too many students still never reach that milestone, with 7,000 on average dropping out every day. Recognizing that many students need additional support to succeed in school, Communities In Schools (CIS) works to provide and connect students with integrated support services to keep…

Educating the humanitarian engineer.

PubMed

Passino, Kevin M

2009-12-01

The creation of new technologies that serve humanity holds the potential to help end global poverty. Unfortunately, relatively little is done in engineering education to support engineers' humanitarian efforts. Here, various strategies are introduced to augment the teaching of engineering ethics with the goal of encouraging engineers to serve as effective volunteers for community service. First, codes of ethics, moral frameworks, and comparative analysis of professional service standards lay the foundation for expectations for voluntary service in the engineering profession. Second, standard coverage of global issues in engineering ethics educates humanitarian engineers about aspects of the community that influence technical design constraints encountered in practice. Sample assignments on volunteerism are provided, including a prototypical design problem that integrates community constraints into a technical design problem in a novel way. Third, it is shown how extracurricular engineering organizations can provide a theory-practice approach to education in volunteerism. Sample completed projects are described for both undergraduates and graduate students. The student organization approach is contrasted with the service-learning approach. Finally, long-term goals for establishing better infrastructure are identified for educating the humanitarian engineer in the university, and supporting life-long activities of humanitarian engineers.

Six Information Technology Services Contracts for the Defense Intelligence Community

DTIC Science & Technology

2000-04-24

This category covers Defense Intelligence Community organizations whose mission is to provide for the planning, development, deployment, operation ... management , and oversight of global information networks and infrastructure supporting intelligence producers. • Information Systems. This category

A little goes a long way: the impact of distal social support on community integration and recovery of individuals with psychiatric disabilities.

PubMed

Townley, Greg; Miller, Henry; Kloos, Bret

2013-09-01

Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted-focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.

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

PubMed

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

2017-05-29

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

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017.

PubMed

Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey

2012-10-01

To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were identified as priorities.

Community resources for frail older patients.

PubMed Central

Borgenicht, K; Carty, E; Feigenbaum, L Z

1997-01-01

The goal of community-based services for frail older patients is to help them achieve the greatest degree of functional ability and independence. The services available include case management, geriatric assessment, adult day health care, home health services, and the Program for All-inclusive Care for the Elderly (PACE). Definitive criteria for referral have not been established, but without some targeting, the efficacy of these services remains uncertain. Targeting criteria identified include dependency in 2 or more activities of daily living, no family support, dementia, many long-term illnesses, and many hospital stays. Although efficacy and cost-effectiveness remain uncertain, patients, families, and physicians generally report these services to be helpful. PMID:9348762

A call for differentiated approaches to delivering HIV services to key populations.

PubMed

Macdonald, Virginia; Verster, Annette; Baggaley, Rachel

2017-07-21

Key populations (KPs) are disproportionally affected by HIV and have low rates of access to HIV testing and treatment services compared to the broader population. WHO promotes the use of differentiated approaches for reaching and recruiting KP into the HIV services continuum. These approaches may help increase access to KPs who are often criminalized or stigmatized. By catering to the specific needs of each KP individual, differentiated approaches may increase service acceptability, quality and coverage, reduce costs and support KP members in leading the HIV response among their communities. WHO recommends the implementation of community-based and lay provider administered HIV testing services. Together, these approaches reduce barriers and costs associated with other testing strategies, allow greater ownership in HIV programmes for KP members and reach more people than do facility-based services. Despite this evidence availability and support for them is limited. Peer-driven interventions have been shown to be effective in engaging, recruiting and supporting clients. Some programmes employ HIV-positive or non-PLHIV "peer navigators" and other staff to provide case management, enrolment and/or re-enrolment in care and treatment services. However, a better understanding of the impact, cost effectiveness and potential burden on peer volunteers is required. Task shifting and non-facility-based service locations for antiretroviral therapy (ART) initiation and maintenance and antiretroviral (ARV) distribution are recommended in both the consolidated HIV treatment and KP guidelines of WHO. These approaches are accepted in generalized epidemics and for the general population where successful models exist; however, few organizations provide or initiate ART at KP community-based services. The application of a differentiated service approach for KP could increase the number of people who know their status and receive effective and sustained prevention and treatment for HIV. However, while community-based and lay provider testing are effective and affordable, they are not implemented to scale. Furthermore regulatory barriers to legitimizing lay and peer providers as part of healthcare delivery systems need to be overcome in many settings. WHO recommendations on task shifting and decentralization of ART treatment and care are often not applied to KP settings.

CEMS: Building a Cloud-Based Infrastructure to Support Climate and Environmental Data Services

NASA Astrophysics Data System (ADS)

Kershaw, P. J.; Curtis, M.; Pechorro, E.

2012-04-01

CEMS, the facility for Climate and Environmental Monitoring from Space, is a new joint collaboration between academia and industry to bring together their collective expertise to support research into climate change and provide a catalyst for growth in related Earth Observation (EO) technologies and services in the commercial sector. A recent major investment by the UK Space Agency has made possible the development of a dedicated facility at ISIC, the International Space Innovation Centre at Harwell in the UK. CEMS has a number of key elements: the provision of access to large-volume EO and climate datasets co-located with high performance computing facilities; a flexible infrastructure to support the needs of research projects in the academic community and new business opportunities for commercial companies. Expertise and tools for scientific data quality and integrity are another essential component, giving users confidence and transparency in its data, services and products. Central to the development of this infrastructure is the utilisation of cloud-based technology: multi-tenancy and the dynamic provision of resources are key characteristics to exploit in order to support the range of organisations using the facilities and the varied use cases. The hosting of processing services and applications next to the data within the CEMS facility is another important capability. With the expected exponential increase in data volumes within the climate science and EO domains it is becoming increasingly impracticable for organisations to retrieve this data over networks and provide the necessary storage. Consider for example, the factor of o20 increase in data volumes expected for the ESA Sentinel missions over the equivalent Envisat instruments. We explore the options for the provision of a hybrid community/private cloud looking at offerings from the commercial sector and developments in the Open Source community. Building on this virtualisation layer, a further core services tier will support and serve applications as part of a service oriented architecture. We consider the constituent services in this layer to support access to the data, data processing and the orchestration of workflows.

What constitutes 'support' for the role of the Aboriginal and Torres Strait Islander child health workforce?

PubMed

Watson, Karen; Young, Jeanine; Barnes, Margaret

2013-02-01

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship.

Should community health workers offer support healthcare services to survivors of sexual violence? a systematic review.

PubMed

Gatuguta, Anne; Katusiime, Barbra; Seeley, Janet; Colombini, Manuela; Mwanzo, Isaac; Devries, Karen

2017-10-12

Sexual violence is widespread, yet relatively few survivors receive healthcare or complete treatment. In low and middle-income countries, community health workers (CHWs) have the potential to provide support services to large numbers of survivors. The aim of this review was to document the role of CHWs in sexual violence services. We aimed to: 1) describe existing models of CHWs services including characteristics of CHWs, services delivered and populations served; 2) explore acceptability of CHWs' services to survivors and feasibility of delivering such services; and 3) document the benefits and challenges of CHW-provided sexual violence services. Quantitative and qualitative studies reporting on CHWs and other community-level paraprofessional volunteer services for sexual violence were eligible for inclusion. CHWs and sexual violence were defined according to WHO criteria. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Quality of included studies was assessed using two quality assessment tools for quantitative, and, the methodology checklist by the National Institute for Health and Clinical Excellence for qualitative studies. Data were extracted and analysed separately for quantitative and qualitative studies and results integrated using a framework approach. Seven studies conducted in six countries (Democratic Republic of Congo, Rwanda, Burma, United States of America, Scotland, Israel) met the inclusion criteria. Different models of care had diverse CHWs roles including awareness creation, identifying, educating and building relationships with survivors, psychosocial support and follow up. Although sociocultural factors may influence CHWs' performance and willingness of survivors to use their services, studies often did not report on CHWs characteristics. Few studies assessed acceptability of CHWs' to survivors or feasibility of delivery of services. However, participants mentioned a range of benefits including decreased incidence of violence, CHWs being trusted, approachable, non-judgmental and compassionate. Challenges identified were high workload, confidentiality issues and community norms influencing performance. There is a dearth of research on CHWs services for sexual violence. Findings suggest that involving CHWs may be beneficial, but potential challenges and harms related to CHW-provided services exist. No different models of CHW-provided care have been robustly evaluated for effects on patient outcomes. Further research to establish survivors' views on these services, and, their effectiveness is desperately needed.

Making space for belonging: critical reflections on the implementation of personalised adult social care under the veil of meaningful inclusion.

PubMed

Power, Andrew

2013-07-01

This paper critically reflects on the way in which recent adult social care reform has been evolving beneath the alleged policy goal of prioritising the cultivation of meaningful inclusion and 'belonging' in the community. With this goal, there has been a focus away from 'services' for persons with intellectual disabilities, to supporting natural connections within the community. This paper draws on a grounded theory study of the perspectives of those responsible for overseeing community living arrangements for persons with disabilities, drawing on interviews and focus groups with service providers and relevant government officials. It examines the socio-spatial implications of the gradual shift towards 'belonging' as a disability policy goal, as it has evolved in two discrete settings - British Columbia, Canada and Ireland. The findings identify the complexities involved in facilitating active community connection for persons with intellectual disabilities and reveal important cautionary lessons for other jurisdictions where community living policy has arguably been moving away from communal services towards self-managed supports in 'real' communities through personal budgets in an effort to remove barriers to participation. The paper thus critically reflects on the rapid pursuit for transformation in personalised adult social care in government policy, arguing that the process of fostering meaningful community inclusion will and should take time. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

PubMed Central

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-01-01

Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394

Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

PubMed

Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

2016-07-07

Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were supported by the Aboriginal Health Team at the local Population Health Unit. Participants reported health services improved in community and hospital settings, leading to increased access and trust in local health services. The evaluation concluded that this process of actively engaging the Aboriginal community in decisions about their health care was a key element in improving local health services, increasing Aboriginal people's trust and access to care.

Food security in older adults: community service provider perceptions of their roles.

PubMed

Keller, Heather H; Dwyer, John J M; Edwards, Vicki; Senson, Christine; Gayle Edward, H

2007-01-01

Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as "the need for personalization of service". Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services.

PubMed

Price, Sarah Kye; Coles, D Crystal; Wingold, Tracey

2017-11-01

Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs. © 2017 National Association of Social Workers.

Investigating preferences for support with life after stroke: a discrete choice experiment.

PubMed

Burton, Christopher R; Fargher, Emily; Plumpton, Catrin; Roberts, Gwerfyl W; Owen, Heledd; Roberts, Eryl

2014-02-08

There is little evidence of service user preferences to guide the commissioning and improvement of services that support life after stroke. We report the first investigation of patients' and family carers' preferences for community services after stroke using a discrete choice experiment (DCE). Two workshops with patients and family carers (n = 8) explored stroke experiences, identifying attributes important in shaping views about service design, and piloted data collection strategies. Attributes were group versus individual support; service provider; additional support for social and leisure activities; and the total time required to access services. Patients and family carers were recruited six months post stroke-onset (mean 331 days) from four stroke services, and invited to participate in the DCE. Patients' general health (EQ5D) and functional dependence (Barthel Index) were also assessed. Of 474 eligible patients, 144 (30%) expressed an interest in the study, and 80 (56%) of these completed the survey questionnaire. 34 of 74 (46%) family carers recruited through patients completed the DCE. All four attributes were significant in shaping patients preferences for stroke support service delivery (p < 0.05), confirming the interpretation of workshop findings. Patients prefer help and support for emotional needs, communication problems and physical difficulties to be provided on an individual basis; and to be offered additional social and leisure activities that they are able to attend on their own. Patients would appear to prefer that voluntary organisations do not provide these services, although this may be linked to lack of experience of these services. Family carers would prefer help and support in their caring role on a one-to-one basis. Whilst health related quality of life is associated with preference for format of service, results were relatively consistent across sub-groups, with the exception of time since stroke, where social and leisure activities had a greater impact on preferences of established service users. The data provide unique insights into how preferences for community services that support life after stroke are shaped. This information can be used to inform both service re-design, and barriers to implementation that will need to be accounted for in policy shifts towards a more mixed economy of service provision.

A narrative review of mental health support for people during transition from incarceration to community: the grass can be greener on the other side of the fence.

PubMed

Smith-Merry, Jennifer; Mellifont, Damian; McKenzie, Kirsty; Clenaghan, Paul

2018-04-28

Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.

Exploring Counseling Services and Their Impact on Female, Underrepresented Minority Community College Students in Science, Technology, Engineering, and Math: A Qualitative Study

NASA Astrophysics Data System (ADS)

Strother, Elizabeth

The economic future of the United States depends on developing a workforce of professionals in science, technology, engineering and mathematics (Adkins, 2012; Mokter Hossain & Robinson, 2012). In California, the college population is increasingly female and underrepresented minority, a population that has historically chosen to study majors other than STEM. In California, community colleges provide a major inroad for students seeking to further their education in one of the many universities in the state. The recent passage of Senate Bill 1456 and the Student Success and Support Program mandate increased counseling services for all California community college students (California Community College Chancellors Office, 2014). This dissertation is designed to explore the perceptions of female, underrepresented minority college students who are majoring in an area of science, technology, engineering and math, as they relate to community college counseling services. Specifically, it aims to understand what counseling services are most effective, and what community college counselors can do to increase the level of interest in STEM careers in this population. This is a qualitative study. Eight participants were interviewed for the case study, all of whom are current or former community college students who have declared a major in a STEM discipline. The semi-structured interviews were designed to help understand what community college counselors can do to better serve this population, and to encourage more students to pursue STEM majors and careers. Through the interviews, themes emerged to explain what counseling services are the most helpful. Successful STEM students benefited from counselors who showed empathy and support. Counselors who understood the intricacies of educational planning for STEM majors were considered the most efficacious. Counselors who could connect students with enrichment activities, such as internships, were highly valued, as were counseling services that helped students learn to negotiate being a woman in male-dominated classes. The interviews shed light on the particular skills required to effectively counsel underrepresented minority females in STEM majors in the community college.

Financial Health and Mental Health Among Clients of a Community Mental Health Center: Making the Connections.

PubMed

Harper, Annie; Clayton, Ashley; Bailey, Margaret; Foss-Kelly, Louisa; Sernyak, Michael J; Rowe, Michael

2015-12-01

This study evaluated financial challenges, satisfaction with financial-management supports, and interest in additional or alternative supports among clients of a mental health center. Six focus groups were held with 39 clients of an urban community mental health center who reported having difficulty with their finances. Five focus groups were held with direct-care staff who provided services to the clients. Investigators used an inductive analytical approach to distill themes from notes taken during the focus groups. Clients emphasized the challenges of living in poverty and described using complex strategies to sustain themselves, including negotiating benefits systems, carefully planning purchases, and developing and relying on social relationships. They spoke of having uneven access to tools and services for managing their money, such as advice from direct-care staff, representative payees, and bank accounts, and had varying opinions about their value. Noting concerns similar to those of clients, direct-care staff expressed frustration at the lack of support services for helping clients manage their finances. Both clients and staff expressed the need for more services to help clients with their finances. Findings suggest a need for more services to support people with mental illness to manage their finances, particularly a more flexible and broader range of options than are provided by current representative-payee mechanisms.

Clinical skill development for community pharmacists.

PubMed

Barnette, D J; Murphy, C M; Carter, B L

1996-09-01

The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

[Kinshicho Model for Community Care by Multifunctional Vertical Integration of Psychiatric Care].

PubMed

Kubota, Akira

2015-01-01

The future of psychiatric community care in Japan requires a medical team for outpatient care to offer support and take responsibility for a region; respecting human rights and supporting high risk patients who have concluded a long-period of hospitalized or repeated involuntary commitment, and for people who suffer from social withdraws over a long period of time. There are over 3,000 private psychiatric outpatient clinics in Japan. Over 400 of them are multifunctional psychiatric outpatient clinics that provide daycare services and outreach activities. In the future, if systematized those clinics entrusted by an administrative organ with performing as a "community mental health center". Multifunctional vertical integration of psychiatric care is possible in Japan to create a catchment area with 24 hours phone service and continued free access.

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

PubMed

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

2014-01-01

This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery. © 2013 Wiley Periodicals, Inc.

A Service Delivery Model for Children with DCD Based on Principles of Best Practice.

PubMed

Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl

2015-01-01

In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

Innovations in service learning: a novel program for community service at NYU School of Medicine.

PubMed

Herlihy, Nola Seta; Brown, Christina

2015-01-01

As NYU medical students, the authors determined that there was no structured form of service learning in their curriculum. They sought to establish a service program that recognizes students for their dedication to community service in both the NYU and NYC communities. In 2012, with the support of the Office of Student Affairs (OSA), the authors created the NYU School of Medicine Community Service Program (CSP). The program tracks and verifies students' participation in service projects. It sets a goal for students to complete 100 service hours through at least five unique service initiatives. Two reflective essays at the completion of pre-clinical and core clerkship curricula challenge students to express how their service experiences will inform their future careers in medicine. The authors developed an innovative online portal for students to track their service involvement and allow the committee to easily approve hours. They created the Community Service Committee, made up of two representatives from each class year, to be in charge of regulating the program together with the OSA. The class of 2015 is the first class to participate; thus far, 13 students have met program requirements. In the classes of 2016 and 2017, 20 and 41 students, respectively, are expected to receive the award. Total participation has significantly increased in successive class years. The authors seek to gather data on CSP participants' changing perspectives and hope the program can serve as a model for other schools to build service learning into their curricula.

Service-Based Learning for Residents: A Success for Communities and Medical Education.

PubMed

Gefter, Liana; Merrell, Sylvia Bereknyei; Rosas, Lisa G; Morioka-Douglas, Nancy; Rodriguez, Eunice

2015-01-01

Community-based service-learning opportunities could support residents' acquisition of Accreditation Council for Graduate Medical Education (ACGME) competencies, but this concept has not been tested, and such programs are difficult to find. The objective of this work was to assess the value and the ACGME competency relevance of a service-learning program for residents that could be easily replicated nationally. Forty-one family medicine residents from three training programs participated in the Stanford Youth Diabetes Coaches Program at six high schools in California and Georgia serving minority students of low socioeconomic status. Residents completed online surveys to provide qualitative feedback and assess the program's impact on their acquisition of residency program competencies and self-management support proficiencies, including prior use and planned use of action plans-a key self-management support strategy. Ninety-five percent of residents indicated that the program was a valuable experience that contributed to acquisition of residency program competencies, including interpersonal and communication skills and communication with teens. Compared with baseline, significantly more residents reported intention to use action plans with patients following participation. Themes from qualitative feedback included: valuing the overall experience, increasing opportunities to practice teaching, enhancing their ability to communicate with adolescents, contributing to the health of the community, recognizing the potential of action plans, and increasing intent to use action plans. This pilot demonstrated that a brief service-learning program can enhance standard residency curriculum by encouraging acquisition of ACGME competencies and promoting utilization of self-management support in clinical practice.

ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

NASA Astrophysics Data System (ADS)

Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi

2017-04-01

End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme (http://swe.ssa.esa.int/) the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) (http://swe.ssa.esa.int/space-radiation) and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

Indian Health Service: Community Health

MedlinePlus

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

Our Community, Our Schools: A Case Study of Program Design for School-Based Mental Health Services

ERIC Educational Resources Information Center

Capp, Gordon

2015-01-01

Schools face increasing demands to support the mental health needs of students and families; some estimate that 80 percent of students receive mental health services at school. Thus, schools face two daunting challenges: (1) to provide effective mental health support to students and (2) to address how mental health needs affect other students,…

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model.

PubMed

Zeigler, Bernard P; Redding, Sarah; Leath, Brenda A; Carter, Ernest L; Russell, Cynthia

2016-01-01

The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health.

Financing Early Childhood Initiatives: Making the Most of Proposition 10. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Hayes, Cheryl D.

How early childhood funds are channeled to communities significantly affects what supports and services are available, how they are provided, how well they are linked to other resources in the community, and who benefits from them. As pressure mounts for states and communities to strengthen their commitment to families with young children and meet…

Outpatient alcohol withdrawal management for Aboriginal and Torres Strait Islander peoples.

PubMed

Brett, Jonathan; Lawrence, Leanne; Ivers, Rowena; Conigrave, Kate

2014-08-01

There is concern from within Aboriginal and Torres Strait Islander communities about the lack of access to alcohol withdrawal management ('detox') services. Outpatient detox is described within national Australian guidelines as a safe option for selected drinkers. However, uncertainly exists as to how suited Aboriginal and Torres Strait Islander peoples are to this approach. 
 Consultations were conducted with stakeholders of four health services providing outpatient detox for Aboriginal and Torres Strait Islander peoples in NSW. Thematic analysis was performed to determine elements perceived as important for success. Key themes that emerged were individual engagement, flexibility, assessment of suitability, Aboriginal staff and community engagement, practical support, counselling, staff education and support, coping with relapse and contingency planning. 
 There is a need to improve access to alcohol detox services for Aboriginal and Torres Strait Islander peoples. The outpatient setting seems to be a feasible and safe environment to provide this kind of service for selected drinkers.

Disaster Response and Decision Support in Partnership with the California Earthquake Clearinghouse

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Rosinski, A.; Vaughan, D.; Morentz, J.

2014-12-01

Getting the right information to the right people at the right time is critical during a natural disaster. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a NASA decision support system designed to produce remote sensing and geophysical modeling data products that are relevant to the emergency preparedness and response communities and serve as a gateway to enable the delivery of NASA decision support products to these communities. The E-DECIDER decision support system has several tools, services, and products that have been used to support end-user exercises in partnership with the California Earthquake Clearinghouse since 2012, including near real-time deformation modeling results and on-demand maps of critical infrastructure that may have been potentially exposed to damage by a disaster. E-DECIDER's underlying service architecture allows the system to facilitate delivery of NASA decision support products to the Clearinghouse through XchangeCore Web Service Data Orchestration that allows trusted information exchange among partner agencies. This in turn allows Clearinghouse partners to visualize data products produced by E-DECIDER and other NASA projects through incident command software such as SpotOnResponse or ArcGIS Online.

["I am nuts, but networking": the qualification process for peer support work with mental health users in the psychosocial care network of Rio de Janeiro].

PubMed

Magalhães Dahl, Catarina; de Araújo Carvalho, Maria C; Moscoso Teixeira de Mendonça, Joana; Mitkiewicz de Souza, Flávia; Wainstok Estivil Bustos, Mayra; Fernandes de Cintra Santos, Jacqueline; Marcos Lovisi, Giovani; Tavares Cavalcanti, Maria

2013-01-01

Peer support work has been increasingly incorporated by community services network in the context of mental health care paradigm shift; however, it is a relatively new device in Latin America. In this article, we will describe the qualification process of peer support workers for implementing a psychosocial intervention in the city of Rio de Janeiro. We use the following methodological strategies based on a narrative, participative and dialogical perspective: focus groups, knowledge transmission through a short course; visits to mental health services and field reports. We used a narrative analysis, building the following thematic categories: experience of the recovery process; what helps and what hinders in the recovery process; the role of the family; the role of community mental health services; prejudice among society and family members; the role of peer support work; challenges. From the users' perspective, recovery is tied to ups and downs and family can either help or disturb this process. Prejudice constitutes the main barrier for recovery. To have a social role and participating in training activities facilitate recovery. Users pointed out that it is necessary to have professional support for peer support work.

Program planning for a community pharmacy residency support service using the nominal group technique.

PubMed

Rupp, Michael T

2002-01-01

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

An exploration of facilitators and challenges in the scale-up of a national, public sector community health worker cadre in Zambia: a qualitative study.

PubMed

Phiri, Sydney Chauwa; Prust, Margaret Lippitt; Chibawe, Caroline Phiri; Misapa, Ronald; van den Broek, Jan Willem; Wilmink, Nikhil

2017-06-24

In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system. Semi-structured, individual interviews were held across 5 districts with 16 CHAs and 6 CHA supervisors, and 10 focus group discussions were held with 93 community members. Audio recordings of interviews and focus group discussions were transcribed and thematically coded using Dedoose web-based software. The study showed that the CHAs play a critical role in providing a wide range of services at the community level, as described by supervisors and community members. Some challenges still remain, that may inhibit the CHAs ability to provide health services effectively. In particular, the respondents highlighted infrequent supervision, lack of medical and non-medical supplies for outreach services, and challenges with the mobile data reporting system. The study shows that in order to optimize the impact of CHAs or other community health workers, key health-system support structures need to be functioning effectively, such as supervision, community surveillance systems, supplies, and reporting. The Ministry of Health with support from partners are currently addressing these challenges through nationwide supervisor and community data trainings, as well as advocating for adding primary health care as a specific focus area in the new National Health Strategy Plan 2017-2021. This study contributes to the evidence base on the introduction of formalized community health worker cadres in developing countries.

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study.

PubMed

Gammon, Deede; Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-05-02

Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. The aim was to illustrate uses and experiences with the secure e-recovery portal "ReConnect" as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users' control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Regardless of providers' portal use, service users' control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users' autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). ©Deede Gammon, Monica Strand, Lillian Sofie Eng, Elin Børøsund, Cecilie Varsi, Cornelia Ruland. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.05.2017.

Linking Schools with Human Service Agencies. ERIC/CUE Digest No. 62.

ERIC Educational Resources Information Center

Ascher, Carol

A number of factors put pressure on schools to work more closely with health, social service, and other youth-serving institutions but poor communications, program redundancies, fear for job security, and concerns about parent and community support for controversial services inhibit close collaboration. Recent successful collaborative school,…

Sacramento City College Re-Entry Services Comprehensive Plan.

ERIC Educational Resources Information Center

White, Maureen E.; Smith, William A.

Sacramento City College (SCC) established its Re-Entry Services program to provide information, referral and support services to students returning to the academic environment after an absence. Since the inception of the program in 1977, the college community has changed considerably. Among these changes are an aging student population, increased…

The Unity Council at 40: a pioneering community development and service organization (1967-2007).

PubMed

Orozco, Gabriel; Schwartz, Sara L; Austin, Michael J

2011-01-01

The Spanish Speaking Unity Council (Unity Council) is a community development nonprofit organization that was established in 1964, during the civil rights movement, by a group of community members who wanted to ensure the political representation of the Latino community. Over its 45-year history, the Unity Council has grown into a $12 million community development organization that delivers a range of programming, including social services and employment training as well as facilitating the development and support of local businesses, low-income housing, and neighborhood improvement activities. The history of the agency presents the multiple challenges and rewards associated with development in an underserved community and an example of the important role that leadership plays in the growth of a nonprofit.

Community perspectives on post-Katrina mental health recovery in New Orleans.

PubMed

Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

2011-01-01

Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems

PubMed Central

Jenkins, Melissa M.; Brookman-Frazee, Lauren

2010-01-01

The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family factors in children’s mental health services; however, stakeholders differed in reports of which factors were most salient. Specifically, clinicians endorsed most factors as being equally salient, while parents described a few salient factors, with parental stress and inadequate social support being the most frequently discussed. These qualitative data further elucidate the context of community services and have implications for evidence-based practice implementation and improving community care. PMID:21170419

More Job Services--Better Employment Outcomes: Increasing Job Attainment for People with IDD

ERIC Educational Resources Information Center

Nord, Derek

2016-01-01

Job search, job placement, and on-the-job supports are valuable services provided to many people with intellectual and developmental disabilities (IDD) to obtain work in the community. Investigating those who were unemployed at the time of service entry, this study seeks to extend understanding about the effect of services. Using extant data, a…

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

PubMed

Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

2017-11-01

A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Intervention Costs From Communities Putting Prevention to Work.

PubMed

Honeycutt, Amanda A; Khavjou, Olga A; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J; Bellard, David; Cash, Amanda J

2016-07-28

In 2010, the Centers for Disease Control and Prevention funded 50 communities to participate in the Communities Putting Prevention to Work (CPPW) program. CPPW supported community-based approaches to prevent or delay chronic disease and promote wellness by reducing tobacco use and obesity. We collected the direct costs of CPPW for the 44 communities funded through the American Recovery and Reinvestment Act (ARRA) and analyzed costs per person reached for all CPPW interventions and by intervention category. From 2011 through 2013, we collected quarterly data on costs from the 44 CPPW ARRA-funded communities. We estimated CPPW program costs as spending on labor; consultants; materials, travel, and services; overhead activities; and partners plus the value of in-kind donations. We estimated communities' costs per person reached for each intervention implemented and compared cost allocations across communities that focused on reducing tobacco use, or obesity, or both. Analyses were conducted in 2014; costs are reported in 2012 dollars. The largest share of CPPW total costs of $363 million supported interventions in communities that focused on obesity ($228 million). Average costs per person reached were less than $5 for 84% of tobacco-related interventions, 88% of nutrition interventions, and 89% of physical activity interventions. Costs per person reached were highest for social support and services interventions, almost $3 for tobacco‑use interventions and $1 for obesity prevention interventions. CPPW cost estimates are useful for comparing intervention cost per person reached with health outcomes and for addressing how community health intervention costs vary by type of intervention and by community size.

Findings of a Formative Evaluation of a Transitional Housing Program for Forensic Patients Discharged into the Community

ERIC Educational Resources Information Center

Cherner, Rebecca; Nandlal, Joan; Ecker, John; Aubry, Tim; Pettey, Donna

2013-01-01

Using results from a formative evaluation, this article describes the transitional rehabilitation housing pilot (TRHP) program located in two metropolitan Canadian cities. TRHP is an innovative community mental health service, created to support hospitalized forensic patients in their transition to living independently in the community. The…

It Takes a Community

ERIC Educational Resources Information Center

Jacobson, Reuben; Villarreal, Lisa; Muñoz, José; Mahaffey, Robert

2018-01-01

Community schools are a sound education reform strategy that gets results. They start by asking local students and their families what they need to succeed in school, then they reach out to relevant community partners and use the school as the hub for organizing partnerships, services, and supports. By listening closely to the assets and needs of…

Integrated Services and Supports in Oakland Community Schools. Knowledge Brief

ERIC Educational Resources Information Center

John W. Gardner Center for Youth and Their Communities, 2015

2015-01-01

This brief is part of a series that shares findings from a research collaboration between the John W. Gardner Center for Youth and Their Communities at Stanford University and Oakland Unified School District (OUSD) focused on understanding implementation of the community school model in the district. This brief highlights findings related to…

A Healthy Harvest: Adolescents Grow Food and Well-Being with Policy Implications for Education, Health and Community Planning

ERIC Educational Resources Information Center

Pevec, Illene Susan

2011-01-01

The severe youth health crisis involving overweight and obesity requires a complex policy response involving multiple domains: education, agriculture, health services, and community planning. This research examines gardening's affective benefits for adolescents and the potential school and youth gardens have to support healthy communities.…

Understanding the Academic Struggles of Community College Student Athletes

ERIC Educational Resources Information Center

Demas, Jason

2017-01-01

When students begin their education at community colleges, they may face more obstacles to obtaining their college education than students starting in four-year institutions. Research has shown the importance of academic and student services in the support of student athletes, that community college student athletes are often at academic risk, and…

The Caring Business: Lynch Community Homes, Willow Grove, Pennsylvania. A Case Study.

ERIC Educational Resources Information Center

Bogdan, Robert

This paper, one of a series of reports describing innovative practices in integrating people with disabilities into community life, describes the Lynch Community Homes in Willow Grove, Pennsylvania. Lynch Homes is a for-profit organization that provides homes and supportive services for approximately 75 people with severe and profound…

Community College Support Service and Activity Program for the Disabled Student.

ERIC Educational Resources Information Center

Katz, David; Flugman, Bert

Through a series of conferences and workshops held since 1973, the Institute for Research and Development in Occupational Education has been collaborating with community college teams to respond to the educational and occupational needs of disabled students. The program for fiscal year 1977 involved 24 community colleges in New York state and…

Retention challenge facing Australia's rural community mental health services: Service managers' perspectives.

PubMed

Cosgrave, Catherine; Hussain, Rafat; Maple, Myfanwy

2015-10-01

This paper aims to contribute to the development of a more sustainable Australian rural community mental health workforce by comparing the findings from a literature search investigating impacting factors on retention with the experiences of community mental health service managers running services in rural Australia. Semi-structured interviews. Public health sector, rural New South Wales. Five community mental health managers, running services in rural Australia. Interviews were undertaken as a pilot for a broader qualitative study investigating factors influencing the decision to stay or leave among community mental health professionals working in rural positions. The purpose of undertaking this pilot study was to test for validity and relevance of the retention phenomena and help inform the research design for the main study. Three key retention focussed themes were identified: (i) Staffing is a persistent challenge; (ii) Small remote towns pose the biggest challenge; and (iii) The decision to stay or leave is complex and multifactorial. The findings of this pilot study support previous research and contribute to the understanding of influences on retention among health professionals working in rural community mental health services. Importantly, those who have worked for several years in rural positions hold important information through which to explore factors that impact retention in rural and remote regions. © 2015 National Rural Health Alliance Inc.

The role of a community coalition in the development of health services for the poor and uninsured.

PubMed

Bibeau, D L; Howell, K A; Rife, J C; Taylor, M L

1996-01-01

Access to primary health care for indigent citizens presents a dilemma for many communities in the United States. In response, communities have developed a variety of strategies to effectively deal with the problem. This article describes the evolution of a small free clinic into a comprehensive primary care clinic developed through the actions of a community-based coalition. The clinic originated within an umbrella organization for indigent residents as free medical service provided at a night shelter by a local physician once a week. Through a coalition of business, religious, medical, hospital, foundation, lay volunteer, county health department, and chamber of commerce representatives, the service was enlarged into a formal clinic operation with a small staff and volunteers providing services for about 3,500 patient visits each year. As the demand for services increased beyond resources, an expanded coalition created HealthServe Medical Center, a comprehensive primary care clinic operating 40 hours per week. The HealthServe Board is currently active in supporting service delivery at the clinic, with plans to serve 24,000 medical and dental visits annually by mid-1995. The evolution process was based upon the characteristics of effective community coalitions and the commitment of individuals from diverse community sectors.

Supporting Collaborative Model and Data Service Development and Deployment with DevOps

NASA Astrophysics Data System (ADS)

David, O.

2016-12-01

Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.

Antenatal peer support workers and initiation of breast feeding: cluster randomised controlled trial.

PubMed

MacArthur, Christine; Jolly, Kate; Ingram, Lucy; Freemantle, Nick; Dennis, Cindy-Lee; Hamburger, Ros; Brown, Julia; Chambers, Jackie; Khan, Khalid

2009-01-30

To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. Cluster randomised controlled trial. Community antenatal clinics in one primary care trust in a multiethnic, deprived population. 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 weeks' gestation within the antenatal clinic or at home. The trained peer support workers were of similar ethnic and sociodemographic backgrounds to their clinic population. Initiation of breast feeding obtained from computerised maternity records of the hospitals where women from the primary care trust delivered. The sample was multiethnic, with only 9.4% of women being white British, and 70% were in the lowest 10th for deprivation. Most of the contacts with peer support workers took place in the antenatal clinics. Data on initiation of breast feeding were obtained for 2398 of 2511 (95.5%) women (1083/1140 intervention and 1315/1371 controls). The groups did not differ for initiation of breast feeding: 69.0% (747/1083) in the intervention group and 68.1% (896/1315) in the control groups; cluster adjusted odds ratio 1.11 (95% confidence interval 0.87 to 1.43). Ethnicity, parity, and mode of delivery independently predicted initiation of breast feeding, but randomisation to the peer support worker service did not. A universal service for initiation of breast feeding using peer support workers provided within antenatal clinics serving a multiethnic, deprived population was ineffective in increasing initiation rates. Current Controlled Trials ISRCTN16126175.

A national campaign to finance supported employment.

PubMed

Hogan, Michael F; Drake, Robert E; Goldman, Howard H

2014-06-01

Medicaid is now the main payment source and financing mechanism for services for adults with serious mental illness. Services formerly paid with state mental health funds have been converted to Medicaid, lightening the burden on state budgets affected by recession and other factors. The change has allowed states to maintain community care and inpatient services (in general hospitals). Medicaid service benefits include clinic and inpatient care, case management, and some rehabilitation services. But using Medicaid to finance some high-priority services such as supported employment has proven difficult. Now critical changes in Medicaid under the Affordable Care Act allow states to amend their Medicaid State Plans to provide more flexible services to people with serious mental illness. Advocacy and support may be needed to encourage this step. A national campaign to finance supported employment would join various stakeholders in the field, including professional organizations, family and service user groups, and organizations representing service providers. The authors of this editorial pledge their energies to support this campaign. They present suggestions for a campaign, including building a coalition, goals and targets, and online resources.

What is “Support” in Supportive Housing: Client and Service Providers’ Perspectives

PubMed Central

Owczarzak, Jill; Dickson-Gomez, Julia; Convey, Mark; Weeks, Margaret

2014-01-01

Supportive housing programs are proposed as a way of increasing housing access and stability for the chronically homeless, improving access to needed services, and decreasing vulnerability to HIV and other diseases. Little is known about residents’ understandings of and experiences with different models of supportive housing and how they fit within residents’ broader strategies to maintain housing. We conducted semi-structured interviews with 23 residents and 10 service providers from nine different supportive housing programs in Hartford, Connecticut. Data analysis explored residents’ perceptions of and experiences with supportive housing programs in the context of strategies to access resources and receive emotional, financial, and other forms of support. Themes of independence, coercion, and choice pervaded participants’ narratives of their experiences accessing services. Concerns with privacy influenced the types of relationships residents formed with program staff and clients. Findings illustrate the need for more ethnographic studies of how supportive housing services are delivered by community agencies and accessed by clients. PMID:25477620

The Research and Application of Information Platform About Community Support Intervention for Patients with Alcohol Dependence.

PubMed

Yang, Liqun

2016-01-01

Through the establishment of electronic health records, health education and measures such as regional information sharing platform, we explored the management of patients with alcohol dependence living in communities and established a medical information resource sharing model between mental hospital-community to strengthen the supportive intervention management of patients with alcohol dependence, improve the effect of intervention and reduce the rate of compound drink. To design the questionnaire of health state for patients with alcohol dependence. After data collection. We should establish electronic health records and community support intervention, make medical health card with terminal configuration card reader in both mental hospitals and community, develop information platform, establish a variety of supporting interventions and the service function modules, unblock information sharing between hospitals and community to make full use of the platform to carry out health education and health intervention management. The effectives of community supportive intervention are improved, rehabilitation rate of patients is reduced greatly, bad ways of life behavior are better. Establishing electronic health records is an important mean of community supportive interventions which is good for Real-time, dynamic management and promoting self-management skills making the dream of medical information resource between hospital-community sharing come true.

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru

PubMed Central

Perez-Brumer, Amaya G.; Reisner, Sari L.; McLean, Sarah A.; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H.; Sanchez, Jorge; Clark, Jesse L.; Mimiaga, Matthew J.; Lama, Javier R.

2017-01-01

Abstract Introduction: In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Methods: Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18–44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Results: Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). Conclusion: This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts. PMID:28362064

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru.

PubMed

Perez-Brumer, Amaya G; Reisner, Sari L; McLean, Sarah A; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Lama, Javier R

2017-02-28

In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts.

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 important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: a study protocol.

PubMed

Jull, Janet; Mazereeuw, Maegan; Sheppard, Amanada; Kewayosh, Alethea; Steiner, Richard; Graham, Ian D

2018-01-01

Tailoring and testing a peer support decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol.First Nations, Inuit and Métis (FNIM) people face higher risks for cancer compared to non-FNIM populations. They also face cultural barriers to health service use. Within non-FNIM populations an approach to health decision making, called shared decision making (SDM), has been found to improve the participation of people in their healthcare. Peer support with SDM further improves these benefits. The purpose of this study is to tailor and test a peer support SDM strategy with community support workers to increase FNIM people's participation in their cancer care.This project has two phases that will be designed and conducted with a Steering Committee that includes members of the FNIM and cancer care communities. First, a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings, and training in the SDM strategy developed for community support workers. Three communities will be supported for participation in the study and community support workers who are peers from each community will be trained to use the SDM strategy.Next, each community support worker will work with a community member who has a diagnosis of cancer or who has supported a family member with cancer. Each community support worker and community member pair will use the SDM strategy. The participation and experience of the community support worker and community member will be evaluated.The research will be used to develop strategies to support people who are making decisions about their health. Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol Background First Nations, Inuit and Métis ("FNIM") people face increased cancer risks in relation to general populations and experience barriers to health service use. Shared decision making (SDM) has been found to improve peoples' participation and outcomes in healthcare and peer support with SDM further improves these benefits. The purpose of this study is to tailor and then field test, by and with FNIM communities, a peer support SDM strategy for use in cancer care. Methods This project has 2 theory-driven phases and 5 stages (a-e). A core research team that includes members of the Aboriginal Cancer Control Unit of Cancer Care Ontario communities and academic researchers, will work with a Steering Committee. In phase 1 , (stage a) a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings and (stage b), training developed that will i) introduce participant communities to SDM, and ii) train community support workers (CSWs) within these communities. Next (stage c), three communities will be approached for voluntary participation in the study. These communities will be introduced to SDM in community meetings, and if in agreement then CSWs from each community will be recruited to participate in the study. One volunteer CSW from each community will be trained to use the peer support SDM strategy to enable phase 2 (field test of the peer support SDM strategy).During phase 2 (stage d), each CSW will be matched to a volunteer community member who has had a diagnosis of cancer or has supported a family member with cancer and is familiar with Ontario cancer systems. Each CSW-community member pair (3 to 4 pairs/community) will use the tailored peer support SDM strategy; their interaction will be audio-recorded and their participation and experience evaluated (total of 9 to 12 interviews). As well (stage e), data will be collected on health systems' factors related to the use of the peer support SDM strategy. Discussion Findings will develop peer support SDM strategies to enhance participation of FNIM people in cancer care decisions, advance knowledge translation science, and support a proposal to conduct a multi-site implementation trial.

[The regional cooperation of medical services and a nutritional support team].

PubMed

Maruyama, Michio

2006-12-01

"Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.