Using community-based participatory research to develop the PARTNERS youth violence prevention program.

PubMed

Leff, Stephen S; Thomas, Duane E; Vaughn, Nicole A; Thomas, Nicole A; MacEvoy, Julie Paquette; Freedman, Melanie A; Abdul-Kabir, Saburah; Woodlock, Joseph; Guerra, Terry; Bradshaw, Ayana S; Woodburn, Elizabeth M; Myers, Rachel K; Fein, Joel A

2010-01-01

School-based violence prevention programs have shown promise for reducing aggression and increasing children's prosocial behaviors. Prevention interventions within the context of urban after-school programs provide a unique opportunity for academic researchers and community stakeholders to collaborate in the creation of meaningful and sustainable violence prevention initiatives. This paper describes the development of a collaborative between academic researchers and community leaders to design a youth violence prevention/leadership promotion program (PARTNERS Program) for urban adolescents. Employing a community-based participatory research (CBPR) model, this project addresses the needs of urban youth, their families, and their community. Multiple strategies were used to engage community members in the development and implementation of the PARTNERS Program. These included focus groups, pilot testing the program in an after-school venue, and conducting organizational assessments of after-school sites as potential locations for the intervention. Community members and academic researchers successfully worked together in all stages of the project development. Community feedback helped the PARTNERS team redesign the proposed implementation and evaluation of the PARTNERS Program such that the revised study design allows for all sites to obtain the intervention over time and increases the possibility of building community capacity and sustainability of programs. Despite several challenges inherent to CBPR, the current study provides a number of lessons learned for the continued development of relationships and trust among researchers and community members, with particular attention to balancing the demand for systematic implementation of community-based interventions while being responsive to the immediate needs of the community.

A Case Study of Peer Educators in a Community-Based Program to Reduce Teen Pregnancy: Selected Characteristics Prior to Training, Perceptions of Training and Work, and Perceptions of How Participation in the Program Has Affected Them

ERIC Educational Resources Information Center

Beshers, Sarah C.

2007-01-01

This investigation is a case study of peer educators in a community-based teen pregnancy prevention program. Research questions focused on identifying ways in which peer educators differed from other teens and exploring the perceptions of the peer educators about their experience in the program and the ways in which it has affected them. Data were…

Evaluation of a community based childhood injury prevention program.

PubMed Central

Bablouzian, L.; Freedman, E. S.; Wolski, K. E.; Fried, L. E.

1997-01-01

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in a home visiting program that augments existing health and human services, received initial home safety assessments. Clients received education about injury prevention practices, in addition to receiving selected home safety supplies. Fourteen questions from the initial assessment tool were repeated upon discharge from the program. Matched analyses were conducted to evaluate differences from initial assessment to discharge. RESULTS: A significantly larger proportion of homes were assessed as safe at discharge, compared with the initial assessment, for the following hazards: children riding unbuckled in all auto travel, Massachusetts Poison Center sticker on the telephone, outlet plugs in all unused electrical outlets, safety latches on cabinets and drawers, and syrup of ipecac in the home. CONCLUSIONS: A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety. PMID:9113841

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

PubMed Central

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

2013-01-01

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

Why Parents Matter!: The Conceptual Basis for a Community-Based HIV Prevention Program for the Parents of African American Youth

ERIC Educational Resources Information Center

Dittus, Patricia; Miller, Kim S.; Kotchick, Beth A.; Forehand, Rex

2004-01-01

The Parents Matter! Program (PMP) is a community-based family intervention designed to promote positive parenting and effective parent-child communication about sexuality and sexual risk reduction. Its ultimate goal is to reduce sexual risk behavior among adolescents. PMP offers parents instruction and guidance in general parenting skills related…

Improved Physical Fitness among Older Female Participants in a Nationally Disseminated, Community-Based Exercise Program

ERIC Educational Resources Information Center

Seguin, Rebecca A.; Heidkamp-Young, Eleanor; Kuder, Julia; Nelson, Miriam E.

2012-01-01

Background: Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. Method: The StrongWomen Program is a nationally…

Exercise and Fall Prevention: Narrowing the Research-to-Practice Gap and Enhancing Integration of Clinical and Community Practice.

PubMed

Li, Fuzhong; Eckstrom, Elizabeth; Harmer, Peter; Fitzgerald, Kathleen; Voit, Jan; Cameron, Kathleen A

2016-02-01

Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence-based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence-to-practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Community-based approaches to strategic environmental assessment: Lessons from Costa Rica

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

Sinclair, A. John; Sims, Laura; Spaling, Harry

This paper describes a community-based approach to strategic environmental assessment (SEA) using a case study of the Instituto Costarricense de Electricidad's (ICE) watershed management agricultural program (WMAP) in Costa Rica. The approach focused on four highly interactive workshops that used visioning, brainstorming and critical reflection exercises. Each workshop represented a critical step in the SEA process. Through this approach, communities in two rural watersheds assessed the environmental, social and economic impacts of a proposed second phase for WMAP. Lessons from this community-based approach to strategic environmental assessment include a recognition of participants learning what a participatory SEA is conceptually andmore » methodologically; the role of interactive techniques for identifying positive and negative impacts of the proposed program and generating creative mitigation strategies; the effect of workshops in reducing power differentials among program participants (proponent, communities, government agencies); and, the logistical importance of notice, timing and location for meaningful participation. The community-based approach to SEA offers considerable potential for assessing regional (watershed) development programs focused on sustainable resource-based livelihoods.« less

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador.

PubMed

Mitchell-Foster, Kendra; Ayala, Efraín Beltrán; Breilh, Jaime; Spiegel, Jerry; Wilches, Ana Arichabala; Leon, Tania Ordóñez; Delgado, Jefferson Adrian

2015-02-01

This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador. An integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS. Overall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction. In the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.

A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women

PubMed Central

Cornell, C. E.; Littleton, M. A.; Greene, P. G.; Pulley, L.; Brownstein, J. N.; Sanderson, B. K.; Stalker, V. G.; Matson-Koffman, D.; Struempler, B.; Raczynski, J. M.

2009-01-01

The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community’s physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention. PMID:19047648

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

PubMed Central

Mitchell-Foster, Kendra; Ayala, Efraín Beltrán; Breilh, Jaime; Spiegel, Jerry; Wilches, Ana Arichabala; Leon, Tania Ordóñez; Delgado, Jefferson Adrian

2015-01-01

Background This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador. Methods An integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS. Results Overall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction. Conclusions In the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects. PMID:25604763

A Model Program for Churches and Ex-Offender Reintegration.

ERIC Educational Resources Information Center

O'Connor, Thomas; Ryan, Patricia; Parikh, Crystal

1998-01-01

Prison Fellowship Ministries' church and community based Transition of Prisoners (TOP) program in Detroit is examined. TOP mobilizes, trains, and equips primarily African-American churches and volunteers to assist ex-offenders to successfully reintegrate into their community. Preliminary outcome data suggest that participation in TOP reduces need…

Expanding the chronic care framework to improve diabetes management: the REACH case study.

PubMed

Jenkins, Carolyn; Pope, Charlene; Magwood, Gayenell; Vandemark, Lisa; Thomas, Virginia; Hill, Karen; Linnen, Florene; Beck, Lorna Shelton; Zapka, Jane

2010-01-01

Reducing the burden of chronic conditions among minorities requires novel approaches to prevent and manage disease. This paper describes the expansion of the Chronic Care Model (CCM) to include a community focus for improving diabetes self-management and reducing health disparities. The literature review assesses the concept of "community" in improving outcomes as viewed by proponents of the CCM for chronic disease. The CCM was then modified and informed by experiences of a major community-based participatory action initiative to improve diabetes outcomes, the Racial and Ethnic Approaches to Community Health (REACH) Charleston and Georgetown Diabetes Coalition. Based on our experiences with community-based and health systems diabetes interventions, we present examples of improvements within both health delivery practice sites and other community systems that are essential for improving diabetes outcomes and reducing disparities. Building on the Centers for Disease Control and Prevention's (CDC) principles of community involvement, our coalition activities provide examples of working with community partners to frame this enhanced ecologically grounded Community CCM (CCCM). The resulting CCCM integrates expanded conceptual frameworks, evidence-based practice, community-based evidence and participatory actions, and highlights the possibilities and challenges for improving chronic disease outcomes and reducing disparities via community programs that foster individual, systems, community, and policy change.

RESOLV: Development of a Telephone-Based Program Designed to Increase Socialization in Older Veterans

ERIC Educational Resources Information Center

Gould, Christine E.; Shah, Shruti; Brunskill, Sarah R.; Brown, Krista; Oliva, Nancy L.; Hosseini, Charissa; Bauer, Elizabeth; Huh, J. W. Terri

2017-01-01

We describe the development of a telephone-based program, Recreation, Education, and Socialization for Older Learning Veterans (RESOLV) that aims to connect Veterans with one another by phone and thereby reduce loneliness. The program was developed through a collaboration between VA and a community-based organization, Episcopal Senior Communities…

Pediatric obesity community programs: barriers & facilitators toward sustainability.

PubMed

Po'e, Eli K; Gesell, Sabina B; Lynne Caples, T; Escarfuller, Juan; Barkin, Shari L

2010-08-01

Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.

Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial.

PubMed

Rapkin, Bruce D; Weiss, Elisa; Lounsbury, David; Michel, Tamara; Gordon, Alexis; Erb-Downward, Jennifer; Sabino-Laughlin, Eilleen; Carpenter, Alison; Schwartz, Carolyn E; Bulone, Linda; Kemeny, Margaret

2017-09-01

Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities. © Society for Community Research and Action 2017.

A randomized controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson's disease: study rationale and protocol.

PubMed

Peters, Catherine; Currin, Michelle; Tyson, Sara; Rogers, Anthea; Healy, Susan; McPhail, Steven; Brauer, Sandra G; Heathcote, Katharine; Comans, Tracy

2012-01-09

Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson's disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.

Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

PubMed Central

Stillwaggon, Eileen; Sawers, Larry; Rout, Jonathan; Addiss, David; Fox, LeAnne

2016-01-01

Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense. PMID:27573626

Involving Communities in the Targeting of Cash Transfer Programs for Vulnerable Children: Opportunities and Challenges☆

PubMed Central

Robertson, Laura; Mushati, Phyllis; Skovdal, Morten; Eaton, Jeffrey W.; Makoni, Jeremiah C.; Crea, Tom; Mavise, Gideon; Dumba, Lovemore; Schumacher, Christina; Sherr, Lorraine; Nyamukapa, Constance; Gregson, Simon

2014-01-01

Summary We used baseline data, collected in July–September 2009, from a randomized controlled trial of a cash transfer program for vulnerable children in eastern Zimbabwe to investigate the effectiveness, coverage, and efficiency of census- and community-based targeting methods for reaching vulnerable children. Focus group discussions and in-depth interviews with beneficiaries and other stakeholders were used to explore community perspectives on targeting. Community members reported that their participation improved ownership and reduced conflict and jealousy. However, all the methods failed to target a large proportion of vulnerable children and there was poor agreement between the community- and census-based methods. PMID:24748713

Strong Hearts, healthy communities: a rural community-based cardiovascular disease prevention program.

PubMed

Seguin, Rebecca A; Eldridge, Galen; Graham, Meredith L; Folta, Sara C; Nelson, Miriam E; Strogatz, David

2016-01-28

Cardiovascular disease is the leading cause of death in the United States and places substantial burden on the health care system. Rural populations, especially women, have considerably higher rates of cardiovascular disease, influenced by poverty, environmental factors, access to health care, and social and cultural attitudes and norms. This community-based study will be a two-arm randomized controlled efficacy trial comparing a multi-level, community program (Strong Hearts, Healthy Communities) with a minimal intervention control program (Strong Hearts, Healthy Women). Strong Hearts, Healthy Communities was developed by integrating content from three evidence-based programs and was informed by extensive formative research (e.g. community assessments, focus groups, and key informant interviews). Classes will meet twice weekly for one hour for 24 weeks and focus on individual-level skill building and behavior change; social and civic engagement are also core programmatic elements. Strong Hearts, Healthy Women will meet monthly for hour-long sessions over the 24 weeks covering similar content in a general, condensed format. Overweight, sedentary women 40 years of age and older from rural, medically underserved communities (12 in Montana and 4 in New York) will be recruited; sites, pair-matched based on rurality, will be randomized to full or minimal intervention. Data will be collected at baseline, midpoint, intervention completion, and six-month, one-year, and eighteen months post-intervention. The primary outcome is change in body weight; secondary outcomes include physiologic, anthropometric, behavioral, and psychosocial variables. In the full intervention, engagement of participants' friends and family members in partnered activities and community events is an intervention target, hypothesizing that there will be a reciprocal influence of physical activity and diet behavior between participants and their social network. Family members and/or friends will be invited to complete baseline and follow-up questionnaires about their health behaviors and environment, height and weight, and attitudes and beliefs. Strong Hearts, Healthy Communities aims to reduce cardiovascular disease morbidity and mortality, improve quality of life, and reduce cardiovascular disease-related health care burden in underserved rural communities. If successful, the long-term goal is for the program to be nationally disseminated, providing a feasible model to reduce cardiovascular disease in rural settings. ClinicalTrials.gov Identifier: NCT02499731 Registered on July 1, 2015.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey

ERIC Educational Resources Information Center

Culler, Corinna S.; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M.

2017-01-01

Background: School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing…

Reduced-risk pest management programs for eastern U.S. peach orchards: effects on arthropod predators, parasitoids, and select pests.

PubMed

Biddinger, David J; Leslie, Timothy W; Joshi, Neelendra K

2014-06-01

We developed new integrated pest management programs for eastern U.S. peaches with minimal use of organophosphates. From 2002-2005, we assessed the ecological impacts of these reduced-risk programs versus grower standard conventional programs that still relied primarily on the use of organophosphorous and carbamate insecticides. Using a split-plot design replicated at four commercial Pennsylvania peach orchards, we quantified pesticide rates, environmental impact, and arthropod community response. We used Environmental Impact Quotient (EIQ) analysis based on the growers' pesticide records from each orchard to calculate seasonal cumulative EIQ field ratings for all years. Ecological effects of the reduced-risk and conventional program were also measured as the abundance and diversity of nontarget arthropod predators, parasitoids, and selected pest taxa. Pesticide inputs and EIQ values were substantially lower in reduced-risk programs compared with conventional spray programs. Arthropod arrays differed significantly between pest management programs: most beneficial predator and parasitoid taxa were positively associated with the reduced-risk program and negatively associated with the standard grower program. Regardless of the pest management program, we observed significant differences in species arrays in the peach tree canopy compared with the ground cover of the orchards, but the arthropod community did not differ among the field sites or based on distance from the edge of the orchard. We conclude that reduced-risk programs not only provide control comparable with that of conventional programs, but they also reduce negative environmental effects while conserving key arthropod biological control agents within eastern U.S. peach orchards.

The outdoor air quality flag program in central California: a school-based educational intervention to potentially help reduce children's exposure to environmental asthma triggers.

PubMed

Shendell, Derek G; Rawling, Mary-Michal; Foster, Christine; Bohlke, Alicia; Edwards, Bobbie; Rico, Susie A; Felix, Justina; Eaton, Sandra; Moen, Stephanie; Roberts, Eric M; Love, Mary Beth

2007-10-01

This paper describes a novel school-based, visual environmental public health educational intervention intended to help reduce the exposure of children-and adults-to outdoor air pollution, including known environmental asthma triggers like ozone and particles. The overarching goal was to enhance the learning, recreational, and work environments of students and staff. The specific purpose of the Asthma-Friendly Outdoor (Ambient) Air Quality Flag Program was to establish an education and communication tool for Central California communities that would accomplish two things: (1) Establish permanent local policy change to existing operating procedures in school districts and schools to help reduce the exposure of students, teachers, staff, and nearby communities to outdoor environmental asthma triggers and (2) provide education on air quality and potential health effects of exposure to air pollutants. Data on the program from its initial years are presented. To date, the following important lessons have been learned: (1) Science-based, simple, visual, low-cost school-based educational interventions to help reduce human exposure to outdoor environmental asthma triggers (i.e., ozone, particles, and pollens) can work in socioeconomically and ethnically diverse urban and rural or agricultural communities, and (2) local health and environmental justice groups such as asthma coalitions can successfully lead school-based environmental interventions to help improve children's quality of life.

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

PubMed Central

Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

2016-01-01

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

PubMed

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

PubMed

House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

2017-03-01

To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Designing and pilot-testing a church-based community program to reduce obesity among African Americans.

PubMed

Cowart, Luvenia W; Biro, Diana J; Wasserman, Timothy; Stein, Ruth Federman; Reider, Lindsey R; Brown, Betty

2010-01-01

Obesity raises the risk for many chronic diseases and poor health outcomes. African Americans have the highest rates of excess weight in the nation, and standard weight management programs have not worked well with this population. The Genesis Health Project, a community-designed, culturally competent intervention to reduce obesity and promote healthy lifestyles, represents a successful partnership among Syracuse University, local Black churches, and several sponsors to empower families of color to adopt and sustain positive health practices across the lifespan. This article describes the Phase I design and pilot-testing of this demonstration project, and reports the results of the first-year nutrition education/exercise-fitness program. Participant feedback indicates notable shifts toward healthier food choices, cooking methods, and exercise habits, as well as increased motivation, improved health indicators, and revamped church menus. Lessons learned from this project can be helpful in developing other community/faith-based health promotion programs for African Americans.

Using Social Network Analysis to Evaluate Community Capacity Building of a Regional Community Cancer Network

ERIC Educational Resources Information Center

Luque, John; Tyson, Dinorah Martinez; Lee, Ji-Hyun; Gwede, Clement; Vadaparampil, Susan; Noel-Thomas, Shalewa; Meade, Cathy

2010-01-01

The Tampa Bay Community Cancer Network (TBCCN) is one of 25 Community Network Programs funded by the National Cancer Institute's (NCI's) Center to Reduce Cancer Health Disparities with the objectives to create a collaborative infrastructure of academic and community based organizations and to develop effective and sustainable interventions to…

Offense History and the Effectiveness of Juvenile Diversion Programs.

ERIC Educational Resources Information Center

Osgood, D. Wayne; And Others

Some evaluations have concluded that diversion programs for juvenile offenders (programs intended as community-based alternatives to formal justice dispositions) reduce recidivism only among youths with the least serious offense histories. To investigate the relationship of offense history to program effectiveness, three diversion programs were…

The development of a culturally appropriate school based intervention for Australian Aboriginal children living in remote communities: A formative evaluation of the Alert Program® intervention.

PubMed

Wagner, Bree; Fitzpatrick, James; Symons, Martyn; Jirikowic, Tracy; Cross, Donna; Latimer, Jane

2017-06-01

Although previous research has demonstrated the benefits of targeting self-regulation in non-Aboriginal children, it is unclear whether such programs would be effective for Aboriginal children attending school in remote communities. Some of these children have been diagnosed with a fetal alcohol spectrum disorder (FASD) impairing their ability to self-regulate. The aim of this article is to describe a three phase formative process to develop and pilot a curriculum version of the Alert Program ® , a promising intervention for improving self-regulation that could be used in remote community schools. This modified version of the program will be subsequently tested in a cluster randomised controlled trial. A mixed methods approach was used. Modifications to the Alert Program ® , its delivery and evaluation were made after community and stakeholder consultation facilitated by a senior Aboriginal community researcher. Changes to lesson plans and program resources were made to reflect the remote community context, classroom environment and the challenging behaviours of children. Standardised study outcome measures were modified by removing several questions that had little relevance to the lives of children in remote communities. Program training for school staff was reduced in length to reduce staff burden. This study identified aspects of the Alert Program ® training, delivery and measures for evaluation that need modification before their use in assessing the efficacy of the Alert Program ® in remote Aboriginal community primary schools. © 2016 Occupational Therapy Australia.

Recommendation for Center-Based Early Childhood Education to Promote Health Equity.

PubMed

2016-01-01

The Community Preventive Services Task Force recommends early childhood education programs based on strong evidence of effectiveness in improving educational outcomes associated with long-term health and sufficient evidence of effectiveness in improving social- and health-related outcomes. When provided to low-income or racial and ethnic minority communities, early childhood education programs are likely to reduce educational achievement gaps, improve the health of low-income student populations, and promote health equity.

PlainTalk Starter Kit: A Practical Guide to Community-Based Programming To Reduce Teen Pregnancy, STDs and HIV/AIDS.

ERIC Educational Resources Information Center

Douglas, Elaine

Plain Talk is a community-based initiative designed to assist neighborhood groups and residents in creating and implementing locally acceptable and effective strategies to protect sexually active youth from pregnancy. Plain Talk aims to affect individual, neighborhood, and community behavior through a process that focuses on helping adults develop…

Community-wide interventions for tobacco control.

PubMed

Cummings, K M

1999-01-01

This article describes the rationale and evidence supporting community-wide interventions for tobacco control. Data were collected from published evaluation studies, government reports, and commentaries that describe the use of community-based approaches to tobacco control. Community-wide interventions attempt to change tobacco use in populations--not just individuals--and have increasingly begun to focus on influencing policies that promote and/or tolerate tobacco use. Examples of community-based tobacco-control activities include organizing community groups to advocate adoption of tobacco-control ordinances (e.g., smoke-free restaurants, ban on self-service tobacco displays); media advocacy to raise public awareness about illegal tobacco sales to minors; paid counter-advertising; and sponsorship of community-wide stop-smoking events such as a quit-and-win contest. Evidence in support of the effectiveness of community-based interventions to reduce smoking is found in the consistently sharper decline in tobacco consumption observed in states that have invested in comprehensive tobacco-prevention and control programs compared to those that have not. However, the results from several randomized controlled trials of community-based tobacco-control interventions have been disappointing in demonstrating large-scale changes in tobacco use. Although there appears to be a wide consensus that community-based approaches to tobacco control are an important part of a comprehensive program to reduce tobacco use, the essential elements and methods of implementation of some community-based tobacco-control efforts are less well defined. Also, given the dynamic nature of community tobacco-control interventions, the traditional randomized controlled trial model probably is not applicable for evaluation purposes. It is more likely that research models based on time-series designs will be most applicable for evaluating the impact of community-based interventions.

Informing best practice with community practice: the community change chronicle method for program documentation and evaluation.

PubMed

Scott, Sheryl A; Proescholdbell, Scott

2009-01-01

Health promotion professionals are increasingly encouraged to implement evidence-based programs in health departments, communities, and schools. Yet translating evidence-based research into practice is challenging, especially for complex initiatives that emphasize environmental strategies to create community change. The purpose of this article is to provide health promotion practitioners with a method to evaluate the community change process and document successful applications of environmental strategies. The community change chronicle method uses a five-step process: first, develop a logic model; second, select outcomes of interest; third, review programmatic data for these outcomes; fourth, collect and analyze relevant materials; and, fifth, disseminate stories. From 2001 to 2003, the authors validated the use of a youth empowerment model and developed eight community change chronicles that documented the creation of tobacco-free schools policies (n = 2), voluntary policies to reduce secondhand smoke in youth hangouts (n = 3), and policy and program changes in diverse communities (n = 3).

Lessons Learned From Community-Based Approaches to Sodium Reduction

PubMed Central

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

Helping Moms, Saving Babies: Faith-Based Partnerships to Reduce Prematurity in the African American Community

ERIC Educational Resources Information Center

Lewis, LaToya L.

2008-01-01

The March of Dimes, Texas Chapter, partnered with the faith community to pilot Honey Child[SM], a prenatal education program for African American women. The program is designed to combat prematurity, which is the leading cause of death for African American infants. Honey Child uses a spiritual approach to promote prenatal health through…

Community-Based Violence Prevention: An Assessment of Pittsburgh's One Vision One Life Program. Monograph

ERIC Educational Resources Information Center

Wilson, Jeremy M.; Chermak, Steven; McGarrell, Edmund F.

2010-01-01

In 2006, more than 6 million individuals were victimized by violent crimes. Although violence is below levels of the early 1990s, it remains high. The extent of violence and its impact highlight a critical need to develop and implement effective programs to reduce violence and victimization. Communities have initiated a wide range of such…

Collaborative evaluation of the healthy habits program: an effective community intervention to improve mobility and cognition of Chinese older adults living in the U.S

USDA-ARS?s Scientific Manuscript database

Objectives: There is a growing demand to reduce ethnic health disparities. The Healthy Habits Program (HHP) was implemented to provide a community-based physical activity and education intervention for Chinese older adults living in Boston, Massachusetts. This study evaluated the HHP by assessing ou...

Changes in Body Mass Index During a 3-Year Elementary School-Based Obesity Prevention Program for American Indian and White Rural Students.

PubMed

Vogeltanz-Holm, Nancy; Holm, Jeffrey

2018-04-01

Childhood obesity is a significant but largely modifiable health risk, disproportionately affecting socioeconomically disadvantaged, racial/ethnic minority, and rural children. Elementary school-aged children typically experience the greatest increases in excess weight gain and therefore are important targets for reducing adolescent and adult obesity while improving children's health. Our study evaluated outcomes of a 3-year elementary school-based program for reducing obesity in American Indian and White students attending eight rural schools in the U.S. upper Midwest. Researchers measured body mass indexes (BMI) and other health indicators and behaviors of 308 beginning third-grade students and then again at the end of students' third, fourth, and fifth grades. The primary focus of this study is a mixed multilevel longitudinal model testing changes in age- and gender-adjusted BMI z scores ( zBMI). There was a significant decrease in zBMI across the 3-year study period. Ethnicity analyses showed that White students had overall decreases in zBMI whereas American Indian students' zBMIs remained stable across the program. Comparisons with children from an age- and cohort-matched national sample provided support for the effectiveness of the school program in reducing BMI and obesity during the study period. An elementary school-based health program that addresses a range of students' obesity-related health behaviors, the school health environment, and that involves educators and parents is an effective intervention for reducing or stabilizing BMI in rural White and American Indian students. School health programs for students living in rural communities may be especially effective due to greater school and community cohesiveness, and valuing of the school's primary role in improving community health.

An Integrated Model of Co-ordinated Community-Based Care.

PubMed

Scharlach, Andrew E; Graham, Carrie L; Berridge, Clara

2015-08-01

Co-ordinated approaches to community-based care are a central component of current and proposed efforts to help vulnerable older adults obtain needed services and supports and reduce unnecessary use of health care resources. This study examines ElderHelp Concierge Club, an integrated community-based care model that includes comprehensive personal and environmental assessment, multilevel care co-ordination, a mix of professional and volunteer service providers, and a capitated, income-adjusted fee model. Evaluation includes a retrospective study (n = 96) of service use and perceived program impact, and a prospective study (n = 21) of changes in participant physical and social well-being and health services utilization. Over the period of this study, participants showed greater mobility, greater ability to meet household needs, greater access to health care, reduced social isolation, reduced home hazards, fewer falls, and greater perceived ability to obtain assistance needed to age in place. This study provides preliminary evidence that an integrated multilevel care co-ordination approach may be an effective and efficient model for serving vulnerable community-based elders, especially low and moderate-income elders who otherwise could not afford the cost of care. The findings suggest the need for multisite controlled studies to more rigorously evaluate program impacts and the optimal mix of various program components. © The Author 2014. 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.

A Randomized Trial of a Multifaceted Intervention to Reduce Falls among Community-Dwelling Adults

ERIC Educational Resources Information Center

Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.

2010-01-01

Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…

Impact of early treatment programs on HIV epidemics: An immunity-based mathematical model.

PubMed

Rahman, S M Ashrafur; Vaidya, Naveen K; Zou, Xingfu

2016-10-01

While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria. Using our model, we evaluate the effects of early treatment on the new infection transmission, disease death, basic reproduction number, HIV prevalence, and the community-level immunity. Our model predicts that the programs with early treatments significantly reduce the new infection transmission and increase the community-level immunity, but the treatments alone may not be enough to eliminate HIV epidemics. These findings, including the community-level immunity, might provide helpful information for proper implementation of HIV treatment programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Dare To Be You: A Diversion Program for First Time Juvenile Offenders.

ERIC Educational Resources Information Center

Vail, Ann; Nest, Judy

This document notes that community-based organizations such as the Cooperative Extension Service have joined the efforts to reduce juvenile delinquency through juvenile diversion programs. It then describes the "Dare to be You" program that was developed by the Colorado Cooperative Extension System. The six objectives of the program delineated in…

A Comprehensive Prevention Approach to Reducing Assault Offenses and Assault Injuries Among Youth

PubMed Central

Heinze, Justin E.; Reischl, Thomas M.; Bai, Mengqiao; Roche, Jessica S.; Morrel-Samuels, Susan; Cunningham, Rebecca M.; Zimmerman, Marc A.

2018-01-01

Since 2011, the CDC-funded Michigan Youth Violence Prevention Center (MI-YVPC), working with community partners, has implemented a comprehensive prevention approach to reducing youth violence in Flint, MI, based on public health principles. MI-YVPC employed an intervention strategy that capitalizes on existing community resources and application of evidence-based programs using a social-ecological approach to change. We evaluated the combined effect of six programs in reducing assaults and injury among 10–24 year olds in the intervention area relative to a matched comparison community. We used generalized linear mixed models to examine change in the intervention area counts of reported assault offenses and assault injury presentation relative to the comparison area over a period six years prior- and two and a half years post-intervention. Results indicated that youth victimization and assault injuries fell in the intervention area subsequent to the initiation of the interventions and that these reductions were sustained over time. Our evaluation demonstrated that a comprehensive multi-level approach can be effective for reducing youth violence and injury. PMID:26572898

Reducing overall health care costs for a city municipality: a real life community based learning model.

PubMed

Hodges, Linda C; Harper, Tricia Satkowski; Hall-Barrow, Julie; Tatom, Iris D

2004-06-01

City municipalities implementing health and wellness programs patterned after North Little Rock, Arkansas, can significantly reduce the cost of health care for employees, as well as reduce costs associated with workers' compensation claims and lost time caused by injury. In addition to primary care services, effective programs include health risk assessments through pre-placement physicals, employee physicals, drug screening, employee health and wellness promotion programs, and immunization and registry. In implementing the program, a team from the University of Arkansas for Medical Sciences College of Nursing worked with city officials to establish a steering committee, safety initiatives through first responders, systems for monitoring immunizations, criteria for pre-placement physicals, and an employee health and wellness program. While the benefits for the city are well documented, the contract also created opportunities for education, research, and services in a real life community based learning laboratory for students in the College of Nursing. In addition, it provided opportunities for faculty to participate in faculty practice and meet the College's service missions. The College's model program holds promise for use by other major health care centers across the region and nation.

Climate Masters of Nebraska: An Innovative Action-Based Approach for Climate Change Education

ERIC Educational Resources Information Center

Pathak, Tapan B.; Bernadt, Tonya; Umphlett, Natalie

2014-01-01

Climate Masters of Nebraska is an innovative educational program that strategically trains community volunteers about climate change science and corresponding ways to reduce greenhouse gas emissions in an interactive and action-based teaching environment. As a result of the program, 91% of participants indicated that they made informed changes in…

Use of Research-Based Information among Leaders of Public Health Agencies

ERIC Educational Resources Information Center

Toomey, Traci L.; Tramel, Sarah; Erickson, Darin J.; Lenk, Kathleen M.

2009-01-01

Background: Researchers have identified numerous policies and programs effective in reducing public health problems, yet many of these programs and policies have not been implemented throughout communities and states. Purpose: To assess the use of research-based information among leaders in the local public health system. Methods: We conducted a…

Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer.

PubMed

Nápoles, Anna María; Ortíz, Carmen; Santoyo-Olsson, Jasmine; Stewart, Anita L; Gregorich, Steven; Lee, Howard E; Durón, Ysabel; McGuire, Peggy; Luce, Judith

2015-07-01

We evaluated a community-based, translational stress management program to improve health-related quality of life in Spanish-speaking Latinas with breast cancer. We adapted a cognitive-behavioral stress management program integrating evidence-based and community best practices to address the needs of Latinas with breast cancer. Spanish-speaking Latinas with breast cancer were randomly assigned to an intervention or usual-care control group. Trained peers delivered the 8-week intervention between February 2011 and February 2014. Primary outcomes were breast cancer-specific quality of life and distress, and general symptoms of distress. Of 151 participants, 95% were retained at 6 months (between May 2011 and May 2014). Improvements in quality of life from baseline to 6 months were greater for the intervention than the control group on physical well-being, emotional well-being, breast cancer concerns, and overall quality of life. Decreases from baseline to 6 months were greater for the intervention group on depression and somatization. Results suggest that translation of evidence-based programs can reduce psychosocial health disparities in Latinas with breast cancer. Integration of this program into community-based organizations enhances its dissemination potential.

Barbershop Talk With Brothers: using community-based participatory research to develop and pilot test a program to reduce HIV risk among Black heterosexual men.

PubMed

Wilson, Tracey E; Fraser-White, Marilyn; Williams, Kim M; Pinto, Angelo; Agbetor, Francis; Camilien, Brignel; Henny, Kirk; Browne, Ruth C; Gousse, Yolene; Taylor, Tonya; Brown, Humberto; Taylor, Raekiela; Joseph, Michael A

2014-10-01

There is a need for feasible, evidence-based interventions that support HIV risk reduction among heterosexual Black men. In this article, we describe the process for development of the Barbershop Talk With Brothers (BTWB) program and evaluation. The BTWB program is a theoretically grounded and community-based HIV prevention program that seeks to improve individual skills and motivation to decrease sexual risk, and that builds men's interest in and capacity for improving their community's health. Formative data collection included barbershop observations and barber focus groups, brief behavioral risk assessments of men in barbershops, and focus groups and individual interviews. Based on this information and in consultation with our steering committee, we developed the BTWB program and accompanying program evaluation. From April through November 2011, 80 men were recruited and completed a baseline assessment of a pilot test of the program; 78 men completed the program and 71 completed a 3-month assessment. The pilot evaluation procedures were feasible to implement, and assessments of pre- and post-test measures indicate that key behavioral outcomes and proposed mediators of those outcomes changed in hypothesized directions. Specifically, attitudes and self-efficacy toward consistent condom use improved, and respondents reported lower levels of sexual risk behavior from baseline to follow-up (all p < 0.05). Perceptions of community empowerment also increased (p = 0.06). While HIV stigma decreased, this difference did not reach statistical significance. Our approach to community-engaged program development resulted in an acceptable, feasible approach to reaching and educating heterosexual Black men about HIV prevention in community settings.

Results of a Pilot Study to Investigate Community College Student Perceptions of the Value of an Online Health-Risk Reduction Program

ERIC Educational Resources Information Center

Donovan, Elizabeth; Hernandez, Jack; Chiauzzi, Emil; DasMahapatra, Pronabesh; Achilles, Tyler; Hemm, Amanda

2012-01-01

Health is associated with academic success. Universal, web-based interventions to reduce risks associated with alcohol and other drug use have been found to be effective at changing four-year college students' health behaviors. An online health program may also be well-suited to a community college population, as it can reach students off campus…

Rewarding Progress, Reducing Debt: Early Results from Ohio's Performance-Based Scholarship Demonstration for Low-Income Parents

ERIC Educational Resources Information Center

Cha, Paulette; Patel, Reshma

2010-01-01

This report presents early results from a rigorous evaluation of a performance-based scholarship program that was implemented at three community colleges in Ohio during the 2008-2009 academic year. The program in Ohio that is the subject of this report is part of MDRC's national Performance-Based Scholarship (PBS) Demonstration, which was launched…

What community-level strategies are needed to secure women’s property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention

PubMed Central

Dworkin, Shari L.; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women’s HIV risks, few science-based programs have focused on securing women’s land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24–30%) and property rights violations were common. The program was designed to reduce women’s HIV risk at the community level by protecting and enhancing women’s access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women’s property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention. PMID:24116828

What community-level strategies are needed to secure women's property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention.

PubMed

Dworkin, Shari L; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women's HIV risks, few science-based programs have focused on securing women's land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24-30%) and property rights violations were common. The program was designed to reduce women's HIV risk at the community level by protecting and enhancing women's access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women's property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention.

Using Interdisciplinary Research Methods to Revise and Strengthen the NWS TsunamiReadyTM Community Recognition Program

NASA Astrophysics Data System (ADS)

Scott, C.; Gregg, C. E.; Ritchie, L.; Stephen, M.; Farnham, C.; Fraser, S. A.; Gill, D.; Horan, J.; Houghton, B. F.; Johnson, V.; Johnston, D.

2013-12-01

The National Tsunami Hazard Mitigation Program (NTHMP) partnered with the National Weather Service (NWS) in early 2000 to create the TsunamiReadyTM Community Recognition program. TsunamiReadyTM, modeled after the older NWS StormReadyTM program, is designed to help cities, towns, counties, universities and other large sites in coastal areas reduce the potential for disastrous tsunami-related consequences. To achieve TsunamiReadyTM recognition, communities must meet certain criteria aimed at better preparing a community for tsunami, including specific actions within the following categories: communications and coordination, tsunami warning reception, local warning dissemination, community preparedness, and administration. Using multidisciplinary research methods and strategies from Public Health; Psychology; Political, Social and Physical Sciences and Evaluation, our research team is working directly with a purposive sample of community stakeholders in collaboration and feedback focus group sessions. Invitation to participate is based on a variety of factors including but not limited to an individual's role as a formal or informal community leader (e.g., in business, government, civic organizations), or their organization or agency affiliation to emergency management and response. Community organizing and qualitative research methods are being used to elicit discussion regarding TsunamiReadyTM requirements and the division of requirements based on some aspect of tsunami hazard, vulnerability and risk, such as proximity to active or passive plate margins or subduction zone generated tsunamis versus earthquake-landslide generated tsunamis . The primary aim of this research is to use social science to revise and refine the NWS TsunamiReadyTM Guidelines in an effort to better prepare communities to reduce risk to tsunamis.

Breast care screening for underserved African American women: Community-based participatory approach.

PubMed

Davis, Cindy; Darby, Kathleen; Moore, Matthew; Cadet, Tamara; Brown, Gwendolynn

2017-01-01

Traditional health promotion models often do not take into account the importance of shared cultural backgrounds, beliefs, and experiences unique to underserved African American women when designing community-based cancer screening and prevention programs. Thus, the purpose of this study was the development, implementation, and evaluation of a community-based participatory research (CBPR) program designed to increase breast cancer screening awareness in an underserved African American population by providing culturally appropriate social support and information. The study includes 357 African American women who participated in the program and completed the 6-month follow-up questionnaire. The program consisted of a 45-minute play, using community members and storytelling to honor and incorporate five different cultural experiences (skits) with breast care and cancer. Overall, findings indicate that the educational intervention was effective. In addition, these findings are consistent with the literature that suggests that educational interventions that include knowledge to alleviate concerns, dispel myths, and create awareness can increase breast cancer screening participation rates. Furthermore, these findings confirm the importance of CBPR in health promotion activities in reducing health and cancer disparities.

“ENHANCING LIFE AFTER CANCER IN DIVERSE COMMUNITIES”

PubMed Central

Kaur, Judith S.; Coe, Kathryn; Rowland, Julia; Braun, Kathryn L.; Conde, Francisco A.; Burhansstipanov, Linda; Heiney, Sue; Kagawa-Singer, Marjorie; Lu, Qian; Witte, Catherine

2012-01-01

Background Although large numbers of cancer survivors exist in every community, including minority communities, there is a significant gap in knowledge about best practices for these patients. Methods Community Networks Programs (CNPs) funded by the National Cancer Institute’s Center to Reduce Cancer Health Disparities, have developed and tested unique services for these communities. These programs have utilized community based participatory research techniques under a framework of diffusion of innovation and communications theory. Results This article describes some specifically tailored interventions that may be useful to a wide range of providers working with the underserved Conclusions Enhancing life after cancer can be achieved in underserved communities by supplementing local resources. PMID:22434384

Empowering Family Caregivers: The Powerful Tools for Caregiving Program

ERIC Educational Resources Information Center

Boise, Linda; Congleton, Leslie; Shannon, Kathy

2005-01-01

"Powerful Tools for Caregiving" is an education program for family caregivers of older adults. Based on a self-efficacy model, the program empowers family caregivers to reduce negative effects of caregiving and to practice self-care. Through a train-the-trainer approach, professional and community volunteers were trained as class leaders and…

A community intervention trial of multimodal suicide prevention program in Japan: a novel multimodal community intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J.

PubMed

Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori; Suzuki, Yuriko; Tajima, Miyuki; Tanaka, Eriko; Uda, Hidenori; Yonemoto, Naohiro; Yotsumoto, Toshihiko; Watanabe, Naoki

2008-09-15

To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. This study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals). The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.

Advancing Understanding of the Characteristics and Capacity of African American Women Who Serve as Lay Health Advisors in Community-Based Settings

ERIC Educational Resources Information Center

Shelton, Rachel C.; Dunston, Sheba King; Leoce, Nicole; Jandorf, Lina; Thompson, Hayley S.; Erwin, Deborah O.

2017-01-01

Lay Health Advisor (LHA) programs hold tremendous promise for reducing health disparities and addressing social determinants of health in medically underserved communities, including African American populations. Very little is understood about the capacity of LHAs in these roles and the broader contributions they make to their communities. This…

Engaging older adults in burn prevention education: results of a community-based urban initiative.

PubMed

Leahy, Nicole E; Sessler, Kelly A; Baggott, Kaitlin; Laverde, Louisa; Rabbitts, Angela; Yurt, Roger W

2012-01-01

The objective of the study is to educate New York City seniors aged 60 years and older about fire safety and burn prevention through the use of a community-based, culturally sensitive delivery platform. The ultimate goal is to reduce burn injury morbidity and mortality among this at-risk population. Programming was developed and provided to older adults attending community-based senior centers. Topics included etiology of injury, factors contributing to burn injuries, methods of prevention, emergency preparedness, and home safety. Attendees completed a postpresentation survey. Of the 234 senior centers invited to participate in the program, 64 (27%) centers requested presentations, and all received the educational programming, reaching 2196 seniors. An additional 2590 seniors received education during community-based health fairs. A majority reported learning new information, found the presentation helpful, and intended to apply this knowledge to daily routines. Data confirm that many opportunities exist to deliver culturally sensitive burn prevention programming to the older adult population of this large metropolitan area in settings that are part of their daily lives. A majority of respondents welcomed the information, perceived it as helpful, and reported that they were likely to integrate the information into their lives.

Effective prevention programs for tobacco use.

PubMed

Pentz, M A

1999-01-01

Several types of prevention programs have shown effects on delaying or reducing youth tobacco use for periods of 1-5 years or more. These are referred to as evidence-based programs. However, they are not widely used. At the same time, with few exceptions, adolescent tobacco use rates have been stable or have increased in the 1990s. The challenge for prevention is to identify critical components shared by effective prevention programs--that is, components most associated with effect, and then to evaluate factors that are most likely to promote adoption, implementation, and diffusion of effective programs across schools and communities in the United States. Effective tobacco prevention programs focus on counteracting social influences on tobacco use, include either direct training of youth in resistance and assertiveness skills or, for policy and community organization interventions, direct or indirect (through adults) training in community activism, and are mainly theory-based, with an emphasis on three levels of theory: (a) personal (attitudes, normative expectations, and beliefs); (b) social (social or group behavior); and/or (c) environmental (communications and diffusion). Program effects increase with the use of booster sessions, standardized implementor training and support, multiple program components, and multiple levels of theory. Overall, multi-component community programs that have a school program as a basis, with supportive parent, media, and community organization components, have shown the most sustained effects on tobacco use. Positive program adoption by the school or community, extent and quality of program implementation, and existence of credible networks of leaders to promote the program are critical for any effect. Research on predictors of adoption, implementation, and diffusion of evidence-based programs is scanty relative to outcome research. In addition, more research is needed on why multi-component programs appear to be most effective, whether effect is related to existing tobacco policies, whether prevention programs have differential effects on youth with different natural trajectories of tobacco use, and whether prevention programs can be used to recruit smokers into cessation programs.

Partnering with education and job and training programs for sustainable tobacco control among Baltimore african american young adults.

PubMed

Smith, Katherine Clegg; Bone, Lee; Clay, Eric A; Owings, Kerry; Thames, Sean; Stillman, Frances

2009-01-01

Young adults are generally overlooked in tobacco control initiatives, even though they are critical to sustained success. African American young adults who are not in higher education or working are particularly vulnerable to harmful tobacco use, given high smoking rates and limited access to cessation services. Guided by community-based participatory research (CBPR) principles, we sought to identify program and community-level strategies to reduce tobacco use among African American young adults in Baltimore. We describe the challenges and opportunities for integrating effective tobacco control into community-based education and job training programs for unemployed young adults. As part of a longstanding community-research partnership in Baltimore, we conducted fourteen semistructured key informant interviews with leaders from city government and education and job training programs for young adults. The research design, data collection, analysis, and dissemination all included dialogue between and active contribution by both research and community partners. Interview data were structured into opportunities (mindset for change and desire for bonds with a trusted adult), challenges (culture of fatalism, tobacco as a stress reliever, and culture of tobacco use among young adults), and possible tobacco control solutions (tobacco education designed with and for program staff and participants and integration of tobacco issues into holistic program goals and policies). The emergent themes enhance our understanding of how tobacco is situated in the lives of unemployed young adults and the potential for building sustainable, community-based public health solutions.

Policy implications of assessing the impact of community-based education on dental school finances.

PubMed

Brown, L Jackson; Bailit, Howard L

2011-10-01

Dental schools are hard pressed to find the resources to adequately fund their mission of education, research, and service. Over the years, schools have tried to make up for the loss in public funds by increasing student tuition, increasing enrollment, and reducing the growth in faculty and staff salaries and program costs. Unfortunately, these strategies have not solved the financial problems. Declining resources are threatening the future of dental education. Data presented in this report attempt to answer the following question: will community-based dental education restore the fiscal health of dental schools and provide students an equal or better education? By reducing the number of chairs per student and developing revenue-sharing relationships with community clinics, community-based dental education offers a realistic option for putting dental schools on a solid financial footing.

Outcomes from a randomized controlled trial of a multi-component alcohol use preventive intervention for urban youth: project northland Chicago.

PubMed

Komro, Kelli A; Perry, Cheryl L; Veblen-Mortenson, Sara; Farbakhsh, Kian; Toomey, Traci L; Stigler, Melissa H; Jones-Webb, Rhonda; Kugler, Kari C; Pasch, Keryn E; Williams, Carolyn L

2008-04-01

The goal of this group-randomized trial was to test the effectiveness of an adapted alcohol use preventive intervention for urban, low-income and multi-ethnic settings. Sixty-one public schools in Chicago were recruited to participate, were grouped into neighborhood study units and assigned randomly to intervention or 'delayed program' control condition. The study sample (n = 5812 students) was primarily African American, Hispanic and low-income. Students, beginning in sixth grade (age 12 years), received 3 years of intervention strategies (curricula, family interventions, youth-led community service projects, community organizing). Students participated in yearly classroom-based surveys to measure their alcohol use and related risk and protective factors. Additional evaluation components included a parent survey, a community leader survey and alcohol purchase attempts. Overall, the intervention, compared with a control condition receiving 'prevention as usual', was not effective in reducing alcohol use, drug use or any hypothesized mediating variables (i.e. related risk and protective factors). There was a non-significant trend (P = 0.066) that suggested the ability to purchase alcohol by young-appearing buyers was reduced in the intervention communities compared to the control communities, but this could be due to chance. Secondary outcome analyses to assess the effects of each intervention component indicated that the home-based programs were associated with reduced alcohol, marijuana and tobacco use combined (P = 0.01), with alcohol use alone approaching statistical significance (P = 0.06). Study results indicate the importance of conducting evaluations of previously validated programs in contexts that differ from the original study sample. Also, the findings highlight the need for further research with urban, low-income adolescents from different ethnic backgrounds to identify effective methods to prevent and reduce alcohol use.

Building a Navigation System to Reduce Cancer Disparities in Urban Black Older Adults

PubMed Central

Bone, Lee; Edington, Kristen; Rosenberg, Jessica; Wenzel, Jennifer; Garza, Mary A.; Klein, Catherine; Schmitt, Lisa; Ford, Jean G.

2014-01-01

Background Although cancer outcomes have improved in recent decades, substantial disparities by race, ethnicity, income and education persist. Increasingly, patient navigation services are demonstrating success in improving cancer detection, treatment and care and in reducing cancer health disparities. To advance progress in developing patient navigation programs, extensive descriptions of each component of the program must be made available to researchers and health service providers. Objective To describe the components of a patient navigation program designed to improve cancer screening based on informed decision-making on cancer screening and cancer treatment services among predominantly Black older adults in Baltimore City. Methods A community-academic participatory approach was used to develop a patient navigation program in Baltimore, Maryland. The components of the patient navigation system included the development of a community academic (advisory) committee (CAC); recruitment and selection of community health workers (CHWs)/navigators and supervisory staff; initial training and continuing education of the CHWs/navigators; and evaluation of CHWs/navigators. The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board. Conclusions The incorporation of community-based participatory research (CPBR) principles into each facet of this patient navigation program facilitated the attainment of the intervention’s objectives. This patient navigation program successfully delivered cancer navigation services to 1302 urban Black older adults. Appropriately recruited, selected and trained CHWs monitored by an experienced supervisor and investigators are the key elements in a patient navigation program. This model has the potential to be adapted by research and health service providers. PMID:23793252

A community based approach to improving resilience of forests and water resources: A local and regional climate adaptation methodology

Treesearch

Toby Thaler; Gwen Griffith; Nancy Gilliam

2014-01-01

Forest-based ecosystem services are at risk from human-caused stressors, including climate change. Improving governance and management of forests to reduce impacts and increase community resilience to all stressors is the objective of forest-related climate change adaptation. The Model Forest Policy Program (MFPP) has applied one method designed to meet this objective...

Methods for Linking Community Views to Measureable Outcomes in a Youth Violence Prevention Program

PubMed Central

McDonald, Catherine C.; Richmond, Therese S.; Guerra, Terry; Thomas, Nicole A.; Walker, Alia; Branas, Charles C.; TenHave, Thomas R.; Vaughn, Nicole A.; Leff, Stephen S.; Hausman, Alice J.

2013-01-01

Background All parties in community–academic partnerships have a vested interest prevention program success. Markers of success that reflect community’s experiences of programmatic prevention success are not always measurable, but critically speak to community-defined needs. Objective The purpose of this manuscript was to (1) describe our systematic process for linking locally relevant community views (community-defined indicators) to measurable outcomes in the context of a youth violence prevention program and (2) discuss lessons learned, next steps, and recommendations for others trying to replicate a similar process. Methods A research team composed of both academic and community researchers conducted a systematic process of matching community-defined indicators of youth violence prevention programmatic success to standardized youth survey items being administered in the course of a program evaluation. The research team of three community partners and Five academic partners considered 43 community-defined indicators and 208 items from the youth surveys being utilized within the context of a community-based aggression prevention program. At the end of the matching process, 92 youth survey items were identified and agreed upon as potential matches to 11 of the community-defined indicators. Conclusions We applied rigorous action steps to match community-defined indicators to survey data collected in the youth violence prevention intervention. We learned important lessons that inform recommendations for others interested in such endeavors. The process used to derive and assess community-defined indicators of success emphasized the principles of community-based participatory research (CBPR) and use of existing and available data to reduce participant burden. PMID:23221296

Effectiveness of a home-based cognitive behavioral program to manage concerns about falls in community-dwelling, frail older people: results of a randomized controlled trial.

PubMed

Dorresteijn, Tanja A C; Zijlstra, G A Rixt; Ambergen, Antonius W; Delbaere, Kim; Vlaeyen, Johan W S; Kempen, Gertrudis I J M

2016-01-06

Concerns about falls are common among older people. These concerns, also referred to as fear of falling, can have serious physical and psychosocial consequences, such as functional decline, increased risk of falls, activity restriction, and lower social participation. Although cognitive behavioral group programs to reduce concerns about falls are available, no home-based approaches for older people with health problems, who may not be able to attend such group programs are available yet. The aim of this study was to assess the effectiveness of a home-based cognitive behavioral program on concerns about falls, in frail, older people living in the community. In a randomized controlled trial in the Netherlands, 389 people aged 70 years and older, in fair or poor perceived health, who reported at least some concerns about falls and related activity avoidance were allocated to a control (n = 195) or intervention group (n = 194). The intervention was a home-based, cognitive behavioral program consisting of seven sessions including three home visits and four telephone contacts. The program aims to instill adaptive and realistic views about fall risks via cognitive restructuring and to increase activity and safe behavior using goal setting and action planning and was facilitated by community nurses. Control group participants received usual care. Outcomes at 5 and 12 months follow-up were concerns about falls, activity avoidance due to concerns about falls, disability and falls. At 12 months, the intervention group showed significant lower levels of concerns about falls compared to the control group. Furthermore, significant reductions in activity avoidance, disability and indoor falls were identified in the intervention group compared with the control group. Effect sizes were small to medium. No significant difference in total number of falls was noted between the groups. The home-based, cognitive behavioral program significantly reduces concerns about falls, related activity avoidance, disability and indoor falls in community-living, frail older people. The program may prolong independent living and provides an alternative for those people who are not able or willing to attend group programs. ClinicalTrials.gov, NCT01358032. Registered 17 May 2011.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana.

PubMed

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S-N; Kirby, Ryan

2016-02-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana

PubMed Central

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S.-N.; Kirby, Ryan

2016-01-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders. PMID:27330828

LLMapReduce: Multi-Lingual Map-Reduce for Supercomputing Environments

DTIC Science & Technology

2015-11-20

1990s. Popularized by Google [36] and Apache Hadoop [37], map-reduce has become a staple technology of the ever- growing big data community...Lexington, MA, U.S.A Abstract— The map-reduce parallel programming model has become extremely popular in the big data community. Many big data ...to big data users running on a supercomputer. LLMapReduce dramatically simplifies map-reduce programming by providing simple parallel programming

Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

PubMed Central

2012-01-01

Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291 PMID:22640372

Dynamics of bed bug infestations in three low-income housing communities with various bed bug management programs.

PubMed

Wang, Changlu; Eiden, Amanda; Singh, Narinderpal; Zha, Chen; Wang, Desen; Cooper, Richard

2018-06-01

Infestations of the common bed bug, Cimex lectularius L., have become common in low-income communities in the USA over the last 15 years. We evaluated community-based integrated pest management (IPM) programs for reducing bed bug infestations. Two housing authorities (Bayonne and Hackensack) implemented bed bug IPM programs. A third housing authority (Paterson) was used as the control site. Building-wide surveys were conducted in all communities, three times, to evaluate the effectiveness of the IPM programs. From 0 to 24 months, the infestation rate at Bayonne, Hackensack, and Paterson decreased by 49, 64, and 26%, respectively. The two sites that adopted IPM achieved faster bed bug elimination than the control site. The bed bug introduction rate over a 24-month period at Bayonne, Hackensack, and Paterson was 7, 3, and 11%, respectively. The introduction rate was positively associated with the initial infestation rate. Residents from buildings enrolled in IPM programs were more satisfied with the bed bug control services than residents from the control site. IPM programs were more effective in reducing bed bug infestations than traditional pest control services, but many factors contributed to the lower than desired level of reduction in infestation rate. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The Effectiveness of Adapted Versions of an Evidence-based Prevention Program in Reducing Alcohol Use among Alternative School Students

PubMed Central

Hopson, Laura M.; Holleran Steiker, Lori K.

2010-01-01

Although there is a strong evidence base for effective substance abuse prevention programs for youth, there is a need to facilitate the implementation and evaluation of these programs in real world settings. This study evaluates the effectiveness of adapted versions of an evidence-based prevention program, keepin’ it REAL (kiR), with alternative school students. Programs are often adapted when used in schools and other community settings for a variety of reasons. The kiR adaptations, developed during an earlier phase of this study, were created to make the curriculum more appropriate for alternative high school youth. The adaptations were evaluated using a quasi-experimental design in which questionnaires were administered at pretest, posttest, and follow-up, and focus groups were conducted at posttest. MANOVA analyses indicate significantly reduced intentions to accept alcohol and, for younger participants, reduced alcohol use. Focus group data support the need for age appropriate prevention content. The authors discuss implications for practitioners implementing prevention programs in schools. PMID:20622971

Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans.

PubMed

Maxwell, Annette E; Danao, Leda L; Cayetano, Reggie T; Crespi, Catherine M; Bastani, Roshan

2014-03-12

Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption - the proportion and representativeness of organizations that decided to implement the program. During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having≥150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14=79%) and among organizations that were referred to us by community partners (5/10=50%) and lowest among new organizations (6/20=30%). Few organizational differences were found between adopters and non-adopters. The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings.

A Comprehensive Approach to Management of Workplace and Environmental Noise at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Cooper, Beth A.

1995-01-01

NASA Lewis Research Center is home to more than 100 experimental research testing facilities and laboratories, including large wind tunnels and engine test cells, which in combination create a varied and complex noise environment. Much of the equipment was manufactured prior to the enactment of legislation limiting product noise emissions or occupational noise exposure. Routine facility maintenance and associated construction also contributes to a noise exposure management responsibility which is equal in magnitude and scope to that of several small industrial companies. The Noise Program, centrally managed within the Office of Environmental Programs at LRC, maintains overall responsibility for hearing conservation, community noise control, and acoustical and noise control engineering. Centralized management of the LRC Noise Program facilitates the timely development and implementation of engineered noise control solutions for problems identified via either the Hearing Conservation of Community Noise Program. The key element of the Lewis Research Center Noise Program, Acoustical and Noise Control Engineering Services, is focused on developing solutions that permanently reduce employee and community noise exposure and maximize research productivity by reducing or eliminating administrative and operational controls and by improving the safety and comfort of the work environment. The Hearing Conservation Program provides noise exposure assessment, medical monitoring, and training for civil servant and contractor employees. The Community Noise Program aims to maintain the support of LRC's neighboring communities while enabling necessary research operations to accomplish their programmatic goals. Noise control engineering capability resides within the Noise Program. The noise control engineering, based on specific exposure limits, is a fundamental consideration throughout the design phase of new test facilities, labs, and office buildings. In summary, the Noise Program addresses hearing conservation, community noise control, and acoustical and noise control engineering.

Climate Masters of Nebraska: An Action Based Approach to Climate Change Education

NASA Astrophysics Data System (ADS)

Umphlett, N.; Bernadt, T.; Pathak, T.

2014-12-01

The Climate Masters of Nebraska pilot program started in 2010 with the goal of assisting the community in becoming more knowledgeable and making informed decisions regarding climate change issues. First, participants engage in a 10-week training course where they learn from experts how to reduce their carbon footprint in everyday life. Participants then volunteer at least 30 hours educating the community through household consultations, outreach events, or other creative efforts they want to take to actively influence the community to reduce greenhouse gas (GHG) emissions. The first two groups of Climate Masters volunteers completed multiple household consultations, started a drip irrigation project, hosted an informational booth at local events, participated in an Adopt a Highway program, formed a Citizens Climate Lobby group, and worked with the City of Lincoln's reEnergize outreach program. All of these projects positively impacted the environment, reduced GHG emissions, or both. The program is continuing for a third year with a new and improved course in the fall. Taking into account suggestions from previous courses, this new course hopes to focus more on the climate issues that are particularly pressing in southeastern Nebraska.

Reducing Youth Violence and Delinquency in Pennsylvania: PCCDs Research-Based Programs Initiative

ERIC Educational Resources Information Center

Chilenski, Sarah Meyer; Bumbarger, Brian K.; Kyler, Sandee; Greenberg, Mark T.

2007-01-01

Youth violence and delinquency are problems that continue to challenge many communities across the U.S. For over a decade, Pennsylvania has been a national leader in confronting youth problem behaviors in a progressive and proactive fashion, investing heavily in supporting local community prevention coalitions and the use of proven-effective…

Reducing Youth Violence and Delinquency in Pennsylvania: PCCD's Research-Based Programs Initiative

ERIC Educational Resources Information Center

Chilenski, Sarah Meyer; Bumbarger, Brian K.; Kyler, Sandee; Greenberg, Mark T.

2007-01-01

Youth violence and delinquency are problems that continue to challenge many communities across the U.S. For over a decade, Pennsylvania has been a national leader in confronting youth problem behaviors in a progressive and proactive fashion, investing heavily in supporting local community prevention coalitions and the use of proven-effective…

The Northern Appalachia Cancer Network: Changing Cancer Research, Changing People's Lives

ERIC Educational Resources Information Center

Lengerich, Eugene J.; Kluhsman, Brenda C.; Bencivenga, Marcyann M.; Lesko, Samuel M.; Garcia-Dominic, Oralia; Aumiller, Betsy B.; Anderson, Marcia

2010-01-01

The Northern Appalachia Cancer Network (NACN) is a community-academic partnership to develop, implement, and evaluate evidence-based interventions intended to reduce the burden of cancer in Appalachian Pennsylvania and New York. The NACN began in 1992 as a loose network of community coalitions intended to implement local programs for cancer…

Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community.

PubMed

Wurz, Amanda; St-Aubin, Anik; Brunet, Jennifer

2015-08-01

The purpose of this qualitative study was to explore the barriers and motives experienced by women attending an 8-week group-based physical activity program offered in the community following treatment for breast cancer. Seven women were interviewed during the first and last week of the program. Data were analyzed using thematic analysis. Factors that hindered women's continued participation could be subdivided into situational barriers, which encompassed community (i.e., distance of center and traffic) and institutional factors (i.e., competing roles and responsibilities), and internal barriers, which consisted of cancer-specific limitations. Motives for initial and continued participation were situational (i.e., gaining social support, networking, and being around similar others) and internal (i.e., feeling a sense of personal fulfillment, acquiring health benefits, and recovering from cancer). The findings contribute to a deeper understanding of women's motives to engage in a group-based physical activity program after treatment for breast cancer. Further, they underscore the necessity of considering situational and internal barriers when developing group-based physical activity programs to increase regular participation, optimize adherence, and reduce drop-out.

A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

PubMed

Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

2014-01-01

At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).

Evaluating the social and economic impact of community-based prenatal care.

PubMed

Cramer, Mary E; Chen, Li-Wu; Roberts, Sara; Clute, Dorothea

2007-01-01

This article describes the evaluation and findings of a community-based prenatal care program, Omaha Healthy Start (OHS), designed to reduce local racial disparities in birth outcomes. This evaluative study used a comparative descriptive design, and Targeting Outcomes of Programs was the conceptual framework for evaluation. The evaluation followed 3 groups for 2 years: OHS birth mothers (N=79; N=157); non-OHS participant birth mothers (N=746; N=774); and Douglas County birth mothers (N=7,962; N=7,987). OHS provided case management, home visits, screening, referral, transportation, and health education to participants. Program outcome measures included low birth weight, infant mortality, adequacy of care, trimester of care, and costs of care. OHS birth outcomes improved during year 2, and there was a 31% cost saving in the average hospital expenditure compared with the nonparticipant groups. Preliminary evaluative analysis indicates that prenatal case management and community outreach can improve birth outcomes for minority women, while producing cost savings. Further prospective study is needed to document trends over a longer period of time regarding the relationship between community-based case management programs for minority populations, birth outcomes, and costs of care.

Community-based approaches to address childhood undernutrition and obesity in developing countries.

PubMed

Shetty, Prakash

2009-01-01

Community-based approaches have been the mainstay of interventions to address the problem of child malnutrition in developing societies. Many programs have been in operation in several countries for decades and originated largely as social welfare, food security and poverty eradication programs. Increasingly conceptual frameworks to guide this activity have been developed as our understanding of the complex nature of the determinants of undernutrition improves. Alongside this evolution, is the accumulation of evidence on the types of interventions in the community that are effective, practical and sustainable. The changing environment is probably determining the altering scenario of child nutrition in developing societies, with rapid developmental transition and urbanization being responsible for the emerging problems of obesity and other metabolic disorders that are largely the result of the now well-recognized linkages between child undernutrition and early onset adult chronic diseases. This dramatic change is contributing to the double burden of malnutrition in developing countries. Community interventions hence need to be integrated and joined up to reduce both aspects of malnutrition in societies. The evidence that community-based nutrition interventions can have a positive impact on pregnancy outcomes and child undernutrition needs to be evaluated to enable programs to prioritize and incorporate the interventions that work in the community. Programs that are operational and successful also need to be evaluated and disseminated in order to enable countries to generate their own programs tailored to tackling the changing nutritional problems of the children in their society. Copyright (c) 2009 S. Karger AG, Basel.

How to Reduce Those Costly School Bus Accidents.

ERIC Educational Resources Information Center

Farmer, Ernest

1985-01-01

The deterrent to school bus accidents is preparedness. Training programs for drivers and mechanics, equipment specifications, and a community support base are some of the ways to prevent tragedy. (MLF)

Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States

PubMed Central

Raj, Sudha; Balasubramanyam, Ashok

2017-01-01

This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program (n = 34) or a control group (n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c (p < 0.0005) and waist circumference (p = 0.04) significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US. PMID:28168201

Effectiveness of a Group-Based Culturally Tailored Lifestyle Intervention Program on Changes in Risk Factors for Type 2 Diabetes among Asian Indians in the United States.

PubMed

Patel, Rupal M; Misra, Ranjita; Raj, Sudha; Balasubramanyam, Ashok

2017-01-01

This study used an experimental, pretest-posttest control group repeated measures design to evaluate the effectiveness of a community-based culturally appropriate lifestyle intervention program to reduce the risk for type 2 diabetes (T2DM) among Gujarati Asian Indians (AIs) in an urban community in the US. Participants included 70 adult AIs in the greater Houston metropolitan area. The primary outcomes were reduction in weight and hemoglobin A1c (HbA1c) and improvement in physical activity. Participants were screened for risk factors and randomly assigned to a 12-week group-based lifestyle intervention program ( n = 34) or a control group ( n = 36) that received standard print material on diabetes prevention. Participants also completed clinical measures and self-reported questionnaires about physical activity, social, and lifestyle habits at 0, 3, and 6 months. No significant baseline differences were noted between groups. While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c ( p < 0.0005) and waist circumference ( p = 0.04) significantly as compared to the control group. Findings demonstrated that participation in a culturally tailored, lifestyle intervention program in a community setting can effectively reduce weight, waist circumference, and HbA1c among Gujarati AIs living in the US.

Developing a trauma-informed, emergency department-based intervention for victims of urban violence.

PubMed

Corbin, Theodore J; Rich, John A; Bloom, Sandra L; Delgado, Dionne; Rich, Linda J; Wilson, Ann S

2011-01-01

The Surgeon General's report on youth violence, the Centers for Disease Control and Prevention, and other national organizations are calling for public health approaches to the issue of youth violence. Hospital-based violence intervention programs have shown promise in reducing recurrent violence and decreasing future involvement in the criminal justice system. These programs seldom address trauma-related symptoms. We describe a conceptual framework for emergency department-based and hospital-based violence intervention programs that intentionally addresses trauma. The intervention described--Healing Hurt People--is a trauma-informed program designed to intervene in the lives of injured patients at the life-changing moment of violent injury. This community-focused program seeks to reduce recurrent violence among 8- to 30-year-olds through opportunities for healing and connection. Healing Hurt People considers the adversity that patients have experienced during their lives and seeks to break the cycle of violence by addressing this trauma.

Can we reduce the burden of depression? The Australian experience with beyondblue: the national depression initiative.

PubMed

Hickie, Ian

2004-01-01

Throughout the Asia Pacific region, there is an urgent need to reduce the burden of depression by increasing depression awareness, reducing stigma and dismantling those social barriers that prevent full participation by people with depression. This paper describes the development and early achievements of the Australian depression initiative, beyondblue. A review of the key priorities of beyondblue and their impacts during the first three years of operation (2001-03). Key achievements include: the degree of national recognition of beyondblue; size and scope of media impact; growth in website utilisation; increased reporting of the community's recognition of people with depression; genuine reforms in life insurance and income protection; development of a new national consumer and carer organisation; establishment of major population-based preventative and early intervention programs; system-wide reform of primary care-based mental health services; national educational program uptake by general practitioners; and, development of key awareness and intervention programs for use in schools and the workplace. In its first three years of operation, beyondblue has had a major impact on depression awareness in Australia and demonstrable gains have been made in reducing stigma and major social barriers. A pre-existing national mental health policy and implementation plan, a substantial funding base and participation by key political, media and community leaders have been essential elements of its short-term success. Its longer-term impact will now depend on more sustainable community and business partnerships as well as the growth of a more influential consumer and carer voice.

Formative process evaluation for implementing a social marketing intervention to increase walking among African Americans in the Positive Action for Today's Health trial.

PubMed

Coulon, Sandra M; Wilson, Dawn K; Griffin, Sarah; St George, Sara M; Alia, Kassandra A; Trumpeter, Nevelyn N; Wandersman, Abraham K; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney

2012-12-01

Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today's Health trial. We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities.

Adaptation of an Alcohol and HIV School-Based Prevention Program for Teens

PubMed Central

Springer, Carolyn; Leu, Cheng-Shiun; Ghosh, Shivnath; Sharma, Sunil Kumar; Rapkin, Bruce

2010-01-01

Given the current status of HIV infection in youth in India, developing and implementing HIV education and prevention interventions is critical. The goal for School-based Teenage Education Program (STEP) was to demonstrate that a HIV/AIDS and alcohol abuse educational program built with specific cultural, linguistic, and community-specific characteristics could be effective. Utilizing the Train-the-Trainer model, the instructors (17–21 years) were trained to present the 10 session manualized program to primarily rural and tribal youth aged 13–16 years in 23 schools (N = 1,421) in the northern state of Himachal Pradesh in India. The intervention had a greater impact on girls; girls evidenced greater communication skills and a trend towards greater self efficacy and reduced risk taking behavior. The STEP has been successfully adapted by the community organizations that were involved in coordinating the program at the local level. Their intention to continue STEP beyond extra funding shows that utilizing the local community in designing, implementing and evaluating programs promotes ownership and sustainability. PMID:20589528

Long term effects of community-based STI screening and mass media HIV prevention messages on sexual risk behaviors of African American adolescents.

PubMed

Sznitman, Sharon; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Brown, Larry K; DiClemente, Ralph; Hennessy, Michael; Salazar, Laura F; Romer, Daniel

2011-11-01

We examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern mid-sized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community-based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.

Healthy Communities Grant Program | Urban Environmental ...

EPA Pesticide Factsheets

2018-03-06

The Healthy Communities Grant Program is EPA New England's main competitive grant program to work directly with communities to reduce environmental risks to protect and improve human health and the quality of life.

University-Based Community College Leadership Programs: Where Future Community College Leaders Are Prepared

ERIC Educational Resources Information Center

Friedel, Janice Nahra

2010-01-01

Community college leadership programs may take a variety of forms, among them university-based programs, leadership institutes, community college-based "grow your own" programs, professional organization-based institutes, or a combination of these. University-based doctorate leadership programs are the principal providers of these…

Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans

PubMed Central

2014-01-01

Background Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption – the proportion and representativeness of organizations that decided to implement the program. Methods During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having ≥ 150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Results Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14 = 79%) and among organizations that were referred to us by community partners (5/10 = 50%) and lowest among new organizations (6/20 = 30%). Few organizational differences were found between adopters and non-adopters. Conclusions The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings. PMID:24618267

Improving -Omics-Based Research and Precision Health in Minority Populations: Recommendations for Nurse Scientists.

PubMed

Taylor, Jacquelyn Y; Barcelona de Mendoza, Veronica

2018-01-01

The purpose of this article is to provide an overview of the role of nurse scientists in -omics-based research and to promote discussion around the conduct of -omics-based nursing research in minority communities. Nurses are advocates, educators, practitioners, scientists, and researchers, and are crucial to the design and successful implementation of -omics studies, particularly including minority communities. The contribution of nursing in this area of research is crucial to reducing health disparities. In this article, challenges in the conduct of -omics-based research in minority communities are discussed, and recommendations for improving diversity among nurse scientists, study participants, and utilization of training and continuing education programs in -omics are provided. Many opportunities exist for nurses to increase their knowledge in -omics and to continue to build the ranks of nurse scientists as leaders in -omics-based research. In order to work successfully with communities of color, nurse scientists must advocate for participation in the Precision Medicine Initiative, improve representation of nurse faculty of color, and increase utilization of training programs in -omics and lead such initiatives. All nursing care has the potential to be affected by the era of -omics and precision health. By taking an inclusive approach to diversity in nursing and -omics research, nurses will be well placed to be leaders in reducing health disparities through research, practice, and education. © 2017 Sigma Theta Tau International.

Unique Practice, Unique Place: Exploring Two Assertive Community Treatment Teams in Maine.

PubMed

Schroeder, Rebecca A

2018-06-01

Assertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial.

PubMed

Crowley, D Max; Jones, Damon E; Coffman, Donna L; Greenberg, Mark T

2014-05-01

Prescription drug abuse has reached epidemic proportions. Nonmedical prescription opioid use carries increasingly high costs. Despite the need to cultivate efforts that are both effective and fiscally responsible, the cost-effectiveness of universal evidence-based-preventive-interventions (EBPIs) is rarely evaluated. This study explores the performance of these programs to reduce nonmedical prescription opioid use. Sixth graders from twenty-eight rural public school districts in Iowa and Pennsylvania were blocked by size and geographic location and then randomly assigned to experimental or control conditions (2002-2010). Within the intervention communities, prevention teams selected a universal family and school program from a menu of EBPIs. All families were offered a family-based program in the 6th grade and received one of three school-based programs in 7th-grade. The effectiveness and cost-effectiveness of each school program by itself and with an additional family-based program were assessed using propensity and marginal structural models. This work demonstrates that universal school-based EBPIs can efficiently reduce nonmedical prescription opioid use. Further, findings illustrate that family-based programs may be used to enhance the cost-effectiveness of school-based programs. Universal EBPIs can effectively and efficiently reduce nonmedical prescription opioid use. These programs should be further considered when developing comprehensive responses to this growing national crisis. Copyright © 2014 Elsevier Inc. All rights reserved.

Reducing childhood obesity through coordinated care: Development of a park prescription program

PubMed Central

Messiah, Sarah E; Jiang, Sandy; Kardys, Jack; Hansen, Eric; Nardi, Maria; Forster, Lourdes

2016-01-01

Major hindrances to controlling the current childhood obesity epidemic include access to prevention and/or treatment programs that are affordable, provide minimal barriers for participation, and are available to the general public. Moreover, successful childhood obesity prevention efforts will require coordinated partnerships in multiple sectors such as government, health care, school/afterschool, and the community but very few documented sustainable programs currently exist. Effective, community-based health and wellness programs with a focus on maintaining healthy weight via physical activity and healthy eating have the potential to be a powerful referral resource for pediatricians and other healthcare professionals who have young patients who are overweight/obese. The Miami Dade County Department of Parks, Recreation and Open Spaces in partnership with the University of Miami UHealth Systems have created a “Park Prescription Program (Parks Rx 4HealthTM)” that formally coordinates pediatricians, families, parents, caregivers, and child/adolescents to provide daily obesity-prevention activities. This Parks Rx 4HealthTM program that we describe here allows UHealth pediatricians to seamlessly refer their overweight and obese patients to Fit2PlayTM, an evidence-based, park-based afterschool health and wellness program. Measurable outcomes that include body mass index, blood pressure, fitness, and nutrition knowledge are being collected at baseline and at 3-and 6-mo after referral to document patient progress. Results are then shared with the referring physician so they can follow up with the patient if necessary. Identifying successful models that integrate primary care, public health, and community-based efforts is important to accelerating progress in preventing childhood obesity. Effective, community-based health and wellness programs with a focus on physical activity and nutrition education could be a powerful referral resource for pediatricians who have obese patients. PMID:27610338

Integrating Behavioral Psychology Services into Adult Day Programming for Individuals with Dementia

ERIC Educational Resources Information Center

LeBlanc, Linda A.

2010-01-01

Many individuals with dementia and problem behavior are served in nursing home settings long before health issues necessitate constant medical care. Alternative community-based adult day health care programs allow individuals with dementia to remain in their home with their families at a substantially reduced cost; however, many adult day programs…

Recognizing the Role of Stakeholders in Drug, Alcohol, and Tobacco Prevention and Reduction Programs.

ERIC Educational Resources Information Center

Gaynor, Joni R.; And Others

Programs to reduce alcohol, tobacco, and other drug (ATOD) use among in-school youth rely on services and contributions from local law enforcement agencies, public health agencies, community-based organizations, volunteers, and parents, who are often overlooked by researchers and policymakers. This paper examines the efforts of these contributing…

System looks outside its own walls to find innovative way to cut kids' asthma admissions.

PubMed

1999-10-01

Atlanta children's hospital system initiates outpatient pediatric asthma disease management program to reduce inpatient admissions and ER visits while reducing costs. Children's Healthcare of Atlanta turned to the primary care physician community for front-line support in keeping mild asthma cases out of the hospital. By offering evidence-based practice guidelines, training for staff, and educational materials for patients and their families, the Partnership to ACE Asthma program is off to a running start. Learn how to set up a similar program.

Making it local: Beacon Communities use health information technology to optimize care management.

PubMed

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

Implementing a mental health ministry committee in faith-based organizations: the promoting emotional wellness and spirituality program.

PubMed

Williams, Laverne; Gorman, Robyn; Hankerson, Sidney

2014-01-01

Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.

The Swedish six-community alcohol and drug prevention trial: effects on youth drinking.

PubMed

Hallgren, Mats; Andréasson, Sven

2013-09-01

Local communities are increasingly targeted for alcohol and drug prevention campaigns. This study describes some of the key findings from the Swedish six-community alcohol and drug prevention trial (2003-2007) and lessons learned following an evaluation of the trial's effectiveness. The paper focuses mainly on changes in youth drinking and related harms. This was a pre- to post-intervention effect study comparing six trial communities that received added training and technical support with six control communities where regular prevention efforts were supported by national alcohol and drug action plans. A repeated, cross-sectional survey of 8092 youths aged 15-19 years assessed changes in alcohol consumption, binge drinking, perceived alcohol availability, access to alcohol via parents and adult attitudes towards the supply of alcohol to youths. National registry data were used to assess changes in hospital admissions due to alcohol intoxication. Overall, there were few significant improvements in the six trial communities compared with the control communities. The absence of program effects was largely attributable to the selection of strategies (in particular, school and parental programs) lacking evidence of effectiveness in reducing alcohol consumption at the aggregate level. Prevention programs based on efficacy studies need to be tested in community-based effectiveness trials before being disseminated. © 2013 Australasian Professional Society on Alcohol and other Drugs.

Using CDBG to Support Community-Based Youth Programs

ERIC Educational Resources Information Center

Torrico, Roxana

2008-01-01

This brief provides policymakers, stakeholders, community leaders, and program developers working in or with community-based youth programs with a basic understanding of how the Community Development Block Grant (CDBG) is structured, how community-based youth programs fit into CDBG purposes and activities, and how communities nationwide are using…

Increasing physical activity in children 8 to 12 years old: experiences with VERB Summer Scorecard.

PubMed

McDermott, Robert J; Davis, Jenna L; Bryant, Carol A; Courtney, Anita H; Alfonso, Moya L

2010-08-01

Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95% CI = 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities.

Impact of a Multi-Strategy Community Intervention to Reduce Maternal and Child Health Inequalities in India: A Qualitative Study in Haryana

PubMed Central

Gupta, Madhu; Bosma, Hans; Angeli, Federica; Kaur, Manmeet; Chakrapani, Venkatesan; Rana, Monica; van Schayck, Onno C. P.

2017-01-01

A multi-strategy community intervention, known as National Rural Health Mission (NRHM), was implemented in India from 2005 to 2012. By improving the availability of and access to better-quality healthcare, the aim was to reduce maternal and child health (MCH) inequalities. This study was planned to explore the perceptions and beliefs of stakeholders about extent of implementation and effectiveness of NRHM’s health sector plans in improving MCH status and reducing inequalities. A total of 33 in-depth interviews (n = 33) with program managers, community representatives, mothers and 8 focus group discussions (n = 42) with health service providers were conducted from September to December 2013, in Haryana, post NRHM. Using NVivo software (version 9), an inductive applied thematic analysis was done based upon grounded theory, program theory of change and a framework approach. Almost all the participants reported that there was an improvement in overall health infrastructure through an increased availability of accredited social health activists, free ambulance services, and free treatment facilities in rural areas. This had increased the demand and utilization of MCH services, especially for those related to institutional delivery, even by the poor families. Service providers felt that acute shortage of human resources was a major health system level barrier. District-specific individual, community, and socio-political level barriers were also observed. Overall program managers, service providers and community representatives believed that NRHM had a role in improving MCH outcomes and in reduction of geographical and socioeconomic inequalities, through improvement in accessibility, availability and affordability of the MCH services in the rural areas and for the poor. Any reduction in gender-based inequalities, however, was linked to the adoption of small family sizes and an increase in educational levels. PMID:28099465

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.

PubMed

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12-0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program: Combining Reach, Effectiveness, and Cost.

PubMed

Estabrooks, Paul A; Wilson, Kathryn E; McGuire, Todd J; Harden, Samantha M; Ramalingam, NithyaPriya; Schoepke, Lia; Almeida, Fabio A; Bayer, Amy L

2017-04-01

Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants. To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics. Longitudinal pre-post quasi-experiment without control. Enrolled participants in Weigh and Win (WAW), a community-based weight loss program. A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach. Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation. A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants. Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.

Evaluation of criteria for sustainability of community-based rural homestay programs via a modified pairwise comparison method

NASA Astrophysics Data System (ADS)

Ramli, Rohaini; Kasim, Maznah Mat; Ramli, Razamin; Kayat, Kalsom; Razak, Rafidah Abd

2014-12-01

Ministry of Tourism and Culture Malaysia has long introduced homestay programs across the country to enhance the quality of life of people, especially those living in rural areas. This type of program is classified as a community-based tourism (CBT) as it is expected to economically improve livelihood through cultural and community associated activities. It is the aspiration of the ministry to see that the income imbalance between people in the rural and urban areas is reduced, thus would contribute towards creating more developed states of Malaysia. Since 1970s, there are 154 homestay programs registered with the ministry. However, the performance and sustainability of the programs are still not satisfying. There are only a number of homestay programs that perform well and able to sustain. Thus, the aim of this paper is to identify relevant criteria contributing to the sustainability of a homestay program. The criteria are evaluated for their levels of importance via the use of a modified pairwise method and analyzed for other potentials. The findings will help the homestay operators to focus on the necessary criteria and thus, effectively perform as the CBT business initiative.

Family, Community, and Health System Considerations for Reducing the Burden of Pediatric Sickle Cell Disease in Uganda Through Newborn Screening

PubMed Central

Green, Nancy S.; Mathur, Sanyukta; Kiguli, Sarah; Makani, Julie; Fashakin, Victoria; LaRussa, Philip; Lyimo, Magdalena; Abrams, Elaine J.; Mulumba, Lukia; Mupere, Ezekiel

2016-01-01

Sickle cell disease (SCD) is associated with high mortality for children under 5 years of age in sub-Saharan Africa. Newborn sickle screening program and enhanced capacity for SCD treatment are under development to reduce disease burden in Uganda and elsewhere in the region. Based on an international stakeholder meeting and a family-directed conference on SCD in Kampala in 2015, and interviews with parents, multinational experts, and other key informants, we describe health care, community, and family perspectives in support of these initiatives. Key stakeholder meetings, discussions, and interviews were held to understand perspectives of public health and multinational leadership, patients and families, as well as national progress, resource needs, medical and social barriers to program success, and resources leveraged from HIV/AIDS. Partnering with program leadership, professionals, patients and families, multinational stakeholders, and leveraging resources from existing programs are needed for building successful programs in Uganda and elsewhere in sub-Saharan Africa. PMID:27336011

Tobacco control recommendations identified by LGBT Atlantans in a community-based participatory research project.

PubMed

Bryant, Lawrence; Damarin, Amanda K; Marshall, Zack

2014-01-01

Lesbian, gay, bisexual, and transgender (LGBT) people are increasingly aware that disproportionately high smoking rates severely impact the health of their communities. Motivated to make a change, a group of LGBT community members, policymakers, and researchers from Atlanta carried out a community-based participatory research (CBPR) project. This formative research study sought to identify recommendations for culturally relevant smoking prevention and cessation interventions that could improve the health of Atlanta's LGBT communities. Data presented here come from four focus groups with 36 participants and a community meeting with 30 participants. Among study participants, the most favored interventions were providing LGBT-specific cessation programs, raising awareness about LGBT smoking rates, and getting community venues to go smoke-free. Participants also suggested providing reduced-cost cessation products for low-income individuals, using LGBT "role models" to promote cessation, and ensuring that interventions reach all parts of the community. Findings reinforce insights from community-based research with other marginalized groups. Similarities include the importance of tailoring cessation programs for specific communities, the need to acknowledge differences within communities, and the significance of community spaces in shaping discussions of cessation. Further, this study highlights the need for heightened awareness. The Atlanta LGBT community is largely unaware that high smoking rates affect its health, and is unlikely to take collective action to address this problem until it is understood.

Evaluation of Salud Para Su Corazón (Health for your Heart) -- National Council of La Raza Promotora Outreach Program.

PubMed

Balcázar, Héctor; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Pedregón, Verónica

2005-07-01

In 2001, the National Heart, Lung, and Blood Institute partnered with the National Council of La Raza to conduct a pilot test of its community-based outreach program Salud Para Su Corazón (Health for Your Heart), which aims to reduce the burden of morbidity and mortality associated with cardiovascular disease among Latinos. The effectiveness of promotores de salud (community health workers) in improving heart-healthy behaviors among Latino families participating in the pilot program at seven sites was evaluated. Data on the characteristics of the promotores in the Salud Para Su Corazón program were compiled. Promotores collected data on family risk factors, health habits, referrals and screenings, information sharing, and program satisfaction from 223 participating Latino families (320 individual family members) through questionnaires. Paired t tests and chi-square tests were used to measure pretest-posttest differences among program participants. Results demonstrated the effectiveness of the promotora model in improving heart-healthy behaviors, promoting community referrals and screenings, enhancing information sharing beyond families, and satisfying participants' expectations of the program. The main outcome of interest was the change in heart-healthy behaviors among families. The community outreach model worked well in the seven pilot programs because of the successes of the promotores and the support of the community-based organizations. Successes stemmed in part from the train-the-trainer approach. Promotoria, as implemented in this program, has the potential to be integrated with a medical model of patient care for primary, secondary, and tertiary prevention.

Dynamic simulation of crime perpetration and reporting to examine community intervention strategies.

PubMed

Yonas, Michael A; Burke, Jessica G; Brown, Shawn T; Borrebach, Jeffrey D; Garland, Richard; Burke, Donald S; Grefenstette, John J

2013-10-01

To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect sustainability. ABM illustrates how intervention models might be used to investigate community-supported crime intervention programs.

Medicaid Waivers Targeting Children With Autism Spectrum Disorder Reduce The Need For Parents To Stop Working.

PubMed

Leslie, Douglas L; Iskandarani, Khaled; Velott, Diana L; Stein, Bradley D; Mandell, David S; Agbese, Edeanya; Dick, Andrew W

2017-02-01

Several states have passed Medicaid home and community-based services waivers that expand eligibility criteria and available services for children with autism spectrum disorder. Although previous research has shown considerable variation in these waivers, little is known about the programs' impact on parents' workforce participation. We used nationally representative survey data combined with detailed information on state Medicaid waiver programs to determine the effects of waivers on whether parents of children with autism spectrum disorder had to stop working because of the child's condition. Increases in the Medicaid home and community-based services waiver cost limit and enrollment limit significantly reduced the likelihood that a parent had to stop working, although the results varied considerably by household income level. These findings suggest that the Medicaid waivers are effective policies to address the care-related needs of children with autism spectrum disorder. Project HOPE—The People-to-People Health Foundation, Inc.

Community-Based Programming: An Opportunity and Imperative for the Community College.

ERIC Educational Resources Information Center

Boone, Edgar J.

1992-01-01

Defines community-based programing as a cooperative process in which the community college serves as leader and catalyst in effecting collaboration among community members, leaders, and groups. Recommends 15 tasks for community college leaders involved in community-based programing, including environmental scanning and coalition building. (DMM)

The 24-month metabolic benefits of the healthy living partnerships to prevent diabetes: A community-based translational study.

PubMed

Pedley, Carolyn F; Case, L Douglas; Blackwell, Caroline S; Katula, Jeffrey A; Vitolins, Mara Z

2018-05-01

Large-scale clinical trials and translational studies have demonstrated that weight loss achieved through diet and physical activity reduced the development of diabetes in overweight individuals with prediabetes. These interventions also reduced the occurrence of metabolic syndrome and risk factors linked to other chronic conditions including obesity-driven cancers and cardiovascular disease. The Healthy Living Partnerships to Prevent Diabetes (HELP PD) was a clinical trial in which participants were randomized to receive a community-based lifestyle intervention translated from the Diabetes Prevention Program (DPP) or an enhanced usual care condition. The objective of this study is to compare the 12 and 24 month prevalence of metabolic syndrome in the two treatment arms of HELP PD. The intervention involved a group-based, behavioral weight-loss program led by community health workers monitored by personnel from a local diabetes education program. The enhanced usual care condition included dietary counseling and written materials. HELP PD included 301 overweight or obese participants (BMI 25-39.9kg/m 2 ) with elevated fasting glucose levels (95-125mg/dl). At 12 and 24 months of follow-up there were significant improvements in individual components of the metabolic syndrome: fasting blood glucose, waist circumference, HDL, triglycerides and blood pressure and the occurrence of the metabolic syndrome in the intervention group compared to the usual care group. This study demonstrates that a community diabetes prevention program in participants with prediabetes results in metabolic benefits and a reduction in the occurrence of the metabolic syndrome in the intervention group compared to the enhanced usual care group. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Innovative and Community-Driven Communication Practices of the South Carolina Cancer Prevention and Control Research Network

PubMed Central

Brandt, Heather M.; Freedman, Darcy A.; Adams, Swann Arp; Young, Vicki M.; Ureda, John R.; McCracken, James Lyndon; Hébert, James R.

2014-01-01

The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) is 1 of 10 networks funded by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI) that works to reduce cancer-related health disparities. In partnership with federally qualified health centers and community stakeholders, the SC-CPCRN uses evidence-based approaches (eg, NCI Research-tested Intervention Programs) to disseminate and implement cancer prevention and control messages, programs, and interventions. We describe the innovative stakeholder- and community-driven communication efforts conducted by the SC-CPCRN to improve overall health and reduce cancer-related health disparities among high-risk and disparate populations in South Carolina. We describe how our communication efforts are aligned with 5 core values recommended for dissemination and implementation science: 1) rigor and relevance, 2) efficiency and speed, 3) collaboration, 4) improved capacity, and 5) cumulative knowledge. PMID:25058673

Innovative and community-driven communication practices of the South Carolina cancer prevention and control research network.

PubMed

Friedman, Daniela B; Brandt, Heather M; Freedman, Darcy A; Adams, Swann Arp; Young, Vicki M; Ureda, John R; McCracken, James Lyndon; Hébert, James R

2014-07-24

The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) is 1 of 10 networks funded by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI) that works to reduce cancer-related health disparities. In partnership with federally qualified health centers and community stakeholders, the SC-CPCRN uses evidence-based approaches (eg, NCI Research-tested Intervention Programs) to disseminate and implement cancer prevention and control messages, programs, and interventions. We describe the innovative stakeholder- and community-driven communication efforts conducted by the SC-CPCRN to improve overall health and reduce cancer-related health disparities among high-risk and disparate populations in South Carolina. We describe how our communication efforts are aligned with 5 core values recommended for dissemination and implementation science: 1) rigor and relevance, 2) efficiency and speed, 3) collaboration, 4) improved capacity, and 5) cumulative knowledge.

Reputationally Strong HIV Prevention Programs: Lessons from the Front Line

ERIC Educational Resources Information Center

Eke, Agatha N.; Mezoff, Jane S.; Duncan, Ted; Sogolow, Ellen D.

2006-01-01

Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite…

Computeen: A Randomized Trial of a Preventive Computer and Psychosocial Skills Curriculum for At-Risk Adolescents

ERIC Educational Resources Information Center

Lang, Jason M.; Waterman, Jill; Baker, Bruce L.

2009-01-01

Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16…

Implementation of an Initial Training Program for New Employees in a Profoundly Mentally and Physically Handicapped Children and Adult Residential Facility.

ERIC Educational Resources Information Center

Hoeft, Linda A.

A project was designed to reduce the turnover of direct care staff in a community-based residential facility that provides a home and educational or adult day training services for 54 severely or profoundly mentally and physically handicapped children and adults. The project sought to reduce total staff turnover by 40%, reduce employee…

The Project P.A.T.H.S. in Hong Kong: Work Done and Lessons Learned in a Decade.

PubMed

Shek, Daniel T L; Wu, Florence K Y

2016-02-01

The Project Positive Adolescent Training through Holistic Social Programs is a positive youth development program initiated and financially supported by The Hong Kong Jockey Club Charities Trust. Since 2005, the project has gone through several phases, including the initial phase (2005-2012), school-based extension phase (2009-2016), and community-based extension phase (2013-2017). In the initial phase, with the involvement of academics from 5 universities in Hong Kong, the research team developed youth enhancement programs for junior secondary school students (20 hours per grade), trained the program implementers (20 hours per grade), assisted in the implementation in more than 250 schools, and evaluated the program using multiple evaluation strategies, including a 5-year longitudinal experimental study. In the school-based extension phase, the project was implemented for another cycle (2009-2010 and 2011-2012 school years) and a 6-year longitudinal study was conducted to understand the psychosocial development of Chinese adolescents in Hong Kong. In the community-based extension phase, the programs were administered by social workers in the community settings. Generally speaking, different evaluation findings showed that the programs in Project Positive Adolescent Training through Holistic Social Programs promoted positive development and reduced risk behavior in Chinese adolescents in Hong Kong. Positive youth development attributes and family functioning also have positive contributions to adolescent developmental outcomes over time. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Formative Process Evaluation for Implementing a Social Marketing Intervention to Increase Walking Among African Americans in the Positive Action for Today’s Health Trial

PubMed Central

Wilson, Dawn K.; Griffin, Sarah; St. George, Sara M.; Alia, Kassandra A.; Trumpeter, Nevelyn N.; Wandersman, Abraham K.; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney

2012-01-01

Objectives. Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today’s Health trial. Methods: We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Results: Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Conclusions: Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities. PMID:23078486

Faith Moves Mountains: an Appalachian cervical cancer prevention program.

PubMed

Schoenberg, Nancy E; Hatcher, Jennifer; Dignan, Mark B; Shelton, Brent; Wright, Sherry; Dollarhide, Kaye F

2009-01-01

To provide a conceptual description of Faith Moves Mountains (FMM), an intervention designed to reduce the disproportionate burden of cervical cancer among Appalachian women. FMM, a community-based participatory research program designed and implemented in collaboration with churches in rural, southeastern Kentucky, aims to increase cervical cancer screening (Pap tests) through a multiphase process of educational programming and lay health counseling. We provide a conceptual overview to key elements of the intervention, including programmatic development, theoretical basis, intervention approach and implementation, and evaluation procedures. After numerous modifications, FMM has recruited and retained over 400 women, 30 churches, and has become a change agent in the community.

Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans

DTIC Science & Technology

2017-05-01

study is a follow-on to prior DOD funded work “Efficacy of a Driving Intervention Program on Safe Community Mobility for Combat Veterans”. Funding for...lack of control groups, suggest that a simu- lator-based OT-DI can provide a safe environment for testing and training of CV to reduce dangerous...AWARD NUMBER: W81XWH-15-1-0032 TITLE: Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans

Second Microgravity Fluid Physics Conference

NASA Technical Reports Server (NTRS)

1994-01-01

The conference's purpose was to inform the fluid physics community of research opportunities in reduced-gravity fluid physics, present the status of the existing and planned reduced gravity fluid physics research programs, and inform participants of the upcoming NASA Research Announcement in this area. The plenary sessions provided an overview of the Microgravity Fluid Physics Program information on NASA's ground-based and space-based flight research facilities. An international forum offered participants an opportunity to hear from French, German, and Russian speakers about the microgravity research programs in their respective countries. Two keynote speakers provided broad technical overviews on multiphase flow and complex fluids research. Presenters briefed their peers on the scientific results of their ground-based and flight research. Fifty-eight of the sixty-two technical papers are included here.

Organizing Asian Pacific Islanders in an urban community to reduce HIV risk: a case study.

PubMed

Loue, S; Lloyd, L S; Phoombour, E

1996-10-01

We present a case study of community organization efforts within the Asian Pacific Islander communities of San Diego County to reduce the risk of HIV transmission. We utilized a five-phase process to implement the strategies of locality development, social planning, and social action: community analysis, program design and initiation, program implementation, program maintenance and consolidation, and program reassessment. An evaluation of the process indicates that there were increases over time in the project's activities as well as in the levels of interagency connectedness. This is one of the few reported efforts to organize Asian Pacific Islander groups to address HIV transmission. Key elements that led to the successful organization of the original project into a tax-exempt nonprofit entity (the Asian Pacific Islander Community AIDS Project) were emphasis on community ownership, reliance on group consensus, use of "gatekeepers" to access communities, simultaneous multilevel programming, and service to the community as a "coordinating" entity.

Design and methods for a community-based intervention to reduce sugar-sweetened beverage consumption among youth: H2GO! study.

PubMed

Wang, Monica L; Lemon, Stephenie C; Clausen, Kristian; Whyte, Julie; Rosal, Milagros C

2016-11-09

Reducing sugar-sweetened beverage (SSB) intake is an important dietary target among underserved children at high risk for obesity and associated morbidities. Community-based approaches to reduce SSB intake are needed. The use of narrative-based approaches (presenting messages within the context of a story) can facilitate connection with target health messages and empower children as behavior change agents within their families. The H 2 GO! program is a community-based behavioral intervention that integrates narrative-based strategies to reduce SSB consumption and promote water intake among school-age youth and parents. Guided by the Social Cognitive Theory and the Social Ecological Model, the H 2 GO! intervention consists of 6 weekly sessions that target beverage knowledge, attitudes, and behaviors through youth-produced messages and narratives to reduce SSB intake and encourage water intake and parent-child activities. To reach underserved youth and families, we identified Boys & Girls Clubs (B&GC) (youth-based community centers that serve an ethnically diverse and predominantly low socioeconomic status population) as a community partner and study setting. Participants (children ages 9-12 years and their parents) will be recruited from B&GC sites in Massachusetts, USA. Intervention efficacy will be assessed through a site-randomized trial (N = 2 youth-based community sites, pair-matched for size and racial/ethnic composition) with 54 parent-child pairs (N = 108) enrolled per site (N = 216 total). The comparison site will carry on with usual practice. Child and parental SSB and water consumption (primary outcomes) and parent and child beverage knowledge and attitudes (secondary outcomes) will be measured via self-report surveys. Additional outcomes include children's anthropometric data, additional dietary behaviors, and physical activity. Measures will be collected at baseline, 2 and 6 months follow-up. With an estimated 20 % dropout rate, the study will have 80 % power to detect a group difference of 3.9 servings of SSBs per week. Community-based approaches hold potential for decreasing SSB consumption among youth and families, particularly among underserved populations who are at greater obesity risk. This article describes the design and methods of a community-based behavioral intervention designed to reduce SSB consumption among youth and parents/caregivers. ClinicalTrials.gov NCT02890056 . Date of Registration: August 31, 2016.

A Web-Based Psychoeducational Intervention Program for Depression and Anxiety in an Adult Community in Selangor, Malaysia: Protocol of a Randomized Controlled Trial.

PubMed

Kader Maideen, Siti Fatimah; Mohd-Sidik, Sherina; Rampal, Lekhraj; Mukhtar, Firdaus; Ibrahim, Normala; Phang, Cheng-Kar; Tan, Kit-Aun; Ahmad, Rozali

2016-06-21

Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens. The objective of this study is to investigate the effectiveness of 4 weeks of a Web-based psychoeducational intervention program for depressive and anxiety symptoms in the community of Selangor, Malaysia. A two-arm randomized controlled trial of a single-blind study will be conducted to meet the objective of this study. We aim to recruit 84 participants each for the intervention and control groups. The recruitment will be from participants who participated in the first phase of this research. The primary outcomes of this study are depressive and anxiety scores, which will be assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7, respectively. The secondary outcome includes mental health literacy of the participants, which will be assessed using the self-developed and adapted Mental Health Literacy Questionnaire. The psychoeducational intervention program consists of four sessions, which will be accessed each week. The depressive and anxiety symptoms will be compared between participants who participated in the psychoeducational program compared with the control group. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at follow-ups at week 5 and week 12, respectively. The psychoeducational intervention program consists of four sessions, which will be accessed at each week. The depressive and anxiety symptoms will be compared between the intervention and control groups using a series of mixed ANOVAs. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at two follow-ups at week 5 and week 12, respectively. To our knowledge, this study will be the first randomized controlled trial of a Web-based psychoeducational intervention program for depression and anxiety in an adult community in Malaysia. The results from this study will determine the effectiveness of a psychoeducational intervention program in the management of depression and anxiety among adults in the community. If proven to be effective, the intervention can serve as a new modality to manage and reduce the burden of these disorders in the community. International Standard Randomized Controlled Trial Number (ISRCTN): 39656144; http://www.isrctn.com/ISRCTN39656144 (Archived by WebCite at http://www.webcitation.org/6hSVhV71K).

Making It Local: Beacon Communities Use Health Information Technology to Optimize Care Management

PubMed Central

Allen, Amy; Des Jardins, Terrisca R.; Heider, Arvela; Kanger, Chatrian R.; Lobach, David F.; McWilliams, Lee; Polello, Jennifer M.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C.; Turske, Scott A.

2014-01-01

Abstract Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks—including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation—the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability. (Population Health Management 2014;17:149–158) PMID:24476558

Low-income Renewable Energy Programs: Case Studies of State Policy in California and Massachusetts

NASA Astrophysics Data System (ADS)

Kelly, Kaitlin

Energy policies aimed at reducing the burden of monthly utility costs on low-income families have been established since the 1970s. Energy use impacts low-income families and organizations through housing specific costs, health and wellness, and opportunity costs. States have begun to run renewable energy installation programs aimed at reducing costs for low-income communities. This thesis examines two of these programs, the solar photovoltaic policies in California as part of the Single Family Affordable Solar Housing and Multi-family Affordable Solar Housing programs, and the Low-income Solar Housing program in Massachusetts. Lessons learned from reviewing these programs are that renewable energy programs are an effective strategy for reducing utility costs for low-income communities, but that the total effectiveness of the program is dependent on removing cost barriers, implementing energy efficiency improvements, and increasing consumer education through established community networks and relationships.

Evaluation of Abdominal Ultrasonography Mass Screening for Hepatocellular Carcinoma in Taiwan

PubMed Central

Yeh, Yen-Po; Hu, Tsung-Hui; Cho, Po-Yuan; Chen, Hsiu-Hsi; Yen, Amy Ming-Fang; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Fann, Jean Ching-Yuan; Su, Wei-Wen; Fang, Yi-Jen; Chen, Shih-Tien; San, Hsiao-Ching; Chen, Hung-Pin; Liao, Chao-Sheng

2014-01-01

Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community-based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high-incidence area to attend a risk score-guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community-based ultrasonography screening. Among the 16 screen-detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age- and gender-adjusted relative mortality rates of 0.69 (95% confidence interval [CI]: 0.56-0.84) and 0.63 (95% CI: 0.52-0.77), respectively. Conclusion: The residents invited to community-based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼31% among subjects aged 45-69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection. (Hepatology 2014;59:1840–1849) PMID:24002724

Implementing a Mental Health Ministry Committee in Faith-Based Organizations: The Promoting Emotional Wellness and Spirituality Program

PubMed Central

Williams, Laverne; Gorman, Robyn; Hankerson, Sidney

2014-01-01

Social workers have successfully collaborated with African American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a pre-existing relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation. PMID:24717187

Community Leadership through Community-Based Programming: The Role of the Community College.

ERIC Educational Resources Information Center

Boone, Edgar J.; And Others

Organized around 15 tasks involved in the community-based programming (CBP) process, this book provides practical, field-tested guidance on successfully implementing CBP in community colleges. Following prefatory materials, the following chapters are provided: (1) "An Introduction to the Community-Based Programming Process" (Edgar J.…

Community-based pulmonary rehabilitation in a non-healthcare facility is feasible and effective.

PubMed

Cecins, Nola; Landers, Holly; Jenkins, Sue

2017-02-01

Pulmonary rehabilitation programs (PRPs) are most commonly provided in hospital settings which present barriers to attendance such as long distances or travel times. Community-based settings have been used in an attempt to alleviate the travel burden. This study evaluated the feasibility and outcomes of a network of community-based PRPs provided in non-healthcare facilities (CPRPs). The CPRPs were established in five venues and comprised two supervised group sessions each week for 8 weeks. Participant inclusion criteria and guidelines for exercise testing and training were developed to reduce the risk of adverse events. Outcome measures included 6-min walk distance (6MWD) and health-related quality of life (chronic respiratory questionnaire (CRQ)). Respiratory-related hospital admission data were collected in the 12 months prior to and following the program. Two hundred and fifty-one participants (79% with chronic obstructive pulmonary disease: mean ± SD FEV 1 49 ± 21%predicted) entered a CPRP of which 166 (66%) completed. Improvements were demonstrated in 6MWD (mean difference (95% CI) 44 m (37-52)) and total CRQ score (0.5 points per item (0.4-0.7)). Fewer participants had a respiratory-related hospital admission following the program (12% vs. 37%, p < 0.0001). Pulmonary rehabilitation is safe, feasible and effective when conducted in community-based non-healthcare facilities.

Adoption of safety eyewear among citrus harvesters in rural Florida.

PubMed

Monaghan, Paul F; Bryant, Carol A; McDermott, Robert J; Forst, Linda S; Luque, John S; Contreras, Ricardo B

2012-06-01

The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida's migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear's ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers' use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection.

Reducing Energy Burden with Solar: Colorado's Strategy and a Roadmap for

Science.gov Websites

purchasing other necessities. In some circumstances, solar photovoltaics (PV) can reduce this energy burden -income community solar demonstration projects Incorporating PV into its weatherization program Promoting utility investment in low-income PV programs. In 2015, CEO launched its low-income community solar program

Yéego Gardening! A Community Garden Intervention to Promote Health on the Navajo Nation.

PubMed

Ornelas, India J; Deschenie, Desiree; Jim, Jesse; Bishop, Sonia; Lombard, Kevin; Beresford, Shirley A

2017-01-01

Yéego Gardening! is a community garden intervention to increase gardening behavior, increase access to low-cost fruit and vegetables, and ultimately increase consumption in Navajo communities. To design a theory-based, culturally relevant intervention with three components: a community garden, monthly workshops on gardening and healthy eating, and community outreach. Gardens were constructed and maintained in collaboration with community-based organizations in two Navajo communities. Monthly workshops were held throughout the growing season and incorporated aspects of Navajo culture and opportunities to build confidence and skills in gardening and healthy eating behaviors. In addition, program staff attended community events to promote gardening and healthy eating. Community input was essential throughout the planning and implementation of the intervention. If effective, community gardens may be a way to increase fruit and vegetable availability and intake, and ultimately reduce risk of obesity and diabetes.

45 CFR 2517.600 - How are funds for community-based service-learning programs distributed?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are funds for community-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2517.600 How are funds for community-based service-learning programs distributed? All...

45 CFR 2517.600 - How are funds for community-based service-learning programs distributed?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false How are funds for community-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2517.600 How are funds for community-based service-learning programs distributed? All...

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college.

PubMed

Scull, Tracy Marie; Kupersmidt, Janis Beth; Malik, Christina Valerie; Keefe, Elyse Mallory

2018-04-01

To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. 184 community college students (ages 18-19) participated in the study from April-December 2015. Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.

Reduced 10-year risk of coronary heart disease in patients who participated in a community-based diabetes prevention program: the DEPLOY pilot study.

PubMed

Lipscomb, Elaine R; Finch, Emily A; Brizendine, Edward; Saha, Chandan K; Hays, Laura M; Ackermann, Ronald T

2009-03-01

We evaluated whether participation in a community-based group diabetes prevention program might lead to relative changes in composite 10-year coronary heart disease (CHD) risk for overweight adults with abnormal glucose metabolism. We used the UK Prospective Diabetes Study engine to estimate CHD risk for group-lifestyle and brief counseling (control) groups. Between-group risk changes after 4 and 12 months were compared using ANCOVA. Baseline 10-year risk was similar between treatment groups (P = 0.667). At 4 and 12 months, the intervention group experienced significant decreases in 10-year risk from baseline (-3.28%, P < 0.001; and -2.23%, P = 0.037) compared with control subjects (-0.78%, P = 0.339; and +1.88%, P = 0.073). Between-group differences were statistically significant and increased from the 4- to 12-month visits. Community-based delivery of the Diabetes Prevention Program lifestyle intervention could be a promising strategy to prevent both CHD and type 2 diabetes in adults with pre-diabetes.

45 CFR 2517.300 - Who may participate in a community-based service-learning program?

Code of Federal Regulations, 2010 CFR

2010-10-01

...-learning program? 2517.300 Section 2517.300 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2517.300 Who may participate in a community-based service-learning program...

45 CFR 2517.300 - Who may participate in a community-based service-learning program?

Code of Federal Regulations, 2011 CFR

2011-10-01

...-learning program? 2517.300 Section 2517.300 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2517.300 Who may participate in a community-based service-learning program...

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

PubMed Central

Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

2017-01-01

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

Hard Times: The Effects of Financial Strain on Home Care Services Use and Participant Outcomes in Michigan

ERIC Educational Resources Information Center

D'Souza, Jennifer C.; James, Mary L.; Szafara, Kristina L.; Fries, Brant E.

2009-01-01

Purpose: When government funding for long-term care is reduced, participant outcomes may be adversely affected. We investigated the effect of program resources on individuals enrolled in the Michigan Home- and Community-Based Services (HCBS) waiver program for elderly and disabled adults. Design and Methods: Using dates of major policy and budget…

On Belay: Providing Connection, Support, and Empowerment to Children Who Have a Parent with Cancer

ERIC Educational Resources Information Center

Tucker, Anita R.; Sugerman, Deb; Zelov, Ryan

2013-01-01

Focus groups with youth and their parents were used in this research study to better understand the impact of the On Belay Program, an adventure-based support group for youth whose parents have cancer. Results demonstrated that challenge course programs reduce isolation in youth by creating a caring community and normalizing the cancer experience.…

How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review.

PubMed

Black, Andrew P; D'Onise, Katina; McDermott, Robyn; Vally, Hassan; O'Dea, Kerin

2017-10-17

Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities. A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes. The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F&V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities. Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.

Community-Based Mindfulness Program for Disease Prevention and Health Promotion: Targeting Stress Reduction.

PubMed

Galla, Brian M; O'Reilly, Gillian A; Kitil, M Jennifer; Smalley, Susan L; Black, David S

2015-01-01

Poorly managed stress leads to detrimental physical and psychological consequences that have implications for individual and community health. Evidence indicates that U.S. adults predominantly use unhealthy strategies for stress management. This study examines the impact of a community-based mindfulness training program on stress reduction. This study used a one-group pretest-posttest design. The study took place at the UCLA Mindful Awareness Research Center in urban Los Angeles. A sample of N = 127 community residents (84% Caucasian, 74% female) were included in the study. Participants received mindfulness training through the Mindful Awareness Practices (MAPs) for Daily Living I. Mindfulness, self-compassion, and perceived stress were measured at baseline and postintervention. Paired-sample t-tests were used to test for changes in outcome measures from baseline to postintervention. Hierarchical regression analysis was fit to examine whether change in self-reported mindfulness and self-compassion predicted postintervention perceived stress scores. There were statistically significant improvements in self-reported mindfulness (t = -10.67, p < .001, d = .90), self-compassion (t = -8.50, p < .001, d = .62), and perceived stress (t = 9.28, p < .001, d = -.78) at postintervention. Change in self-compassion predicted postintervention perceived stress (β = -.44, t = -5.06, p < .001), but change in mindfulness did not predict postintervention perceived stress (β = -.04, t = -.41, p = .68). These results indicate that a community-based mindfulness training program can lead to reduced levels of psychological stress. Mindfulness training programs such as MAPs may offer a promising approach for general public health promotion through improving stress management in the urban community.

Development of a sustainable community-based dental education program.

PubMed

Piskorowski, Wilhelm A; Fitzgerald, Mark; Mastey, Jerry; Krell, Rachel E

2011-08-01

Increasing the use of community-based programs is an important trend in improving dental education to meet the needs of students and the public. To support this trend, understanding the history of programs that have established successful models for community-based education is valuable for the creation and development of new programs. The community-based education model of the University of Michigan School of Dentistry (UMSOD) offers a useful guide for understanding the essential steps and challenges involved in developing a successful program. Initial steps in program development were as follows: raising funds, selecting an outreach clinical model, and recruiting clinics to become partners. As the program developed, the challenges of creating a sustainable financial model with the highest educational value required the inclusion of new clinical settings and the creation of a unique revenue-sharing model. Since the beginning of the community-based program at UMSOD in 2000, the number of community partners has increased to twenty-seven clinics, and students have treated thousands of patients in need. Fourth-year students now spend a minimum of ten weeks in community-based clinical education. The community-based program at UMSOD demonstrates the value of service-based education and offers a sustainable model for the development of future programs.

Establishment of an appropriate fall prevention program: A community-based study.

PubMed

Otaka, Yohei; Morita, Mitsuo; Mimura, Toshio; Uzawa, Mitsuyoshi; Liu, Meigen

2017-07-01

To identify an appropriate community-based fall prevention program METHODS: We introduced two programs to 24 senior centers, "community salons," in a Japanese city, and carried out a prospective controlled trial between 2004 and 2005. Eight salons (185 participants aged 72.0 ± 7.1 years) received a single-visit program consisting of one multidisciplinary team visit that included fall risk assessment with feedback and a fall prevention lecture. A total of 16 salons (418 participants aged 73.6 ± 7.4 years) received a year-round comprehensive program, with visits carried out every 3 months. We compared the fall rates for 1 year between the two programs. Based on the results, we implemented a modified program until 2014 and examined the long-term consequences. In the prospective controlled trial, fall rates did not differ significantly between programs (P = 0.449). Instead, fall rates for both programs decreased significantly by 0.89 (95% CI 0.84-0.94) times each month. Therefore, we implemented a modified version of the single-visit program. By March 2014, the programs had been delivered to 1863 individuals, and the total number of attendees was 6622. The average attendance frequency per participant was 0.62 times per year. The majority (85.3%) of salons requested the program every year. Overall, the risk of falling (fall rates in the preceding year) decreased significantly as the number of program attendances increased (incident rate ratio = 0.89, 95% CI 0.85-0.92) irrespective of initial program types. The programs including fall risk assessment with feedback and a fall prevention lecture reduced falls when embedded into the community, and they were accepted well over the course of 10 years. Geriatr Gerontol Int 2017; 17: 1081-1089. © 2016 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Healing the community to heal the individual: literature review of aboriginal community-based alcohol and substance abuse programs.

PubMed

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-07-01

To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.

Logistics of Guinea Worm Disease Eradication in South Sudan

PubMed Central

Jones, Alexander H.; Becknell, Steven; Withers, P. Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R.; Stobbelaar, David; Makoy, Samuel Yibi

2014-01-01

From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical–logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries. PMID:24445199

Logistics of Guinea worm disease eradication in South Sudan.

PubMed

Jones, Alexander H; Becknell, Steven; Withers, P Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R; Stobbelaar, David; Makoy, Samuel Yibi

2014-03-01

From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical-logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries.

Academic Facility Utilization and Survival Outcomes in Adult Head and Neck Sarcomas: An NCDB Analysis.

PubMed

Cannon, Richard B; Carpenter, Patrick S; Boothe, Dustin; Buchmann, Luke O; Hunt, Jason P; Lloyd, Shane; Hitchcock, Ying J; Houlton, Jeffrey J; Weis, John R; Shepherd, Hailey M; Monroe, Marcus M

2018-04-01

Objectives To investigate clinicopathologic and treatment factors associated with survival in adult head and neck sarcomas in the National Cancer Database (NCDB). To analyze whether treatment settings and therapies received influence survival outcomes and to compare trends in utilization via an aggregated national data set. Study Design Prospectively gathered data. Setting NCDB. Subjects and Methods The study comprised a total of 6944 adult patients treated for a head and neck sarcoma from January 2004 to December 2013. Overall survival (OS) was the primary outcome. Results Increased age and tumor size, nodal involvement, and poorly differentiated histology had significantly reduced OS ( P < .001). Angiosarcoma, malignant nerve sheath tumor, malignant fibrous histiocytoma, osteosarcoma, and rhabdomyosarcoma histologic subtypes had significantly reduced OS, while liposarcoma, chondrosarcoma, and chordoma had improved OS ( P < .001). Utilization of surgical therapy was associated with improved OS, while positive surgical margins were associated with treatment at a community-based cancer program and had reduced OS ( P < .001). On multivariate analysis, treatment with radiation and/or chemotherapy was not significantly associated with OS; however, primary treatment with definitive chemoradiotherapy had significantly reduced OS. Patients treated at academic/research cancer programs (n = 3874) had significantly improved 5- and 10-year OS (65% and 54%, respectively) when compared with patients treated at community-based cancer programs (n = 3027; 49% and 29%; P < .001). The percentage utilization of these programs (56% vs 44%) did not change over the study period. Conclusion For adult head and neck sarcomas, treatment at an academic/research cancer program was associated with improved survival; however, despite increasing medical specialization, the percentage utilization of these programs for this rare tumor remains constant.

School-Based Caries Prevention, Tooth Decay, and the Community Environment.

PubMed

Ruff, R R; Niederman, R

2018-04-01

The school and community context can contribute to inequity in child oral health. Whether the school and community affect the effectiveness of school-based caries prevention is unknown. The association between the school and community environment and dental caries, as well as their moderating effects with school-based caries prevention, was assessed using multilevel mixed-effects regression. Data were derived from a 6-y prospective cohort study of children participating in a school-based caries prevention program. For the school and community, living in a dental-shortage area and the proportion of children receiving free or reduced lunch were significantly related to an increased risk of dental caries at baseline. Caries prevention was associated with a significant per-visit decrease in the risk of untreated caries, but the rate of total caries experience increased over time. Caries prevention was more effective in children who had prior dental care at baseline and in schools with a higher proportion of low socioeconomic status students. There was significant variation across schools in the baseline prevalence of dental caries and the effect of prevention over time, although effects were modest. The school and community environment have a direct impact on oral health and moderate the association between school-based caries prevention and dental caries. Knowledge Transfer Statement: School-based caries prevention can be an effective means to reduce oral health inequity by embedding dental care within schools. However, the socioeconomic makeup of schools and characteristics of the surrounding community can affect the impact of school-based care.

Witness for Wellness: preliminary findings from a community-academic participatory research mental health initiative.

PubMed

Bluthenthal, Ricky N; Jones, Loretta; Fackler-Lowrie, Nicole; Ellison, Marcia; Booker, Theodore; Jones, Felica; McDaniel, Sharon; Moini, Moraya; Williams, Kamau R; Klap, Ruth; Koegel, Paul; Wells, Kenneth B

2006-01-01

Quality improvement programs promoting depression screening and appropriate treatment can significantly reduce racial and ethnic disparities in mental-health care and outcomes. However, promoting the adoption of quality-improvement strategies requires more than the simple knowledge of their potential benefits. To better understand depression issues in racial and ethnic minority communities and to discover, refine, and promote the adoption of evidence-based interventions in these communities, a collaborative academic-community participatory partnership was developed and introduced through a community-based depression conference. This partnership was based on the community-influenced model used by Healthy African-American Families, a community-based agency in south Los Angeles, and the Partners in Care model developed at the UCLA/RAND NIMH Health Services Research Center. The integrated model is described in this paper as well as the activities and preliminary results based on multimethod program evaluation techniques. We found that combining the two models was feasible. Significant improvements in depression identification, knowledge about treatment options, and availability of treatment providers were observed among conference participants. In addition, the conference reinforced in the participants the importance of community mobilization for addressing depression and mental health issues in the community. Although the project is relatively new and ongoing, already substantial gains in community activities in the area of depression have been observed. In addition, new applications of this integrated model are underway in the areas of diabetes and substance abuse. Continued monitoring of this project should help refine the model as well as assist in the identification of process and outcome measures for such efforts.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

PubMed

Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Towards a framework for analyzing determinants of performance of community health workers in malaria prevention and control: a systematic review.

PubMed

Chipukuma, Helen Mwiinga; Zulu, Joseph Mumba; Jacobs, Choolwe; Chongwe, Gershom; Chola, Mumbi; Halwiindi, Hikabasa; Zgambo, Jessy; Michelo, Charles

2018-05-08

Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking. We systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications. We included 16 full text articles that evaluated CHW performance in malaria control. Search terms were used and studies that had performance as an outcome of interest attributed to community-based interventions done by CHWs were included. Sixteen studies were included in the final review and were mostly on malaria Rapid Diagnosis and Treatment, as well as adherence to referral guidelines. Factors determining performance and effective implementation of CHW malaria programs included health system factors such as nature of training of CHWs; type of supervision including feedback process; availability of stocks, supplies, and job aids; nature of work environment and reporting systems; availability of financial resources and transport systems; types of remuneration; health staff confidence in CHWs; and workload. In addition, community dynamics such as nature of community connectedness and support from the community and utilization of services by the community also influenced performance. Furthermore, community health worker characteristics such marital status, sex, and CHW confidence levels also shaped CHW performance. Effectively analyzing and promoting the performance of CHWs in malaria prevention and control programs may require adopting a framework that considers health systems and community factors as well as community health worker characteristics.

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

PubMed

Shannon, Crystal

2014-01-01

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

Measuring impacts of community forestry program through repeat photography and satellite remote sensing in the Dolakha district of Nepal.

PubMed

Niraula, Rabin Raj; Gilani, Hammad; Pokharel, Bharat Kumar; Qamer, Faisal Mueen

2013-09-15

During the 1990's community-based forest management gained momentum in Nepal. This study systematically evaluates the impacts that this had on land cover change and other associated aspects during the period 1990-2010 using repeat photography and satellite imagery in combination with interviews with community members. The results of the study clearly reflect the success of community-based forest management in the Dolakha district of the mid-hills of Nepal: during the study period, the rate of conversion of sparse forest into dense forest under community-based management was found to be between 1.13% and 3.39% per year. Similarly, the rate of conversion of non-forest area into forest was found to be between 1.11% and 1.96% per year. Community-based forest management has resulted in more efficient use of forest resources, contributed to a decline in the use of slash-and-burn agricultural practices, reduced the incidence of forest fires, spurred tree plantation, and encouraged the conservation and protection of trees on both public and private land. The resulting reclamation of forest in landside areas and river banks and the overall improvement in forest cover in the area has reduced flash floods and associated landslides. Copyright © 2013 Elsevier Ltd. All rights reserved.

What Health Service Provider Factors Are Associated with Low Delivery of HIV Testing to Children with Acute Malnutrition in Dowa District of Malawi?

PubMed

Chitete, Lusungu; Puoane, Thandi

2015-01-01

The Community-based Management of Acute Malnutrition is the national program for treating acute malnutrition in Malawi. Under this program's guidelines all children enrolled should undergo an HIV test, so that those infected can receive appropriate treatment and care. However, the national data of 2012 shows a low delivery of testing. Prior studies have investigated client-related factors affecting uptake of HIV testing in Community-based Management of Acute Malnutrition program. Lacking is the information on the service provider factors that are associated with the delivery of testing. This study investigated service provider factors that affect delivery of HIV testing among children enrolled in the program and explored ways in which this could be improved. A descriptive study that used qualitative methods of data collection. Client registers were reviewed to obtain the number of children enrolled in Community-based Management of Acute Malnutrition and the number of children who were tested for HIV over a 12-month period. In-depth interviews were conducted with Community-based Management of Acute Malnutrition and HIV Testing and Counselling focal persons to investigate factors affecting HIV test delivery. Descriptive statistics were used to analyze data from client registers. Information from interviews was analyzed using a thematic approach. Quantitative data revealed that 1738 (58%) of 2981 children enrolled in Community-based Management of Acute Malnutrition were tested for HIV. From in-depth interviews four themes emerged, that is, lack of resources for HIV tests; shortage of staff skilled in HIV testing and counseling; lack of commitment among staff in referring children for HIV testing; and inadequately trained staff. There is a need for a functioning health system to help reduce child mortality resulting from HIV related conditions.

A Model for Community College/High School Articulation.

ERIC Educational Resources Information Center

Wellsfry, Norval; Rosen, M. Frances

By initiating formal structures for cooperation and coordination of programming between themselves and local high schools, community colleges can reduce the amount of unnecessary duplication of efforts and programs and can benefit many students who, without such a program of articulation, would be unprepared for community college course work.…

Faith Moves Mountains: An Appalachian Cervical Cancer Prevention Program

PubMed Central

Schoenberg, Nancy E.; Hatcher, Jennifer; Dignan, Mark B.; Shelton, Brent; Wright, Sherry; Dollarhide, Kaye F.

2009-01-01

Objective To provide a conceptual description of Faith Moves Mountains (FMM), an intervention designed to reduce the disproportionate burden of cervical cancer among Appalachian women. Methods FMM, a community-based participatory research program designed and implemented in collaboration with churches in rural, southeastern Kentucky, aims to increase cervical cancer screening (Pap tests) through a multiphase process of educational programming and lay health counseling. Results We provide a conceptual overview to key elements of the intervention, including programmatic development, theoretical basis, intervention approach and implementation, and evaluation procedures. Conclusions After numerous modifications, FMM has recruited and retained over 400 women, 30 churches, and has become a change agent in the community. PMID:19320612

Expanding a community's justice response to sex crimes through advocacy, prosecutorial, and public health collaboration: introducing the RESTORE program.

PubMed

Koss, Mary P; Bachar, Karen J; Hopkins, C Quince; Carlson, Carolyn

2004-12-01

Problems in criminal justice system response to date-acquaintance rape and nonpenetration sexual offenses include (a) they are markers of a sexual offending career, yet are viewed as minor; (b) perpetrators are not held accountable in ways that reduce reoffense; and (c) criminal justice response disappoints and traumatizes victims. To address these problems, a collaboration of victim services, prosecutors, legal scholars, and public health professionals are implementing and evaluating RESTORE, a victim-driven, community-based restorative justice program for selected sex crimes. RESTORE prepares survivors, responsible persons (offenders), and both parties' families and friends for face-to-face dialogue to identify the harm and develop a redress plan. The program then monitors the offender's compliance for 12 months. The article summarizes empirical data on problems in criminal justice response, defines restorative justice models, and examines outcome. Then the RESTORE program processes and goals are described. The article highlights community collaboration in building and sustaining this program.

Exergaming for health: a community-based pediatric weight management program using active video gaming.

PubMed

Christison, Amy; Khan, Huma Ali

2012-04-01

To evaluate the efficacy and feasibility of a multifaceted, community-based weight intervention program for children using exergaming technology (activity-promoting video gaming). This is a prospective observational pilot study. Forty-eight children, between the ages of 8 and 16 years, who are overweight or obese, enrolled in Exergaming for Health, a multidisciplinary weight management program, which used active video gaming. Primary outcome measures were change in body mass index (BMI) z scores. Most children (n = 40, 83%) completed the program and participated in outcome evaluations. The average BMI change was -0.48 kg/m(2) (SD = 0.93), P < .002 (BMI z-score change was -0.072, SD = 0.14, P < .0001). The average Global Self-Worth score improved, screen time and soda intake reduced, and exercise hours per week increased. The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates. A larger randomized controlled trial is needed to confirm these results.

A randomized, controlled trial of a school-based intervention to reduce violence and substance use in predominantly Latino high school students.

PubMed

Shetgiri, Rashmi; Kataoka, Sheryl; Lin, Hua; Flores, Glenn

2011-01-01

Few studies have rigorously evaluated school-based interventions to reduce violence and substance use in high school students, especially Latinos. This study assessed the effects of a school-based program on reducing violence and substance use among primarily Latino high school students. Ninth-grade students at risk for violence and substance use were randomized to intervention or control groups. The intervention was based on an existing program developed for white and African American youth. Data on smoking, alcohol and drug use, fighting, and grades were collected at baseline and 4 and 8 months post enrollment. There were 55 students in the control and 53 in the intervention group; 74% of controls and 78% of intervention students were Latino. There were no significant changes in fighting, smoking, or alcohol or drug use, from baseline to 8-month follow-up, between the intervention and control group. Pre and post grade point average (GPA) decreased from 2.3 at baseline to 1.8 at follow-up (p<.01) in the intervention group, with no significant between-group changes in GPA from baseline to follow-up. This school-based program showed no reduction in violence or substance use. The findings suggest that a program targeting non-Latino youth may not be optimal for reducing violence and substance use in Latinos; greater attention to cultural appropriateness and racial/ethnic differences may be needed. There was a decrease in intervention-group GPA but no significant change compared with controls. Further studies of the impact of school-based substance use and violence prevention programs on academics, and the effectiveness of afterschool or community-based programs compared to school-based programs are needed.

Development of a culturally sensitive educational intervention program to reduce the high incidence of tuberculosis among foreign-born Vietnamese.

PubMed

Houston, H Rika; Harada, Nancy; Makinodan, Takashi

2002-11-01

In Los Angeles County and Orange County, 98% of Asians with tuberculosis (TB) were foreign born; newly arrived Vietnamese immigrants had the highest TB risk: i.e. > 100 times higher than that of the USA. The study objective was to find ways to reduce the high incidence of tuberculosis among the Vietnamese by: (1) identifying and understanding the cultural health beliefs and barriers among the Vietnamese population of Orange County, California; and (2) developing a partnership between UCLA/VA/RAND MEDTEP, key Vietnamese community-based organizations, and community leaders in Orange County to develop and implement a comprehensive, culturally sensitive educational intervention program. Vietnamese residing in Orange County were recruited to obtain qualitative and quantitative data in 1998 and 1999, respectively. The study design included focus groups, in-depth interviews, and community surveys. Data were collected via qualitative reports, computer-assisted random telephone interviews, and self-administered questionnaires. A conceptual schema was identified within the Vietnamese health belief system that recognized two different forms of tuberculosis: non-infectious psychological and infectious physical tuberculosis. It was possible to engage community organizations in developing programs to combat TB in the Vietnamese population. The Health beliefs of Vietnamese will be important considerations in developing a culturally sensitive educational intervention program to service this at-risk population.

Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy

PubMed Central

Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra; Hecht, Mindy; Hedmann, Monique; Huq, Saima; Gerin, William; Chinchilli, Vernon; Ogedegbe, Gbenga; Noble, James

2015-01-01

Objective Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke. Methods Hip Hop Stroke (HHS) is a school-based, child-mediated, culturally-tailored stroke communication multimedia intervention developed using validated models of behavior change and designed to improve stroke literacy (knowledge of stroke symptoms, the urgent need to call 911, and prevention measures) of 4th, 5th and 6th grade students and their parents residing in poor urban communities. Children in the intervention arm will receive the HHS intervention, while those in the attentional control arm will receive standardized nutrition education based on the USDA's MyPyramid program. Children will be trained and motivated to share stroke information with their parents or other adult caregiver. Both children and parents will complete a stroke knowledge assessment at baseline, immediately following the program, and at 3-months post-program. The primary outcome is the effect of the child mediation on parental stroke literacy. Conclusion Stroke literate children, a captive audience in school systems, may represent a viable channel for spreading stroke information into households of poor urban communities where mass media stroke campaigns have shown the lowest penetration. These children may also call 911 when witnessing a stroke in their homes or communities. The HHS program may highlight the potential role of children in the chain of stroke recovery as a strategy for reducing prehospital delays to acute stroke treatment. PMID:26779395

Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy.

PubMed

Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra; Hecht, Mindy; Hedmann, Monique; Huq, Saima; Gerin, William; Chinchilli, Vernon; Ogedegbe, Gbenga; Noble, James

2015-10-01

Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke. Hip Hop Stroke (HHS) is a school-based, child-mediated, culturally-tailored stroke communication multimedia intervention developed using validated models of behavior change and designed to improve stroke literacy (knowledge of stroke symptoms, the urgent need to call 911, and prevention measures) of 4 th , 5 th and 6 th grade students and their parents residing in poor urban communities. Children in the intervention arm will receive the HHS intervention, while those in the attentional control arm will receive standardized nutrition education based on the USDA's MyPyramid program. Children will be trained and motivated to share stroke information with their parents or other adult caregiver. Both children and parents will complete a stroke knowledge assessment at baseline, immediately following the program, and at 3-months post-program. The primary outcome is the effect of the child mediation on parental stroke literacy. Stroke literate children, a captive audience in school systems, may represent a viable channel for spreading stroke information into households of poor urban communities where mass media stroke campaigns have shown the lowest penetration. These children may also call 911 when witnessing a stroke in their homes or communities. The HHS program may highlight the potential role of children in the chain of stroke recovery as a strategy for reducing prehospital delays to acute stroke treatment.

Alberta Healthy Living Program--a model for successful integration of chronic disease management services.

PubMed

Morrin, Louise; Britten, Judith; Davachi, Shahnaz; Knight, Holly

2013-08-01

The most common presentation of chronic disease is multimorbidity. Disease management strategies are similar across most chronic diseases. Given the prevalence of multimorbidity and the commonality in approaches, fragmented single disease management must be replaced with integrated care of the whole person. The Alberta Healthy Living Program, a community-based chronic disease management program, supports adults with, or at risk for, chronic disease to improve their health and well being. Participants gain confidence and skills in how to manage their chronic disease(s) by learning to understand their health condition, make healthy eating choices, exercise safely and cope emotionally. The program includes 3 service pillars: disease-specific and general health patient education, disease-spanning supervised exercise and Better Choices, Better Health(TM) self-management workshops. Services are delivered in the community by an interprofessional team and can be tailored to target specific diverse and vulnerable populations, such as Aboriginal, ethno-cultural and francophone groups and those experiencing homelessness. Programs may be offered as a partnership between Alberta Health Services, primary care and community organizations. Common standards reduce provincial variation in care, yet maintain sufficient flexibility to meet local and diverse needs and achieve equity in care. The model has been implemented successfully in 108 communities across Alberta. This approach is associated with reduced acute care utilization and improved clinical indicators, and achieves efficiencies through an integrated, disease-spanning patient-centred approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Primary prevention of metabolic syndrome in the community using an evidence-based exercise program.

PubMed

Dalleck, Lance C; Van Guilder, Gary P; Quinn, Esther M; Bredle, Don L

2013-10-01

The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors. MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire. Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (p<0.05), while prevalence of participants with no MetS components increased 56% (from 65 to 102; p<0.05). Compared to the lowest quartile of relative energy expenditure, participants with the highest quartile were 6.4 (95% CI 1.8-23.2; p<0.05), 7 (95% CI 2.5-20.0; p<0.05) and 9.3 (95% CI 2.6-34.0; p<0.05) times more likely to eliminate low-HDL cholesterol, impaired fasting glucose, and low cardiorespiratory fitness as MetS risk factors, respectively. A community exercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination. Copyright © 2013 Elsevier Inc. All rights reserved.

Influences of a Church-Based Intervention on Falls Risk Among Seniors.

PubMed

Briggs, Morgan; Morzinski, Jeffrey A; Ellis, Julie

2017-08-01

Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency. The 100 Healthy, At-Risk Families study team implemented 8 monthly educational health sessions promoting self-care and social support. Community nurses led the 60- to 90-minute sessions at each of 10 churches. To collect study data, nurses interviewed enrolled seniors pre- and post-intervention. Descriptive and comparison statistics were analyzed in Excel and Statistical Package for Social Sciences. Senior data at baseline found high rates of polypharmacy and physical imbalance, and no significant depression or gaps in social support. There was not a statistically significant change pre- to post-program in fall frequency "in prior year." Study findings reveal insights about African American senior health and fall risks. Church settings may provide a protective, psychosocial buffer for seniors, while polypharmacy and mobility/balance concerns indicate need for continued attention to fall risks. No increase in pre- to post-program falls was encouraging.

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

PubMed Central

Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

2017-01-01

Background Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. Methods In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. Conclusion BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility. PMID:28264043

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

PubMed

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

2012-12-01

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

DEVELOPING A TRANSCULTURAL ACADEMIC-COMMUNITY PARTNERSHIP TO ARREST OBESITY

PubMed Central

LEE, REBECCA E.; SOLTERO, ERICA G.; MAMA, SCHEREZADE K.; SAAVEDRA, FIORELLA; LEDOUX, TRACEY A.; McNEILL, LORNA

2015-01-01

Innovative and empirically tested strategies are needed to define and understand obesity prevention and reduction in a transcultural society. This manuscript describes the development of Science & Community, a partnership developed over a 3-year period with the end goal of implementing a community-based participatory research (CBPR) trial to reduce and prevent obesity. Outreach strategies focused on promoting the project via existing and new channels and identifying and contacting potential partners using established strategies. Science & Community developed and fostered partnerships by hosting a series of interactive meetings, including three Opportunity Receptions, four Community Open Forum Symposia, and quarterly Community Advisory Board (CAB) meetings. Opportunity Reception (N = 62) and Symposia attendees (N = 103) represented the diversity of the community, and participants reported high satisfaction with content and programming. From these events, the CAB was formed and was comprised of 13 community representatives. From these meetings, a Partnership representing 34 organizations and 614 individuals emerged that has helped to guide the development of future proposals and strategies to reduce obesity in Houston/Harris County. PMID:25030103

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

PubMed

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

Improving the state of health programming by using diffusion theory.

PubMed

Dearing, James W

2004-01-01

Year by year, the gaps between what is known about behavior change and what is actually practiced in social programs grow larger, especially for community-based programs intended to help minority populations, the poor, and those living in inner-city and rural areas. Internationally, such gaps between the state of knowledge and the state of practice lead to disparities in health, education, and development among societal groups, demographic sub-populations, communities, and countries. Data about disparities are used as evidence of inequality. Here, I discuss uses of certain diffusion of innovation theory-based concepts to systematically redress problems of inequality and disparity by reducing the differences between evidence and practice in social programs that are implemented by intermediaries (practitioners) and communicated by them to needy populations. The emphasis here is on the integrated application of knowledge about innovation attributes, opinion leadership, and clustering from diffusion theory to achieve the objective of more extensive and more rapid diffusion of especially effective programs. A set of implementation steps are offered for researchers, funders of international health programs, and the intermediaries who implement health programs.

Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren

PubMed Central

Caballero, Benjamin; Clay, Theresa; Davis, Sally M.; Ethelbah, Becky; Rock, Bonnie Holy; Lohman, Timothy; Norman, James; Story, Mary; Stone, Elaine J.; Stephenson, Larry; Stevens, June

2016-01-01

Background Childhood obesity is a major public health problem in the United States, particularly among American Indian communities. Objective The objective was to evaluate the effectiveness of a school-based, multicomponent intervention for reducing percentage body fat in American Indian schoolchildren. Design This study was a randomized, controlled, school-based trial involving 1704 children in 41 schools and was conducted over 3 consecutive years, from 3rd to 5th grades, in schools serving American Indian communities in Arizona, New Mexico, and South Dakota. The intervention had 4 components: 1) change in dietary intake, 2) increase in physical activity, 3) a classroom curriculum focused on healthy eating and lifestyle, and 4) a family-involvement program. The main outcome was percentage body fat; other outcomes included dietary intake, physical activity, and knowledge, attitudes, and behaviors. Results The intervention resulted in no significant reduction in percentage body fat. However, a significant reduction in the percentage of energy from fat was observed in the intervention schools. Total energy intake (by 24-h dietary recall) was significantly reduced in the intervention schools but energy intake (by direct observation) was not. Motion sensor data showed similar activity levels in both the intervention and control schools. Several components of knowledge, attitudes, and behaviors were also positively and significantly changed by the intervention. Conclusions These results document the feasibility of implementing a multicomponent program for obesity prevention in elementary schools serving American Indian communities. The program produced significant positive changes in fat intake and in food- and health-related knowledge and behaviors. More intense or longer interventions may be needed to significantly reduce adiposity in this population. PMID:14594792

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

PubMed Central

2012-01-01

Background The model of volunteer community health workers (CHWs) is a common approach to serving the poor communities in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in this area, has been using female CHWs as core workers in its community-based health programs since 1977. After 25 years of implementing of the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through a community-based maternal health intervention. However, BRAC experiences high dropout rates among CHWs suggesting a need to better understand the impact of their dropout which would help to reduce dropout and increase program sustainability. The main objective of the study was to estimate impact of dropout of volunteer CHWs from both BRAC and community perspectives. Also, we estimated cost of possible strategies to reduce dropout and compared whether these costs were more or less than the costs borne by BRAC and the community. Methods We used the ‘ingredient approach’ to estimate the cost of recruiting and training of CHWs and the so-called ‘friction cost approach’ to estimate the cost of replacement of CHWs after adapting. Finally, we estimated forgone services in the community due to CHW dropout applying the concept of the friction period. Results In 2009, average cost per regular CHW was US$ 59.28 which was US$ 60.04 for an ad-hoc CHW if a CHW participated a three-week basic training, a one-day refresher training, one incentive day and worked for a month in the community after recruitment. One month absence of a CHW with standard performance in the community meant substantial forgone health services like health education, antenatal visits, deliveries, referrals of complicated cases, and distribution of drugs and health commodities. However, with an additional investment of US$ 121 yearly per CHW BRAC could save another US$ 60 invested an ad-hoc CHW plus forgone services in the community. Conclusion Although CHWs work as volunteers in Dhaka urban slums impact of their dropout is immense both in financial term and forgone services. High cost of dropout makes the program less sustainable. However, simple and financially competitive strategies can improve the sustainability of the program. PMID:22897922

The Power of Plain Talk: Exploring One Program' Influence on the Adolescent Reproductive Health Field

ERIC Educational Resources Information Center

Summerville, Geri; Canova, Karen

2006-01-01

Launched by the Annie E. Casey Foundation in the early 1990s, Plain Talk is a community-based initiative that seeks to reduce the incidence of teen pregnancy and STDs by improving adult/teen communication about sex. A key component of the program is parental involvement--which was once seen by many in the adolescent reproductive health (ARH) field…

Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial.

PubMed

Kitzman, Heather; Dodgen, Leilani; Mamun, Abdullah; Slater, J Lee; King, George; Slater, Donna; King, Alene; Mandapati, Surendra; DeHaven, Mark

2017-11-01

Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (M age =48.8±11.2; M BMI =36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessing Community Readiness to Reduce Childhood Diarrheal Disease and Improve Food Security in Dioro, Mali.

PubMed

Borresen, Erica C; Stone, Cordelia; Boré, Abdoulaye; Cissoko, Alima; Maiga, Ababacar; Koita, Ousmane A; Ryan, Elizabeth P

2016-06-08

Diarrhea and malnutrition represent leading causes of death for children in Mali. Understanding a community's needs and ideas are critical to ensure the success of prevention and treatment interventions for diarrheal disease, as well as to improve food security to help reduce malnutrition. The objective of this study was to incorporate the Community Readiness Model (CRM) for the issues of childhood diarrheal disease and food security in Mali to measure baseline community readiness prior to any program implementation. Thirteen key respondents residing in Dioro, Mali were selected based on varied social roles and demographics and completed two questionnaires on these public health issues. The overall readiness score to reduce childhood diarrheal disease was 5.75 ± 1.0 standard deviation (preparation stage). The overall readiness score to improve food security was 5.5 ± 0.5 standard deviation (preparation stage). The preparation stage indicates that at least some of the community have basic knowledge regarding these issues, and want to act locally to reduce childhood diarrhea and improve food security and nutrition. Proposed activities to increase community readiness on these issues are provided and are broad enough to allow opportunities to implement community- and culturally-specific activities by the Dioro community.

Utilizing program evaluation as a strategy to promote community change: evaluation of a comprehensive, community-based, family violence initiative.

PubMed

Kaufman, Joy S; Crusto, Cindy A; Quan, Michael; Ross, Ellen; Friedman, Stacey R; O'Rielly, Kim; Call, Stephanie

2006-12-01

This paper describes the authors' work in a community that received Federal funding for an integrated system of care to reduce the impact and incidence of exposure to violence for children less than six years of age. The paper includes a review of the conceptual framework that guided the work of the authors and provides a brief overview of the issue of family violence, the impact of this violence on young children, and the Federal response to this issue. In addition, a description of the Initiative and the community in which it was based is provided along with some aspects of the evaluation plan. Finally, the authors discuss how their work with this Initiative depicts an approach to facilitating change within communities.

Improving Urban Minority Girls' Health Via Community Summer Programming.

PubMed

Bohnert, Amy M; Bates, Carolyn R; Heard, Amy M; Burdette, Kimberly A; Ward, Amanda K; Silton, Rebecca L; Dugas, Lara R

2017-12-01

Summertime has emerged as a high-risk period for weight gain among low-income minority youth who often experience a lack of resources when not attending school. Structured programming may be an effective means of reducing risk for obesity by improving obesogenic behaviors among these youth. The current multi-method study examined sedentary time, physical activity, and dietary intake among low-income urban minority girls in two contexts: an unstructured summertime setting and in the context of a structured 4-week community-based summer day camp program promoting physical activity. Data were analyzed using paired-sample t tests and repeated-measure analyses of variance with significance at the p < .05 level. Results evidenced no significant differences in total calories and fat consumed between the unstructured and structured settings. Participants exhibited significant increases in fruit consumption and physical activity and significant decreases in sedentary time of over 2 h/day and dairy consumption when engaged in structured summer programming. All improvements were independent of weight status and age, and African-American participants evidenced greater changes in physical activity during programming. The study concludes that structured, community-based summertime programming may be associated with fewer obesogenic behaviors in low-income urban youth and may be a powerful tool to address disparities in weight gain and obesity among high-risk samples.

The SMILE Program: Does Timing and Dosing of Nurse Home Visits Matter in Reducing Adverse Birth Outcomes for African American Women

DTIC Science & Technology

2013-03-13

might expect in community-based participatory research or other public health initiatives, randomization is not an option given that health service...based participatory research to ameliorate cancer disparities. Health Soc Work, 35(4), 302-309. Gennaro, S. (2005). Overview of current state of...20 Future Research

Eliminating tobacco disparities among native Hawaiian Pacific Islanders through policy change: the role of community-based organizations.

PubMed

Palmer, Paula Healani; Lee, Cevadne; Sablan-Santos, Lola; Lepule, Jonathan Tana; Pang, Victor Kaiwi; Tui'one, Vanessa; Schmidt-Vaivao, Dorothy; Sabado, Melanie Dee; Sur, Roger; Tanjasiri, Sora P

2013-09-01

Although cigarette smoking in the general U.S. population has decreased considerably over the past several decades, prevalence rates among Native Hawaiian Pacific Islanders (NHPI) have remained elevated by comparison with other groups. The aggregation of NHPI smoking data with that of Asians has drawn attention away from the serious smoking problems that NHPIs experience, thus, limiting funding, programs, and policies to reduce tobacco-related health disparities in their communities. In California, community-based organizations (CBOs) have played a major role in supporting the state's comprehensive tobacco control program, which is arguably one of the most successful in the nation. In this commentary, we describe the tobacco control activities of five NHPI-serving CBOs in Southern California and how they have provided anti-tobacco education for thousands of Native Hawaiians, Chamorros, Marshallese, Samoans, Tongans, and other Pacific Islander subgroups, and used advocacy and coalition building to promote smoke-free environment policies in their communities. The concerted efforts of the CBOs and their community members have made vital contributions to the reduction of tobacco-related disparities for NHPI populations in California.

Active transportation to support diabetes prevention: Expanding school health promotion programming in an Indigenous community.

PubMed

Macridis, Soultana; Garcia Bengoechea, Enrique; McComber, Alex M; Jacobs, Judi; Macaulay, Ann C

2016-06-01

School-based physical activity (PA) interventions, including school active transportation (AT), provide opportunities to increase daily PA levels, improves fitness, and reduces risk of diseases, such as type 2 diabetes. Based on a community-identified need, the Kahnawake Schools Diabetes Prevention Project, within an Indigenous community, undertook school travel planning to contribute to PA programming for two elementary schools. Using community-based participatory research, the Active & Safe Routes to School's School Travel Planning (STP) process was undertaken in two schools with an STP-Committee comprised of community stakeholders and researchers. STP activities were adapted for local context including: school profile form, family survey, in-class travel survey, pedestrian-traffic observations, walkability checklist, and student mapping. STP data were jointly collected, analyzed and interpreted by researchers and community. Traffic-pedestrian observations, walkability and parent surveys identified key pedestrian-traffic locations, helped develop safe/direct routes, and traffic calming strategies. In-class travel and mapping surveys identified a need and student desire to increase school AT. The STP-Committee translated findings into STP-action plans for two schools, which were implemented in 2014-2015 school year. Combining CBPR with STP merges community and researcher expertise. This project offered evidence-informed practice for active living promotions. Experience and findings could benefit Indigenous and non-Indigenous communities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation.

PubMed

Heerman, William J; Schludnt, David; Harris, Dawn; Teeters, Leah; Apple, Rachel; Barkin, Shari L

2018-04-13

Expanding the use of evidence-based behavioral interventions in community settings has met with limited success in various health outcomes as fidelity and dose of clinical interventions are often diluted when translated to communities. We conducted a pilot implementation study to examine adoption of the rigorously evaluated Healthier Families Program by Parks and Recreation centers in 3 cities across the country (MI, GA, NV) with diverse socio-cultural environments. Using the RE-AIM framework, we evaluated the program both quantitatively (pre/post surveys of health behavior change; attendance & fidelity) and qualitatively (interviews with Parks and Recreation staff and participants following the program). The 3 partner sites recruited a total of 26 parent-child pairs. Among the 24 participants who completed pre/post surveys, 62.5% were 25-34 years old, and average child age was 3.6 (SD 0.7) years. The distribution of self-reported race/ethnicity was 54% non-Hispanic White, 38% non-Hispanic Black, and 8% Latino. Qualitative interviews with participants demonstrated increased use of the built environment for physical activity and continued use of key strategies for health behavior change. Three of five (60%) collaborating sites proceeded with implementation of the program. The average attendance for the 12-week program was 7.6 (SD 3.9) sessions, with 71% attending > 50% of sessions. Average fidelity for the 12 weekly sessions was 25.2 (SD 1.2; possible range 9-27). All 3 partner sites continued offering the program after grant funding was complete. This pilot is among the first attempts to scale-out an evidence-based childhood obesity intervention in community Parks and Recreation centers. While this pilot was not intended to confirm the efficacy of the original trial on Body Mass Index (BMI) reduction, the effective and sustained behavior change among a geographically and ethnically diverse population with high attendance and fidelity demonstrates an effective approach on which to base future large-scale implementation efforts to reduce childhood obesity in community settings.

75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... registration information will be posted on the CMS Care Transitions Web site at http://www.cms.gov/DemoProjects...

Employing continuous quality improvement in community-based substance abuse programs.

PubMed

Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

2012-01-01

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

Reach and effectiveness of a community program to reduce smoking among ethnic Turkish residents in Rotterdam, the Netherlands: a quasi-experimental design.

PubMed

Nierkens, Vera; Kunst, Anton E; De Vries, Hein; Voorham, Toon A J; Stronks, Karien

2013-01-01

Community interventions have been considered promising strategies to reduce smoking prevalence among ethnic minority populations. We assessed the reach and effectiveness of a community program targeted at the Turkish population in Rotterdam, the Netherlands. The study had a quasi-experimental design, with 1 pretest and 1 posttest among 18- to 60-year-old Turkish residents in a district in Rotterdam (n = 388 at pretest) and in a comparison area in the city of Utrecht (n = 389 at pretest). The surveys included measures of reach and measures of effectiveness. Logistic regression analysis assessed changes in the outcome measures over time, adjusting for sex, age, and educational level. At posttest, more smokers (62.5%) perceived pros of quitting, and 8.2% had quit. Compared with the comparison group, in the intervention group the changes tended to be greater, but differences were not statistically significant. Of all respondents, 61.2% recognized at least 1 program component, and 23.1% participated in at least 1. Based on the greater changes in the intervention group (particularly regarding quit rates and pros of smoking), this community intervention can become a promising strategy. To increase potential effectiveness, participation rates need to increase and interventions should last longer and include smoking-cessation support.

A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia.

PubMed

Taylor, Morag E; Lord, Stephen R; Brodaty, Henry; Kurrle, Susan E; Hamilton, Sarah; Ramsay, Elisabeth; Webster, Lyndell; Payne, Narelle L; Close, Jacqueline C T

2017-01-01

Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia. Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial. Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions. This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.

Addressing food insecurity in a Native American reservation using community-based participatory research.

PubMed

Jernigan, Valarie Blue Bird; Salvatore, Alicia L; Styne, Dennis M; Winkleby, Marilyn

2012-08-01

The food insecurity faced by many Native American communities has numerous implications for the health and welfare of families. To identify and address upstream causes of food insecurity in a rural California reservation, we conducted a community assessment using the Tool for Health and Resilience in Vulnerable Environments (THRIVE). Guided by a community-based participatory research orientation, the THRIVE tool was adapted using digital storytelling and implemented in a series of focus groups. As a result of the THRIVE assessment, community members identified racial injustice and physical and financial barriers to accessing healthy and culturally appropriate foods as areas of greatest importance. Subsequently, the project partnership developed policies to reduce identified barriers which included an integrated community supported agriculture and commodity food program, the introduction of Electronic Benefits Transfer and culturally appropriate foods at the local farmers' market and reallocation of shelf space at the grocery store to include vegetables and fruits as well as special foods for diabetics. Results suggest that a participatory research orientation coupled with the use of a culturally adapted THRIVE tool may be an effective means for identifying structural determinants of food insecurity and initiating novel policy interventions to reduce health disparities experienced by Native American communities.

Exploratory Retrospective Analysis of Power Plant Emissions in Vulnerable Communities in the United States

NASA Astrophysics Data System (ADS)

Declet-Barreto, J.; Pham, M.

2016-12-01

Carbon emissions trading has been implemented in parts of the United States (and elsewhere) to reduce greenhouse gas emissions. Data from one such program focused on power plant emissions in the U.S. Northeast and Mid-Atlantic, the Regional Greenhouse Gas Initiative (RGGI), have shown that regionally, power sector carbon dioxide emissions have been reduced since the adoption of the program in 2009. However, it is not known what the spatial distributions of such reductions have been in individual plants, and if emissions reductions have ocurred in plants impacting low-income and ethnic minority communities, arguably the populations most overburdened by health threats from co-pollutants (e.g., fine particulates, nitrous oxides, and sulfurous oxides) emitted along greenhouse gases. In this research, we explore the trajectory of power plant emissions in the RGGI region in vulnerable communities. This is a first, exploratory step in understanding the environmental justice implications of market-based carbon reduction policies.

Picture This: Exploring the Lived Experience of High-Functioning Stroke Survivors Using Photovoice.

PubMed

Maratos, Marie; Huynh, Linh; Tan, Julia; Lui, Jordon; Jarus, Tal

2016-07-01

An increasing number of high-functioning stroke survivors are present with minimal functional impairments and are often discharged with reduced access to community reintegration. Our objectives were to explore the lived experience of high-functioning stroke survivors and to identify gaps in community and rehabilitation services. Photovoice was used with five high-functioning stroke survivors to photo-document their experiences. A modified inductive thematic analysis was used, and meanings behind the photographs were elicited through four focus group sessions followed by photography exhibitions. Five themes emerged: lack of understanding and consideration for persons with disability, emotional and behavioral impacts after stroke, self-reliance and dependence on others, importance of appropriate and accessible services, and financial determinants of quality of life. By including service users' voices; investing in adapted, community-based programs; and providing educational programs for creating attitudinal change among service providers, the polarization between who can and cannot access services will be reduced. © The Author(s) 2016.

Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care

PubMed Central

Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

2016-01-01

Abstract Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by −$482 relative to the comparison (95% CI, −$573 to −$391; P < .001). The lower costs were driven primarily by inpatient (−$218; P < .001) and outpatient hospital expenditures (−$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196–205) PMID:26348492

Neighborhood Energy/Economic Development project

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

Not Available

1991-12-31

Energy costs impact low income communities more than anyone else. Low income residents pay a larger percentage of their incomes for energy costs. In addition, they generally have far less discretionary energy use to eliminate in response to increasing energy prices. Furthermore, with less discretionary income, home energy efficiency improvements are often too expensive. Small neighborhood businesses are in the same situation. Improved efficiency in the use of energy can improve this situation by reducing energy costs for residents and local businesses. More importantly, energy management programs can increase the demand for local goods and services and lead to themore » creation of new job training and employment opportunities. In this way, neighborhood based energy efficiency programs can support community economic development. The present project, undertaken with the support of the Urban Consortium Energy Task Force, was intended to serve as a demonstration of energy/economic programming at the neighborhood level. The San Francisco Neighborhood Energy/Economic Development (NEED) project was designed to be a visible demonstration of bringing the economic development benefits of energy management home to low-income community members who need it most. To begin, a Community Advisory Committee was established to guide the design of the programs to best meet needs of the community. Subsequently three neighborhood energy/economic development programs were developed: The small business energy assistance program; The youth training and weatherization program; and, The energy review of proposed housing development projects.« less

Experiences of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers.

PubMed

Cassidy, Tali; Worrell, Caitlin M; Little, Kristen; Prakash, Aishya; Patra, Inakhi; Rout, Jonathan; Fox, LeAnne M

2016-02-01

Globally 68 million people are infected with lymphatic filariasis (LF), 17 million of whom have lymphedema. This study explores the effects of a lymphedema management program in Odisha State, India on morbidity and psychosocial effects associated with lymphedema. Focus groups were held with patients (eight groups, separated by gender), their family members (eight groups), community members (four groups) and program volunteers (four groups) who had participated in a lymphedema management program for the past three years. Significant social, physical, and economic difficulties were described by patients and family members, including marriageability, social stigma, and lost workdays. However, the positive impact of the lymphedema management program was also emphasized, and many family and community members indicated that community members were accepting of patients and had some improved understanding of the etiology of the disease. Program volunteers and community members stressed the role that the program had played in educating people, though interestingly, local explanations and treatments appear to coexist with knowledge of biomedical treatments and the mosquito vector. Local and biomedical understandings of disease can co-exist and do not preclude individuals from participating in biomedical interventions, specifically lymphedema management for those with lymphatic filariasis. There is a continued need for gender-specific psychosocial support groups to address issues particular to men and women as well as a continued need for improved economic opportunities for LF-affected patients. There is an urgent need to scale up LF-related morbidity management programs to reduce the suffering of people affected by LF.

Growing partners: building a community-academic partnership to address health disparities in rural North Carolina.

PubMed

De Marco, Molly; Kearney, William; Smith, Tosha; Jones, Carson; Kearney-Powell, Arconstar; Ammerman, Alice

2014-01-01

Community-based participatory research (CBPR) holds tremendous promise for addressing public health disparities. As such, there is a need for academic institutions to build lasting partnerships with community organizations. Herein we have described the process of establishing a relationship between a research university and a Black church in rural North Carolina. We then discuss Harvest of Hope, the church-based pilot garden project that emerged from that partnership. The partnership began with a third-party effort to connect research universities with Black churches to address health disparities. Building this academic-community partnership included collaborating to determine research questions and programming priorities. Other aspects of the partnership included applying for funding together and building consensus on study budget and aims. The academic partners were responsible for administrative details and the community partners led programming and were largely responsible for participant recruitment. The community and academic partners collaborated to design and implement Harvest of Hope, a church-based pilot garden project involving 44 youth and adults. Community and academic partners shared responsibility for study design, recruitment, programming, and reporting of results. The successful operation of the Harvest of Hope project gave rise to a larger National Institutes of Health (NIH)-funded study, Faith, Farming and the Future (F3) involving 4 churches and 60 youth. Both projects were CBPR efforts to improve healthy food access and reducing chronic disease. This partnership continues to expand as we develop additional CBPR projects targeting physical activity, healthy eating, and environmental justice, among others. Benefits of the partnership include increased community ownership and cultural appropriateness of interventions. Challenges include managing expectations of diverse parties and adequate communication. Lessons learned and strategies for building and maintaining similar partnerships are discussed. The benefits of community-based research for addressing health disparities are many, and there are lessons to be learned that can strengthen community-academic partnerships.

Promoting Integrated Approaches to Reducing Health Inequities among Low-Income Workers: Applying a Social Ecological Framework

PubMed Central

Baron, Sherry L; Beard, Sharon; Davis, Letitia K.; Delp, Linda; Forst, Linda; Kidd-Taylor, Andrea; Liebman, Amy K.; Linnan, Laura; Punnett, Laura; Welch, Laura S.

2013-01-01

Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. An example of successful approaches to developing integrated programs in each of these settings is described. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed. PMID:23532780

Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

PubMed Central

2014-01-01

Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and decrease the disabling effects of musculoskeletal diseases within two low-income Mexican communities. PMID:25474820

Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

PubMed

Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

2015-12-01

Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

A systematic review on US-based community health navigator (CHN) interventions for cancer screening promotion--comparing community- versus clinic-based navigator models.

PubMed

Hou, Su-I; Roberson, Kiersten

2015-03-01

This study synthesized lessons learned from US-based community and clinic health navigator (CHN) interventions on cancer screening promotion to identify characteristics of models and approaches for addressing cancer disparities. The combination terms "cancer screening" and "community health workers or navigators" or "patient navigators" were used in searching Medline, CINAHL, and PsycInfo. A total of 27 articles published during January 2005∼April 2014 were included. Two CHN models were identified: community-based (15 studies) and clinic/hospital-based (12 studies). While both models used the term "navigators," most community-based programs referred them as community health workers/navigators/advisors, whereas clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, while clinic-based programs mostly targeted urban low income or mixed ethnic groups. Most community-based CHN programs outreached members from community networks, while clinic-based programs commonly worked with pre-identified in-service clients. Overall, regardless model type, CHNs had similar roles and responsibilities, and interventions demonstrated effective outcomes. Our review identified characteristics of CHN interventions with attention to different settings. Lessons learned have implication on the dissemination and implementation of CHN interventions for cancer screening promotion across setting and target groups.

[Community marketing of contraceptives].

PubMed

Urrutia, J M

1987-09-01

The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for contraceptives through educational and informational activities. The distribution scheme must continue to cover all the established points of sale in pharmacies despite the reduced profit margins.

Impact of alcohol harm reduction strategies in community sports clubs: pilot evaluation of the Good Sports program.

PubMed

Rowland, Bosco; Allen, Felicity; Toumbourou, John W

2012-05-01

Approximately 4.5 million Australians are involved in community sports clubs. A high level of alcohol consumption tends to be commonplace in this setting. The only program of its type in the world, the Good Sports program was designed to reduce harmful alcohol consumption in these Australian community sports clubs. The program offers a staged accreditation process to encourage the implementation of alcohol harm-reduction strategies. We conducted a postintervention adoption study to evaluate whether community sports club accreditation through the Good Sports program was associated with lower rates of alcohol consumption. We examined alcohol consumption rates in 113 clubs (N = 1,968 participants) and compared these to consumption rates in the general community. We hypothesized that members of clubs with more advanced implementation of the Good Sports accreditation program (Stage Two) would consume less alcohol than those with less advanced implementation (Stage One). Multilevel modeling (MLM) indicated that on days when teams competed, Stage Two club members consumed 19% less alcohol than Stage One club members. MLM also indicated that the length of time a club had been in the Good Sports program was associated with reduced rates of weekly drinking that exceeded Australian short-term risky drinking guidelines. However consumption rates for all clubs were still higher than the general community. Higher accreditation stage also predicted reduced long-term risky drinking by club members. Our findings suggest that community sports clubs show evidence of higher levels of alcohol consumption and higher rates of risky consumption than the general community. Implementation of the Good Sports accreditation strategy was associated with lower alcohol consumption in these settings.

Can cash transfers improve determinants of maternal mortality? Evidence from the household and community programs in Indonesia.

PubMed

Kusuma, Dian; Cohen, Jessica; McConnell, Margaret; Berman, Peter

2016-08-01

Despite global efforts in maternal health, 303,000 maternal deaths still occurred globally in 2015. One explanation is a considerable inequality in maternal mortality and the sources such as nutritional status and health utilization. One strategy to fight health inequality due to poverty is conditional cash transfer (CCT). Taking advantage of two large clustered-randomized trials in Indonesia from 2007 to 2009, this paper provides evidence on the effects of household cash transfers (PKH) and community cash transfers (Generasi) on determinants of maternal mortality. The sample sizes are 14,000 households for PKH and 12,000 households for Generasi. After two years of implementation, difference-in-differences (DID) analyses show that the two programs can improve determinants of maternal mortality with Generasi provides positive impact in some aspects of determinants, but PKH does not. Generasi improves maternal health knowledge, reduces financial barriers to accessing health services and improves utilization of health services, increases utilization among higher-risk women, improves posyandu equipment, and increases nutritional intake. As for PKH, evidence shows its strongest effects only on utilization of health services. Both programs, however, are unlikely to have a large effect on maternal mortality due to design and implementation issues that might significantly reduce program effectiveness. While the programs improved utilization, they did so at community-based facilities not equipped with emergency obstetric care. In the midst of popularity of household cash transfer, our results show that community cash transfer offers a viable policy alternative to improve the determinants of maternal mortality by allowing more flexibility in activities and at lower cost by monitoring at community level. Copyright © 2016 Elsevier Ltd. All rights reserved.

McDonald's Litter Hunt: A Community Litter Control System for Youth.

ERIC Educational Resources Information Center

McNees, M. Patrick; And Others

1979-01-01

Describes a community litter control program. Special adhesive stickers were randomly placed on existing litter throughout a community and youth were rewarded with special prizes for participating in the program. Litter was reduced 32 percent across the city. (Author/MA)

Community-based participatory research with Native American communities: the Chronic Disease Self-Management Program.

PubMed

Jernigan, Valarie Blue Bird

2010-11-01

Health disparities among Native Americans persist despite efforts to translate evidence-based programs from research to practice. Few evidence-based, theory-driven prevention and management interventions have been successfully translated within Native American communities. The use of community-based participatory research (CBPR) has shown promise in this process. This article provides an overview of the use of CBPR with Native American communities and discusses the translation of the Stanford Chronic Disease Self-Management Program, using a CBPR approach, with an urban Native American community. This article highlights not only how the CBPR process facilitates the successful translation of the Stanford program but also how CBPR is used within this community to build community capacity.

Trial protocol: a clustered, randomised, longitudinal, type 2 translational trial of alcohol consumption and alcohol-related harm among adolescents in Australia.

PubMed

Rowland, B; Abraham, C; Carter, R; Abimanyi-Ochom, J; Kelly, A B; Kremer, P; Williams, J W; Smith, R; Hall, J K; Wagner, D; Renner, H; Hosseini, T; Osborn, A; Mohebbi, M; Toumbourou, J W

2018-04-27

This cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed. Fourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data. Community-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community. The trial was retrospectively registered in September, 2017 ( ACTRN12616001276448 ), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

Community Involvement in a Place-Based Program for Hawaiian High School Students

ERIC Educational Resources Information Center

Yamauchi, Lois A.; Purcell, Andrea K.

2009-01-01

This study examined the development of community involvement in a place-based high school program for at-risk youth. Teachers and community members founded the program to address concerns about low achievement and high dropout rates among Native Hawaiians. In addition to funding, community members provided program development, supervision of…

A community intervention for behaviour modification: an experience to control cardiovascular diseases in Yogyakarta, Indonesia.

PubMed

Tetra Dewi, Fatwa Sari; Stenlund, Hans; Marlinawati, V Utari; Öhman, Ann; Weinehall, Lars

2013-11-04

Non-communicable Disease (NCD) is increasingly burdening developing countries including Indonesia. However only a few intervention studies on NCD control in developing countries are reported. This study aims to report experiences from the development of a community-based pilot intervention to prevent cardiovascular disease (CVD), as initial part of a future extended PRORIVA program (Program to Reduce Cardiovascular Disease Risk Factors in Yogyakarta, Indonesia) in an urban area within Jogjakarta, Indonesia. The study is quasi-experimental and based on a mixed design involving both quantitative and qualitative methods. Four communities were selected as intervention areas and one community was selected as a referent area. A community-empowerment approach was utilized to motivate community to develop health promotion activities. Data on knowledge and attitudes with regard to CVD risk factors, smoking, physical inactivity, and fruit and vegetable were collected using the WHO STEPwise questionnaire. 980 people in the intervention areas and 151 people in the referent area participated in the pre-test. In the post-test 883 respondents were re-measured from the intervention areas and 144 respondents from the referent area. The qualitative data were collected using written meeting records (80), facilitator reports (5), free-listing (112) and in-depth interviews (4). Those data were analysed to contribute a deeper understanding of how the population perceived the intervention. Frequency and participation rates of activities were higher in the low socioeconomic status (SES) communities than in the high SES communities (40 and 13 activities respectively). The proportion of having high knowledge increased significantly from 56% to 70% among men in the intervention communities. The qualitative study shows that respondents thought PRORIVA improved their awareness of CVD and encouraged them to experiment healthier behaviours. PRORIVA was perceived as a useful program and was expected for the continuation. Citizens of low SES communities thought PRORIVA was a "cheerful" program. A community-empowerment approach can encourage community participation which in turn may improve the citizen's knowledge of the danger impact of CVD. Thus, a bottom-up approach may improve citizens' acceptance of a program, and be a feasible way to prevent and control CVD in urban communities within a low income country.

Experiences of Patient-Centredness With Specialized Community-Based Care

PubMed Central

Winsor, S; Smith, A; Vanstone, M; Giacomini, M; Brundisini, FK; DeJean, D

2013-01-01

Background Specialized community-based care (SCBC) endeavours to help patients manage chronic diseases by formalizing the link between primary care providers and other community providers with specialized training. Many types of health care providers and community-based programs are employed in SCBC. Patient-centred care focuses on patients’ psychosocial experience of health and illness to ensure that patients’ care plans are modelled on their individual values, preferences, spirituality, and expressed needs. Objectives To synthesize qualitative research on patient and provider experiences of SCBC interventions and health care delivery models, using the core principles of patient-centredness. Data Sources This report synthesizes 29 primary qualitative studies on the topic of SCBC interventions for patients with chronic conditions. Included studies were published between 2002 and 2012, and followed adult patients in North America, Europe, Australia, and New Zealand. Review Methods Qualitative meta-synthesis was used to integrate findings across primary research studies. Results Three core themes emerged from the analysis: patients’ health beliefs affect their participation in SCBC interventions; patients’ experiences with community-based care differ from their experiences with hospital-based care; patients and providers value the role of nurses differently in community-based chronic disease care. Limitations Qualitative research findings are not intended to generalize directly to populations, although meta-synthesis across several qualitative studies builds an increasingly robust understanding that is more likely to be transferable. The diversity of interventions that fall under SCBC and the cross-interventional focus of many of the studies mean that findings might not be generalizable to all forms of SCBC or its specific components. Conclusions Patients with chronic diseases who participated in SCBC interventions reported greater satisfaction when SCBC helped them better understand their diagnosis, facilitated increased socialization, provided them with a role in managing their own care, and assisted them in overcoming psychological and social barriers. Plain Language Summary More and more, to reduce bed shortages in hospitals, health care systems are providing programs called specialized community-based care (SCBC) to patients with chronic diseases. These SCBC programs allow patients with chronic diseases to be managed in the community by linking their family physicians with other community-based health care providers who have specialized training. This report looks at the experiences of patients and health care providers who take part in SCBC programs, focusing on psychological and social factors. This kind of lens is called patient-centred. Three themes came up in our analysis: patients’ health beliefs affect how they take part in SCBC interventions; patients’ experiences with care in the community differ from their experiences with care in the hospital; patients and providers value the role of nurses differently. The results of this analysis could help those who provide SCBC programs to better meet patients’ needs. PMID:24228080

Experiences of patient-centredness with specialized community-based care: a systematic review and qualitative meta-synthesis.

PubMed

Winsor, S; Smith, A; Vanstone, M; Giacomini, M; Brundisini, F K; DeJean, D

2013-01-01

Specialized community-based care (SCBC) endeavours to help patients manage chronic diseases by formalizing the link between primary care providers and other community providers with specialized training. Many types of health care providers and community-based programs are employed in SCBC. Patient-centred care focuses on patients' psychosocial experience of health and illness to ensure that patients' care plans are modelled on their individual values, preferences, spirituality, and expressed needs. To synthesize qualitative research on patient and provider experiences of SCBC interventions and health care delivery models, using the core principles of patient-centredness. This report synthesizes 29 primary qualitative studies on the topic of SCBC interventions for patients with chronic conditions. Included studies were published between 2002 and 2012, and followed adult patients in North America, Europe, Australia, and New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Three core themes emerged from the analysis: patients' health beliefs affect their participation in SCBC interventions;patients' experiences with community-based care differ from their experiences with hospital-based care;patients and providers value the role of nurses differently in community-based chronic disease care. Qualitative research findings are not intended to generalize directly to populations, although meta-synthesis across several qualitative studies builds an increasingly robust understanding that is more likely to be transferable. The diversity of interventions that fall under SCBC and the cross-interventional focus of many of the studies mean that findings might not be generalizable to all forms of SCBC or its specific components. Patients with chronic diseases who participated in SCBC interventions reported greater satisfaction when SCBC helped them better understand their diagnosis, facilitated increased socialization, provided them with a role in managing their own care, and assisted them in overcoming psychological and social barriers. More and more, to reduce bed shortages in hospitals, health care systems are providing programs called specialized community-based care (SCBC) to patients with chronic diseases. These SCBC programs allow patients with chronic diseases to be managed in the community by linking their family physicians with other community-based health care providers who have specialized training. This report looks at the experiences of patients and health care providers who take part in SCBC programs, focusing on psychological and social factors. This kind of lens is called patient-centred. Three themes came up in our analysis: patients' health beliefs affect how they take part in SCBC interventions; patients' experiences with care in the community differ from their experiences with care in the hospital; patients and providers value the role of nurses differently. The results of this analysis could help those who provide SCBC programs to better meet patients' needs.

Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP).

PubMed

Mathews, Elezebeth; Thomas, Emma; Absetz, Pilvikki; D'Esposito, Fabrizio; Aziz, Zahra; Balachandran, Sajitha; Daivadanam, Meena; Thankappan, Kavumpurathu Raman; Oldenburg, Brian

2018-01-04

Type 2 diabetes mellitus (T2DM) is now one of the leading causes of disease-related deaths globally. India has the world's second largest number of individuals living with diabetes. Lifestyle change has been proven to be an effective means by which to reduce risk of T2DM and a number of "real world" diabetes prevention trials have been undertaken in high income countries. However, systematic efforts to adapt such interventions for T2DM prevention in low- and middle-income countries have been very limited to date. This research-to-action gap is now widely recognised as a major challenge to the prevention and control of diabetes. Reducing the gap is associated with reductions in morbidity and mortality and reduced health care costs. The aim of this article is to describe the adaptation, development and refinement of diabetes prevention programs from the USA, Finland and Australia to the State of Kerala, India. The Kerala Diabetes Prevention Program (K-DPP) was adapted to Kerala, India from evidence-based lifestyle interventions implemented in high income countries, namely, Finland, United States and Australia. The adaptation process was undertaken in five phases: 1) needs assessment; 2) formulation of program objectives; 3) program adaptation and development; 4) piloting of the program and its delivery; and 5) program refinement and active implementation. The resulting program, K-DPP, includes four key components: 1) a group-based peer support program for participants; 2) a peer-leader training and support program for lay people to lead the groups; 3) resource materials; and 4) strategies to stimulate broader community engagement. The systematic approach to adaptation was underpinned by evidence-based behavior change techniques. K-DPP is the first well evaluated community-based, peer-led diabetes prevention program in India. Future refinement and utilization of this approach will promote translation of K-DPP to other contexts and population groups within India as well as other low- and middle-income countries. This same approach could also be applied more broadly to enable the translation of effective non-communicable disease prevention programs developed in high-income settings to create context-specific evidence in rapidly developing low- and middle-income countries. Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909 . Registered 10 March 2011.

Young driver education programs that build resilience have potential to reduce road crashes.

PubMed

Senserrick, Teresa; Ivers, Rebecca; Boufous, Soufiane; Chen, Huei-Yang; Norton, Robyn; Stevenson, Mark; van Beurden, Eric; Zask, Avigdor

2009-11-01

The research aimed to explore associations between participation in 2 education programs for school-based learner drivers and subsequent road traffic offenses and crashes among a large cohort of newly licensed drivers. DRIVE is a prospective cohort study of 20822 first-year drivers aged 17 to 24 in New South Wales (NSW), Australia. Participants completed a detailed questionnaire and consented to data linkage in 2003-2004. Questionnaire items included year of participation in 2 specific education programs: a 1-day workshop-only program focusing on driving risks ("driver-focused") and a whole-of-community program also including a 1-day workshop but also longer term follow-up activities and a broader focus on reducing risk-taking and building resilience ("resilience-focused"). Survey data were subsequently linked to police-reported crash and offense data for 1996-2005. Poisson regression models that adjusted for multiple confounders were created to explore offenses and crashes as a driver (dichotomized as 0 vs >or=1) after program participation. Offenses did not differ between groups; however, whereas the driver-focused program was not associated with reduced crash risk, the resilience-focused program was associated with a 44% reduced relative risk for crash (0.56 [95% confidence interval: 0.34-0.93]). The large effect size observed and complementary findings from a comparable randomized, controlled trial in the United States suggest programs that focus more generally on reducing risks and building resilience have the potential to reduce crashes. A large, representative, randomized, controlled trial is urgently needed to confirm road safety benefits and ensure evidence-based spending and practitioner recommendations in this field.

Cost-benefit comparisons of investments in improved water supply and cholera vaccination programs.

PubMed

Jeuland, Marc; Whittington, Dale

2009-05-18

This paper presents the first cost-benefit comparison of improved water supply investments and cholera vaccination programs. Specifically, we compare two water supply interventions -- deep wells with public hand pumps and biosand filters (an in-house, point-of-use water treatment technology) -- with two types of cholera immunization programs with new-generation vaccines -- general community-based and targeted and school-based programs. In addition to these four stand-alone investments, we also analyze five combinations of water and vaccine interventions: (1) borehole+hand pump and community-based cholera vaccination, (2) borehole+hand pump and school-based cholera vaccination, (3) biosand filter and community-based cholera vaccination, (4) biosand filter and school-based cholera vaccination, and (5) biosand filter and borehole+hand pump. Using recent data applicable to developing country locations for parameters such as disease incidence, the effectiveness of vaccine and water supply interventions against diarrheal diseases, and the value of a statistical life, we construct cost-benefit models for evaluating these interventions. We then employ probabilistic sensitivity analysis to estimate a frequency distribution of benefit-cost ratios for all four interventions, given a wide variety of possible parameter combinations. Our results demonstrate that there are many plausible conditions in developing countries under which these interventions will be attractive, but that the two improved water supply interventions and the targeted cholera vaccination program are much more likely to yield attractive cost-benefit outcomes than a community-based vaccination program. We show that implementing community-based cholera vaccination programs after borehole+hand pump or biosand filters have already been installed will rarely be justified. This is especially true when the biosand filters are already in place, because these achieve substantial cholera risk reductions on their own. On the other hand, implementing school-based cholera vaccination programs after the installation of boreholes with hand pump is more likely to be economically attractive. Also, if policymakers were to first invest in cholera vaccinations, then subsequently investing in water interventions is still likely to yield positive economic outcomes. This is because point-of-use water treatment delivers health benefits other than reduced cholera, and deep boreholes+hand pumps often yield non-health benefits such as time savings. However, cholera vaccination programs are much cheaper than the water supply interventions on a household basis. Donors and governments with limited budgets may thus determine that cholera vaccination programs are more equitable than water supply interventions because more people can receive benefits with a given budget. Practical considerations may also favor cholera vaccination programs in the densely crowded slums of South Asian and African cities where there may be insufficient space in housing units for some point-of-use technologies, and where non-networked water supply options are limited.

Training community health promoters to implement diabetes self-management support programs for urban minority adults.

PubMed

Comellas, Mariceli; Walker, Elizabeth A; Movsas, Sharon; Merkin, Sheryl; Zonszein, Joel; Strelnick, Hal

2010-01-01

To develop, implement, and evaluate a peer-led diabetes self-management support program in English and Spanish for a diverse, urban, low-income population. The program goals and objectives were to improve diabetes self-management behaviors, especially becoming more physically active, healthier eating, medication adherence, problem solving, and goal setting. After a new training program for peers led by a certified diabetes educator (CDE) was implemented with 5 individuals, this pilot evaluation study was conducted in 2 community settings in the East and South Bronx. Seventeen adults with diabetes participated in the new peer-led 5-session program. Survey data were collected pre- and postintervention on diabetes self-care activities, quality of well-being, and number of steps using a pedometer. This pilot study established the acceptance and feasibility of both the peer training program and the community-based, peer-led program for underserved, minority adults with diabetes. Significant improvements were found in several physical activity and nutrition activities, with a modest improvement in well-being. Feedback from both peer facilitators and participants indicated that a longer program, but with the same educational materials, was desirable. To reduce health disparities in urban communities, it is essential to continue program evaluation of the critical elements of peer-led programs for multiethnic adults with diabetes to promote self-management support in a cost-effective and culturally appropriate manner. Practice Implications A diabetes self-management support program can be successfully implemented in the community by peers, within a model including remote supervision by a CDE.

76 FR 21372 - Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions Program, which was authorized by section 3026 of the Affordable Care Act. DATES: Proposals will be...

Healing the community to heal the individual

PubMed Central

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-01-01

ABSTRACT OBJECTIVE To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for long-term program sustainability. Programs require increased documentation of their inroads in this developing field. PMID:18625824

Evaluating community-based public health leadership training.

PubMed

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

2011-01-01

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

Sex workers as peer health advocates: community empowerment and transformative learning through a Canadian pilot program.

PubMed

Benoit, Cecilia; Belle-Isle, Lynne; Smith, Michaela; Phillips, Rachel; Shumka, Leah; Atchison, Chris; Jansson, Mikael; Loppie, Charlotte; Flagg, Jackson

2017-08-30

Social marginalization and criminalization create health and safety risks for sex workers and reduce their access to health promotion and prevention services compared to the general population. Community empowerment-based interventions that prioritize the engagement of sex workers show promising results. Peer-to-peer interventions, wherein sex workers act as educators of their colleagues, managers, clients and romantic partners, foster community mobilization and critical consciousness among sex workers and equip them to exercise agency in their work and personal lives. A pilot peer health education program was developed and implemented, with and for sex workers in one urban centre in Canada. To explore how the training program contributed to community empowerment and transformative learning among participants, the authors conducted qualitative interviews, asked participants to keep personal journals and to fill out feedback forms after each session. Thematic analysis was conducted on these three data sources, with emerging themes identified, organized and presented in the findings. Five themes emerged from the analysis. Our findings show that the pilot program led to reduced internalized stigma and increased self-esteem in participants. Participants' critical consciousness increased concerning issues of diversity in cultural background, sexual orientation, work experiences and gender identity. Participants gained knowledge about how sex work stigma is enacted and perpetuated. They also became increasingly comfortable challenging negative judgments from others, including frontline service providers. Participants were encouraged to actively shape the training program, which fostered positive relationships and solidarity among them, as well as with colleagues in their social network and with the local sex worker organization housing the program. Resources were also mobilized within the sex worker community through skills building and knowledge acquisition. The peer education program proved successful in enhancing sex workers' community empowerment in one urban setting by increasing their knowledge about health issues, sharing information about and building confidence in accessing services, and expanding capacity to disseminate this knowledge to others. This 'proof of concept' built the foundation for a long-term initiative in this setting and has promise for other jurisdictions wishing to adapt similar programs.

Targets of opportunity : community based alcohol programs

DOT National Transportation Integrated Search

1988-04-01

Targets of Opportunity (TOP), were comprehensive community based programs addressing the drinking and driving concerns within a particular community. The program incorporated six elements: 1) General deterrence - public information,leducation and enf...

Planning Community-Based Assessments of HIV Educational Intervention Programs in Sub-Saharan Africa

ERIC Educational Resources Information Center

Kelcey, Ben; Shen, Zuchao

2017-01-01

A key consideration in planning studies of community-based HIV education programs is identifying a sample size large enough to ensure a reasonable probability of detecting program effects if they exist. Sufficient sample sizes for community- or group-based designs are proportional to the correlation or similarity of individuals within communities.…

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

PubMed

Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

2015-04-01

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

Social network analysis of public health programs to measure partnership.

PubMed

Schoen, Martin W; Moreland-Russell, Sarah; Prewitt, Kim; Carothers, Bobbi J

2014-12-01

In order to prevent chronic diseases, community-based programs are encouraged to take an ecological approach to public health promotion and involve many diverse partners. Little is known about measuring partnership in implementing public health strategies. We collected data from 23 Missouri communities in early 2012 that received funding from three separate programs to prevent obesity and/or reduce tobacco use. While all of these funding programs encourage partnership, only the Social Innovation for Missouri (SIM) program included a focus on building community capacity and enhancing collaboration. Social network analysis techniques were used to understand contact and collaboration networks in community organizations. Measurements of average degree, density, degree centralization, and betweenness centralization were calculated for each network. Because of the various sizes of the networks, we conducted comparative analyses with and without adjustment for network size. SIM programs had increased measurements of average degree for partner collaboration and larger networks. When controlling for network size, SIM groups had higher measures of network density and lower measures of degree centralization and betweenness centralization. SIM collaboration networks were more dense and less centralized, indicating increased partnership. The methods described in this paper can be used to compare partnership in community networks of various sizes. Further research is necessary to define causal mechanisms of partnership development and their relationship to public health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integrating Consumer Requests Into Community Organized Programs

ERIC Educational Resources Information Center

Brown, Sanford M.

1977-01-01

The environmental health administrative problem of reducing and/or eliminating individual complaints or requests by integrating them with the planned community environmental health program is discussed. Four parameters are detailed: problem assessment, priority establishment, activity sequencing and the evaluation of program effectiveness. (BT)

An overview of the Hadoop/MapReduce/HBase framework and its current applications in bioinformatics

PubMed Central

2010-01-01

Background Bioinformatics researchers are now confronted with analysis of ultra large-scale data sets, a problem that will only increase at an alarming rate in coming years. Recent developments in open source software, that is, the Hadoop project and associated software, provide a foundation for scaling to petabyte scale data warehouses on Linux clusters, providing fault-tolerant parallelized analysis on such data using a programming style named MapReduce. Description An overview is given of the current usage within the bioinformatics community of Hadoop, a top-level Apache Software Foundation project, and of associated open source software projects. The concepts behind Hadoop and the associated HBase project are defined, and current bioinformatics software that employ Hadoop is described. The focus is on next-generation sequencing, as the leading application area to date. Conclusions Hadoop and the MapReduce programming paradigm already have a substantial base in the bioinformatics community, especially in the field of next-generation sequencing analysis, and such use is increasing. This is due to the cost-effectiveness of Hadoop-based analysis on commodity Linux clusters, and in the cloud via data upload to cloud vendors who have implemented Hadoop/HBase; and due to the effectiveness and ease-of-use of the MapReduce method in parallelization of many data analysis algorithms. PMID:21210976

An overview of the Hadoop/MapReduce/HBase framework and its current applications in bioinformatics.

PubMed

Taylor, Ronald C

2010-12-21

Bioinformatics researchers are now confronted with analysis of ultra large-scale data sets, a problem that will only increase at an alarming rate in coming years. Recent developments in open source software, that is, the Hadoop project and associated software, provide a foundation for scaling to petabyte scale data warehouses on Linux clusters, providing fault-tolerant parallelized analysis on such data using a programming style named MapReduce. An overview is given of the current usage within the bioinformatics community of Hadoop, a top-level Apache Software Foundation project, and of associated open source software projects. The concepts behind Hadoop and the associated HBase project are defined, and current bioinformatics software that employ Hadoop is described. The focus is on next-generation sequencing, as the leading application area to date. Hadoop and the MapReduce programming paradigm already have a substantial base in the bioinformatics community, especially in the field of next-generation sequencing analysis, and such use is increasing. This is due to the cost-effectiveness of Hadoop-based analysis on commodity Linux clusters, and in the cloud via data upload to cloud vendors who have implemented Hadoop/HBase; and due to the effectiveness and ease-of-use of the MapReduce method in parallelization of many data analysis algorithms.

Comparison of Service Effectiveness for Youth with Depressed Versus Nondepressed Caregivers

ERIC Educational Resources Information Center

McCarthy, Michael; Schellinger, Jeffrey; Smith, Rachel R.; Behimer, Gretchen; Hargraves, Daniel; Scherra, Karen

2017-01-01

Purpose: (1) To compare demographic, mental health, service usage, and emotional and behavioral characteristics and strengths of youth receiving care from depressed versus nondepressed caregivers and (2) to determine whether a community-based program for reducing problematic behaviors and bolstering strengths is equally effective for youth with…

Micro-Credit and Community Wildlife Management: Complementary Strategies to Improve Conservation Outcomes in Serengeti National Park, Tanzania

NASA Astrophysics Data System (ADS)

Kaaya, Emmanuel; Chapman, Margaret

2017-09-01

Community wildlife management programs in African protected areas aim to deliver livelihood and social benefits to local communities in order to bolster support for their conservation objectives. Most of these benefits are delivered at the community level. However, many local people are also seeking more individual or household-level livelihood benefits from community wildlife management programs because it is at this level that many of the costs of protected area conservation are borne. Because community wildlife management delivers few benefits at this level, support for their conservation objectives amongst local people often declines. The study investigated the implications of this for reducing poaching in Serengeti National Park, Tanzania. Three community wildlife management initiatives undertaken by Park management were compared with regard to their capacity to deliver the individual and household-level benefits sought by local people: community conservation services, wildlife management areas and community conservation banks. Interviews were carried out with poachers and local people from four villages in the Western Serengeti including members of village conservation banks, as well as a number of key informants. The results suggest that community conservation banks could, as a complementary strategy to existing community wildlife management programs, potentially provide a more effective means of reducing poaching in African protected areas than community wildlife management programs alone.

Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system.

PubMed

Cha, Seon-Ah; Lim, Sun-Young; Kim, Kook-Rye; Lee, Eun-Young; Kang, Borami; Choi, Yoon-Hee; Yoon, Kun-Ho; Ahn, Yu-Bae; Lee, Jin-Hee; Ko, Seung-Hyun

2017-05-05

The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM). The community-based Korean Diabetes Prevention Study (C-KDPS) is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks) and usual care (control group). The major goals of the C-KDPS lifestyle intervention program are: 1) a minimum of 5-7% loss of initial body weight in 6 months and maintenance of this weight loss, 2) increased physical activity (≥ 150 min/week of moderate intensity activity), 3) balanced healthy eating, and 4) quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Clinical Research Information Service (CRIS), Republic of Korea (No. KCT0001981 ). Date of registration; July 28, 2016.

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.

Marketing and Distributive Education. Community/Work-Based Programs. An Instructor's Guide to Program Strategies. Cooperative Vocational Education; Vocational Work Experience Education; Community Classroom.

ERIC Educational Resources Information Center

Holzkamper, Charlot

Designed for use in high school and adult education programs, this manual was developed to help marketing and distributive education teachers to develop or upgrade community/work-based programs; and to assist teachers who operate these programs to use legal operational practices and to meet the occupational needs of their students and communities.…

Community-based dental education and the importance of faculty development.

PubMed

McAndrew, Maureen

2010-09-01

Community-based dental education offers a variety of positive learning experiences for students while providing needed dental services for the underserved. More dental students are being instructed by a growing body of largely volunteer community-based faculty who practice in a wide range of community settings including community hospitals and clinics, nursing homes, and private practices. These geographically dispersed instructors may have little experience as educators. Their practice styles and their motivation to improve teaching effectiveness are likely to differ from the styles and motivation of school-based faculty members. Moreover, many dental schools have begun to emphasize practices that may be unfamiliar to community-based faculty such as evidence-based practice. Providing faculty development for them is challenging, yet crucial to the success of these programs and dental education in general. Fundamental elements that must be considered for effective community faculty development programming include fostering a culture of respect between school-based and community faculty members, basing programs on the actual needs of these educators, integrating principles of adult learning theory, and establishing ongoing institutional support. This article provides background on this movement, reviews the literature for faculty development programs geared specifically to community-based educators, makes recommendations for development programs for these dental educators, and includes suggestions for future research.

Building a co-created citizen science program with gardeners neighboring a superfund site: The Gardenroots case study

PubMed Central

Ramirez-Andreotta, Monica D; Brusseau, Mark L; Artiola, Janick; Maier, Raina M; Gandolfi, A Jay

2014-01-01

A research project that is only expert-driven may ignore the role of local knowledge in research, give low priority to the development of a comprehensive communication strategy to engage the community, and may not deliver the results of the study to the community in an effective way. Objective To demonstrate how a research program can respond to a community research need, establish a community-academic partnership, and build a co-created citizen science program. Methods A place-based, community-driven project was designed where academics and community members maintained a reciprocal dialogue, and together, we: 1) defined the question for study, 2) gathered information, 3) developed hypotheses, 3) designed data collection methodologies, 4) collected environmental samples (soil, irrigation water, and vegetables), 5) interpreted data, 6) disseminated results and translated results into action, and 7) discussed results and asked new questions. Results The co-created environmental research project produced new data and addressed an additional exposure route (consumption of vegetables grown in soils with elevated arsenic levels). Public participation in scientific research improved environmental health assessment, information transfer, and risk communication efforts. Furthermore, incorporating the community in the scientific process produced both individual learning outcomes and community-level outcomes. Conclusions This approach illustrates the benefits of a community-academic co-created citizen-science program in addressing the complex problems that arise in communities neighboring a contaminated site. Such a project can increase the community's involvement in risk communication and decision-making, which ultimately has the potential to help mitigate exposure and thereby reduce associated risk. PMID:25954473

Building a co-created citizen science program with gardeners neighboring a superfund site: The Gardenroots case study.

PubMed

Ramirez-Andreotta, Monica D; Brusseau, Mark L; Artiola, Janick; Maier, Raina M; Gandolfi, A Jay

2015-01-01

A research project that is only expert-driven may ignore the role of local knowledge in research, give low priority to the development of a comprehensive communication strategy to engage the community, and may not deliver the results of the study to the community in an effective way. To demonstrate how a research program can respond to a community research need, establish a community-academic partnership, and build a co-created citizen science program. A place-based, community-driven project was designed where academics and community members maintained a reciprocal dialogue, and together, we: 1) defined the question for study, 2) gathered information, 3) developed hypotheses, 3) designed data collection methodologies, 4) collected environmental samples (soil, irrigation water, and vegetables), 5) interpreted data, 6) disseminated results and translated results into action, and 7) discussed results and asked new questions. The co-created environmental research project produced new data and addressed an additional exposure route (consumption of vegetables grown in soils with elevated arsenic levels). Public participation in scientific research improved environmental health assessment, information transfer, and risk communication efforts. Furthermore, incorporating the community in the scientific process produced both individual learning outcomes and community-level outcomes. This approach illustrates the benefits of a community-academic co-created citizen-science program in addressing the complex problems that arise in communities neighboring a contaminated site. Such a project can increase the community's involvement in risk communication and decision-making, which ultimately has the potential to help mitigate exposure and thereby reduce associated risk.

An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial.

PubMed

Richardson, Caroline R; Buis, Lorraine R; Janney, Adrienne W; Goodrich, David E; Sen, Ananda; Hess, Michael L; Mehari, Kathleen S; Fortlage, Laurie A; Resnick, Paul J; Zikmund-Fisher, Brian J; Strecher, Victor J; Piette, John D

2010-12-17

Approximately half of American adults do not meet recommended physical activity guidelines. Face-to-face lifestyle interventions improve health outcomes but are unlikely to yield population-level improvements because they can be difficult to disseminate, expensive to maintain, and inconvenient for the recipient. In contrast, Internet-based behavior change interventions can be disseminated widely at a lower cost. However, the impact of some Internet-mediated programs is limited by high attrition rates. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Our objective was to measure the impact of adding online community features to an Internet-mediated walking program on participant attrition and average daily step counts. This randomized controlled trial included sedentary, ambulatory adults who used email regularly and had at least 1 of the following: overweight (body mass index [BMI] ≥ 25), type 2 diabetes, or coronary artery disease. All participants (n = 324) wore enhanced pedometers throughout the 16-week intervention and uploaded step-count data to the study server. Participants could log in to the study website to view graphs of their walking progress, individually-tailored motivational messages, and weekly calculated goals. Participants were randomized to 1 of 2 versions of a Web-based walking program. Those randomized to the "online community" arm could post and read messages with other participants while those randomized to the "no online community" arm could not read or post messages. The main outcome measures were participant attrition and average daily step counts over 16 weeks. Multiple regression analyses assessed the effect of the online community access controlling for age, sex, disease status, BMI, and baseline step counts. Both arms significantly increased their average daily steps between baseline and the end of the intervention period, but there were no significant differences in increase in step counts between arms using either intention-to-treat or completers analysis. In the intention-to-treat analysis, the average step count increase across both arms was 1888 ± 2400 steps. The percentage of completers was 13% higher in the online community arm than the no online community arm (online community arm, 79%, no online community arm, 66%, P = .02). In addition, online community arm participants remained engaged in the program longer than no online community arm participants (hazard ratio = 0.47, 95% CI = 0.25 - 0.90, P = .02). Participants with lower baseline social support posted more messages to the online community (P < .001) and viewed more posts (P < .001) than participants with higher baseline social support. Adding online community features to an Internet-mediated walking program did not increase average daily step counts but did reduce participant attrition. Participants with low baseline social support used the online community features more than those with high baseline social support. Thus, online communities may be a promising approach to reducing attrition from online health behavior change interventions, particularly in populations with low social support. NCT00729040; http://clinicaltrials.gov/ct2/show/NCT00729040 (Archived by WebCite at http://www.webcitation.org/5v1VH3n0A).

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

PubMed Central

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

2014-01-01

Background American Indian communities have a high prevalence of chronic diseases including diabetes, obesity, cardiovascular disease, and cancer. Innovative community-based approaches are needed to identify, prioritize, and create sustainable interventions to reduce environmental barriers to healthy lifestyles and ultimately improve health. Community Context Healthy Children, Strong Families was a family-based and community-based intervention to increase healthy lifestyles on Wisconsin American Indian reservations. This intervention arose from a long-standing partnership between University of Wisconsin researchers and 3 of these American Indian communities. Methods In each community, community advisory boards (CABs) were established by the residents and university partners. CAB meetings were open and held at various times and locations to increase member participation. CABs featured continual, snowball recruitment; internal and external expert consultation; and coordination with standing tribal committees. Meetings initially focused on understanding community supports for and barriers to healthy lifestyles but quickly turned toward community action for change. Outcome CAB interventions decreased environmental barriers to health at each site and improved options for healthy lifestyle choices. Over 5 years, 71 CAB meetings occurred with a total of 1,070 participants. Successful CAB interventions included planting community gardens and an apple orchard, conducting gardening and canning workshops, instituting food-related policies and dog control regulations, building an environmentally friendly playground, and providing access to recreational facilities. The CABs are now self-sustaining. Interpretation CABs can be highly effective action teams capable of improving community environments. Our experience shows that academic researchers can partner with community residents to generate programs and policies that will expand access to local food, increase people’s choices for engaging in physical activity, and encourage local policy changes that improve overall community health. PMID:25232747

Experiences of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers

PubMed Central

Cassidy, Tali; Worrell, Caitlin M.; Little, Kristen; Prakash, Aishya; Patra, Inakhi; Rout, Jonathan; Fox, LeAnne M.

2016-01-01

Background Globally 68 million people are infected with lymphatic filariasis (LF), 17 million of whom have lymphedema. This study explores the effects of a lymphedema management program in Odisha State, India on morbidity and psychosocial effects associated with lymphedema. Methodology/Principal Findings Focus groups were held with patients (eight groups, separated by gender), their family members (eight groups), community members (four groups) and program volunteers (four groups) who had participated in a lymphedema management program for the past three years. Significant social, physical, and economic difficulties were described by patients and family members, including marriageability, social stigma, and lost workdays. However, the positive impact of the lymphedema management program was also emphasized, and many family and community members indicated that community members were accepting of patients and had some improved understanding of the etiology of the disease. Program volunteers and community members stressed the role that the program had played in educating people, though interestingly, local explanations and treatments appear to coexist with knowledge of biomedical treatments and the mosquito vector. Conclusions/Significance Local and biomedical understandings of disease can co-exist and do not preclude individuals from participating in biomedical interventions, specifically lymphedema management for those with lymphatic filariasis. There is a continued need for gender-specific psychosocial support groups to address issues particular to men and women as well as a continued need for improved economic opportunities for LF-affected patients. There is an urgent need to scale up LF-related morbidity management programs to reduce the suffering of people affected by LF. PMID:26849126

Community-partnered cluster-randomized comparative effectiveness trial of community engagement and planning or resources for services to address depression disparities.

PubMed

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

2013-10-01

Depression contributes to disability and there are ethnic/racial disparities in access and outcomes of care. Quality improvement (QI) programs for depression in primary care improve outcomes relative to usual care, but health, social and other community-based service sectors also support clients in under-resourced communities. Little is known about effects on client outcomes of strategies to implement depression QI across diverse sectors. To compare the effectiveness of Community Engagement and Planning (CEP) and Resources for Services (RS) to implement depression QI on clients' mental health-related quality of life (HRQL) and services use. Matched programs from health, social and other service sectors were randomized to community engagement and planning (promoting inter-agency collaboration) or resources for services (individual program technical assistance plus outreach) to implement depression QI toolkits in Hollywood-Metro and South Los Angeles. From 93 randomized programs, 4,440 clients were screened and of 1,322 depressed by the 8-item Patient Health Questionnaire (PHQ-8) and providing contact information, 1,246 enrolled and 1,018 in 90 programs completed baseline or 6-month follow-up. Self-reported mental HRQL and probable depression (primary), physical activity, employment, homelessness risk factors (secondary) and services use. CEP was more effective than RS at improving mental HRQL, increasing physical activity and reducing homelessness risk factors, rate of behavioral health hospitalization and medication visits among specialty care users (i.e. psychiatrists, mental health providers) while increasing depression visits among users of primary care/public health for depression and users of faith-based and park programs (each p < 0.05). Employment, use of antidepressants, and total contacts were not significantly affected (each p > 0.05). Community engagement to build a collaborative approach to implementing depression QI across diverse programs was more effective than resources for services for individual programs in improving mental HRQL, physical activity and homelessness risk factors, and shifted utilization away from hospitalizations and specialty medication visits toward primary care and other sectors, offering an expanded health-home model to address multiple disparities for depressed safety-net clients.

Community-Based Management of Acute Malnutrition to Reduce Wasting in Urban Informal Settlements of Mumbai, India: A Mixed-Methods Evaluation

PubMed Central

Shah More, Neena; Waingankar, Anagha; Ramani, Sudha; Chanani, Sheila; D'Souza, Vanessa; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2018-01-01

Background: We evaluated an adaptation of a large-scale community-based management of acute malnutrition program run by an NGO with government partnerships, in informal settlements of Mumbai, India. The program aimed to reduce the prevalence of wasting among children under age 3 and covered a population of approximately 300,000. Methods: This study used a mixed-methods approach including a quasi-experimental design to compare prevalence estimates of wasting in intervention areas with neighboring informal settlements. Cross-sectional data were collected from March through November 2014 for the baseline and October through December 2015 for the endline. Endline data were analyzed using mixed-effects logistic regression models, adjusting for child, maternal, and household characteristics. In addition, we conducted in-depth interviews with 37 stakeholders (13 staff and 24 mothers) who reported on salient features that contributed to successful implementation of the program. Results: We interviewed 2,578 caregivers at baseline and 3,455 at endline in intervention areas. In comparison areas, we interviewed 2,082 caregivers at baseline and 2,122 at endline. At endline, the prevalence of wasting decreased by 28% (18% to 13%) in intervention areas and by 5% (16.9% to 16%) in comparison areas. Analysis of the endline data indicated that children in intervention areas were significantly less likely to be malnourished (adjusted odds ratio, 0.81; confidence interval, 0.67 to 0.99). Stakeholders identified 4 main features as contributing to the success of the program: (1) tailoring and reinforcement of information provided to caregivers in informal settings, (2) constant field presence of staff, (3) holistic case management of issues beyond immediate malnourishment, and (4) persistence of field staff in persuading reluctant families. Staff capabilities were enhanced through training, stringent monitoring mechanisms, and support from senior staff in tackling difficult cases. Conclusion: NGO–government partnerships can revitalize existing community-based programs in urban India. Critical to success are processes that include reinforced knowledge-building of caregivers, a high level of field support and encouragement to the community, and constant monitoring and follow-up of cases by all staff levels. PMID:29602868

Community-Based Management of Acute Malnutrition to Reduce Wasting in Urban Informal Settlements of Mumbai, India: A Mixed-Methods Evaluation.

PubMed

Shah More, Neena; Waingankar, Anagha; Ramani, Sudha; Chanani, Sheila; D'Souza, Vanessa; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2018-03-21

We evaluated an adaptation of a large-scale community-based management of acute malnutrition program run by an NGO with government partnerships, in informal settlements of Mumbai, India. The program aimed to reduce the prevalence of wasting among children under age 3 and covered a population of approximately 300,000. This study used a mixed-methods approach including a quasi-experimental design to compare prevalence estimates of wasting in intervention areas with neighboring informal settlements. Cross-sectional data were collected from March through November 2014 for the baseline and October through December 2015 for the endline. Endline data were analyzed using mixed-effects logistic regression models, adjusting for child, maternal, and household characteristics. In addition, we conducted in-depth interviews with 37 stakeholders (13 staff and 24 mothers) who reported on salient features that contributed to successful implementation of the program. We interviewed 2,578 caregivers at baseline and 3,455 at endline in intervention areas. In comparison areas, we interviewed 2,082 caregivers at baseline and 2,122 at endline. At endline, the prevalence of wasting decreased by 28% (18% to 13%) in intervention areas and by 5% (16.9% to 16%) in comparison areas. Analysis of the endline data indicated that children in intervention areas were significantly less likely to be malnourished (adjusted odds ratio, 0.81; confidence interval, 0.67 to 0.99). Stakeholders identified 4 main features as contributing to the success of the program: (1) tailoring and reinforcement of information provided to caregivers in informal settings, (2) constant field presence of staff, (3) holistic case management of issues beyond immediate malnourishment, and (4) persistence of field staff in persuading reluctant families. Staff capabilities were enhanced through training, stringent monitoring mechanisms, and support from senior staff in tackling difficult cases. NGO-government partnerships can revitalize existing community-based programs in urban India. Critical to success are processes that include reinforced knowledge-building of caregivers, a high level of field support and encouragement to the community, and constant monitoring and follow-up of cases by all staff levels. © Shah More et al.

Partnering for Health with Nebraska's Latina Immigrant Community Using Design Thinking Process.

PubMed

Ramos, Athena K; Trinidad, Natalia; Correa, Antonia; Rivera, Roy

2016-01-01

The Center for Reducing Health Disparities at the University of Nebraska Medical Center partnered with El Centro de Las Americas, a community-based organization, and various community members to develop a 1-day Spanish-language health conference entitled El Encuentro de La Mujer Sana (Healthy Woman Summit) for immigrant Latinas in Nebraska during May 2013 as part of National Women's Health Week. Design thinking was used to create a meaningful learning experience specifically designed for monolingual Spanish-speaking immigrant Latinas in Nebraska and build a foundation for collaboration between an academic institution, community-based organizational partners, and community members. We used the design thinking methodology to generate ideas for topics and prototyped agendas with community stakeholders that would be relevant and provide culturally and linguistically appropriate health education. By developing community-based health education programs for Latinas with Latinas through a community-engaged co-creation process, organizations and communities build trust, enhance community capacity, and meet identified needs for education and service. Design thinking is a valuable tool that can be used to develop community health education initiatives and enhance civic participation. This method holds promise for health education and public health in becoming more relevant for traditionally marginalized or disenfranchised populations.

Integrating community health workers within Patient Protection and Affordable Care Act implementation.

PubMed

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau

2015-01-01

The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.

Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

PubMed Central

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

2015-01-01

Context The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models. PMID:25414955

Fostering Sustainable Behavior: An Introduction to Community-Based Social Marketing.

ERIC Educational Resources Information Center

McKenzie-Mohr, Doug; Smith, William

This book discusses incorporating community-based social marketing techniques programs. The first chapter explains why programs that rely heavily on conventional methods to promote behavior change are often ineffective, and introduces community-based social marketing as an attractive alternative for the delivery of programs. Chapter 2 describes…

Developing and marketing a community pharmacy-based asthma management program.

PubMed

Rupp, M T; McCallian, D J; Sheth, K K

1997-01-01

To develop a community pharmacy-based asthma management program and successfully market the program to a managed care organization. Community-based ambulatory care. Independent community pharmacy. Development of a structured, stepwise approach to creating, testing, delivering, and marketing a community pharmacy-based disease management program. Peak expiratory flow rates, quality of life, use of health care services, HMO contract renewal. A pharmacy-based asthma management program was developed, pilot tested, and successfully marketed to a local HMO. During the first full year of the program, HMO patients experienced significant improvements in quality of life and decreases in use of health care services, including a 77% decrease in hospitalization, a 78% decrease in emergency room visits, and a 25% decrease in urgent care visits. A contract that pays the pharmacy a flat fee for each patient admitted to the program has recently been renewed for a third year. The program has proved to be an effective, practical, and profitable addition to the portfolio of services offered by the pharmacy.

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

PubMed Central

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

2013-01-01

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

The Role of Effective Partnerships in an Australian Place-Based Intervention to Reduce Race-Based Discrimination

PubMed Central

Paradies, Yin; Kelaher, Margaret Anne

2013-01-01

Localities Embracing and Accepting Diversity (LEAD) is an ongoing place-based pilot program aimed at improving health outcomes among Aboriginal and migrant communities through increased social and economic participation. Specifically, LEAD works with mainstream organizations to prevent race-based discrimination from occurring. The partnership model of LEAD was designed to create a community intervention that was evidence-based, effective, and flexible enough to respond to local contexts and needs. LEAD's complex organizational and partnership model, in combination with an innovative approach to reducing race-based discrimination, has necessitated the use of new language and communication strategies to build genuinely collaborative partnerships. Allocating sufficient time to develop strategies aligned with this new way of doing business has been critical. However, preliminary data indicate that a varied set of partners has been integral to supporting the widespread influence of the emerging LEAD findings across partner networks in a number of different sectors. PMID:24179280

Pesticide Environmental Stewardship Program (PESP)

EPA Pesticide Factsheets

PESP is an EPA partnership program that works with the nation's pesticide-user community to promote IPM practices. Pesticide users can reduce the risks from pests and pesticides. Members include organizations and companies in the pesticide-user community.

Strengthening the network of mentored, underrepresented minority scientists and leaders to reduce HIV-related health disparities.

PubMed

Sutton, Madeline Y; Lanier, Yzette A; Willis, Leigh A; Castellanos, Ted; Dominguez, Ken; Fitzpatrick, Lisa; Miller, Kim S

2013-12-01

We reviewed data for the Minority HIV/AIDS Research Initiative (MARI), which was established in 2003 to support underrepresented minority scientists performing HIV prevention research in highly affected communities. MARI was established at the Centers for Disease Prevention and Control as a program of competitively awarded, mentored grants for early career researchers conducting HIV prevention research in highly affected racial/ethnic and sexual minority communities. We have described progress from 2003 to 2013. To date, MARI has mentored 27 scientist leaders using low-cost strategies to enhance the development of effective HIV prevention interventions. These scientists have (1) developed research programs in disproportionately affected communities of color, (2) produced first-authored peer-reviewed scientific and programmatic products (including articles and community-level interventions), and (3) obtained larger, subsequent funding awards for research and programmatic work related to HIV prevention and health disparities work. The MARI program demonstrates how to effectively engage minority scientists to conduct HIV prevention research and reduce racial/ethnic investigator disparities and serves as a model for programs to reduce disparities in other public health areas in which communities of color are disproportionately affected.

Strengthening the Network of Mentored, Underrepresented Minority Scientists and Leaders to Reduce HIV-Related Health Disparities

PubMed Central

Lanier, Yzette A.; Willis, Leigh A.; Castellanos, Ted; Dominguez, Ken; Fitzpatrick, Lisa; Miller, Kim S.

2013-01-01

Objectives. We reviewed data for the Minority HIV/AIDS Research Initiative (MARI), which was established in 2003 to support underrepresented minority scientists performing HIV prevention research in highly affected communities. Methods. MARI was established at the Centers for Disease Prevention and Control as a program of competitively awarded, mentored grants for early career researchers conducting HIV prevention research in highly affected racial/ethnic and sexual minority communities. We have described progress from 2003 to 2013. Results. To date, MARI has mentored 27 scientist leaders using low-cost strategies to enhance the development of effective HIV prevention interventions. These scientists have (1) developed research programs in disproportionately affected communities of color, (2) produced first-authored peer-reviewed scientific and programmatic products (including articles and community-level interventions), and (3) obtained larger, subsequent funding awards for research and programmatic work related to HIV prevention and health disparities work. Conclusions. The MARI program demonstrates how to effectively engage minority scientists to conduct HIV prevention research and reduce racial/ethnic investigator disparities and serves as a model for programs to reduce disparities in other public health areas in which communities of color are disproportionately affected. PMID:24134360

Addressing food insecurity in a Native American reservation using community-based participatory research

PubMed Central

Blue Bird Jernigan, Valarie; Salvatore, Alicia L.; Styne, Dennis M.; Winkleby, Marilyn

2012-01-01

The food insecurity faced by many Native American communities has numerous implications for the health and welfare of families. To identify and address upstream causes of food insecurity in a rural California reservation, we conducted a community assessment using the Tool for Health and Resilience in Vulnerable Environments (THRIVE). Guided by a community-based participatory research orientation, the THRIVE tool was adapted using digital storytelling and implemented in a series of focus groups. As a result of the THRIVE assessment, community members identified racial injustice and physical and financial barriers to accessing healthy and culturally appropriate foods as areas of greatest importance. Subsequently, the project partnership developed policies to reduce identified barriers which included an integrated community supported agriculture and commodity food program, the introduction of Electronic Benefits Transfer and culturally appropriate foods at the local farmers’ market and reallocation of shelf space at the grocery store to include vegetables and fruits as well as special foods for diabetics. Results suggest that a participatory research orientation coupled with the use of a culturally adapted THRIVE tool may be an effective means for identifying structural determinants of food insecurity and initiating novel policy interventions to reduce health disparities experienced by Native American communities. PMID:21994709

Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

PubMed

Brinkley-Rubinstein, Lauren; Cloud, David H; Davis, Chelsea; Zaller, Nickolas; Delany-Brumsey, Ayesha; Pope, Leah; Martino, Sarah; Bouvier, Benjamin; Rich, Josiah

2017-03-13

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

M-Health for Improving Screening Accuracy of Acute Malnutrition in a Community-Based Management of Acute Malnutrition Program in Mumbai Informal Settlements.

PubMed

Chanani, Sheila; Wacksman, Jeremy; Deshmukh, Devika; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2016-12-01

Acute malnutrition is linked to child mortality and morbidity. Community-Based Management of Acute Malnutrition (CMAM) programs can be instrumental in large-scale detection and treatment of undernutrition. The World Health Organization (WHO) 2006 weight-for-height/length tables are diagnostic tools available to screen for acute malnutrition. Frontline workers (FWs) in a CMAM program in Dharavi, Mumbai, were using CommCare, a mobile application, for monitoring and case management of children in combination with the paper-based WHO simplified tables. A strategy was undertaken to digitize the WHO tables into the CommCare application. To measure differences in diagnostic accuracy in community-based screening for acute malnutrition, by FWs, using a mobile-based solution. Twenty-seven FWs initially used the paper-based tables and then switched to an updated mobile application that included a nutritional grade calculator. Human error rates specifically associated with grade classification were calculated by comparison of the grade assigned by the FW to the grade each child should have received based on the same WHO tables. Cohen kappa coefficient, sensitivity and specificity rates were also calculated and compared for paper-based grade assignments and calculator grade assignments. Comparing FWs (N = 14) who completed at least 40 screenings without and 40 with the calculator, the error rates were 5.5% and 0.7%, respectively (p < .0001). Interrater reliability (κ) increased to an almost perfect level (>.90), from .79 to .97, after switching to the mobile calculator. Sensitivity and specificity also improved significantly. The mobile calculator significantly reduces an important component of human error in using the WHO tables to assess acute malnutrition at the community level. © The Author(s) 2016.

What Works Clearinghouse Quick Review of the Report "Efficacy of a Theory-Based Abstinence-Only Intervention Over 24 Months"

ERIC Educational Resources Information Center

What Works Clearinghouse, 2010

2010-01-01

The study examined whether a theory-based abstinence-only education program could reduce sexual behavior over a 24-month follow-up period. The study recruited sixth- and seventh-grade volunteers from four public middle schools serving low-income African-American communities in a city in the northeastern United States. The study authors randomly…

Potential GLOF Hazards and Initiatives taken to minimize its Impacts on Downstream Communities and Infrastructures in Nepal Himalaya

NASA Astrophysics Data System (ADS)

Regmi, D.; Kargel, J. S.; Leonard, G. J.; Haritashya, U. K.; Karki, A.; Poudyal, S.

2017-12-01

With long-term temperature increases due to climate change, glacier lakes in several parts of the world are a fast-developing threat to infrastructure and downstream communities. There are more than 2000 glacier lakes in Nepal; while most pose no significant hazard to people, a comparative few are very dangerous, such as Tso Rolpa, Imja, Barun and Thulagi glacier lakes. The objectives of this study are to present 1) a review of prior glacier lake studies that have been carried out in the Nepal Himalaya; 2) recent research results, including bathymetric studies of the lakes; 3) a summary of possible infrastructure damages, especially multi-million-dollar hydropower projects, that are under threat of glacier lake outburst floods (GLOFs); 4) to present the outcome of the recently completed Imja lake lowering project, which is the highest altitude lake ever controlled by lowering the water level. This project is being undertaken as a response to a scientific ground-based bathymetric and geophysical survey funded by the United Nations Development Program and a satellite-based study of the long-term development of the lake (funded by NASA's SERVIR program, J. Kargel, PI). The objective of the Imja Lake GLOF mitigation project is to lower the water level by three meters to reduce the lake volume, increase the freeboard, and improve the safety of tourism, downstream communities, and the infrastructure of Nepal's Everest region. This GLOF mitigation step taken by Nepal's government to reduce the risk of an outburst flood is a good step to reduce the chances of a GLOF, and to reduce the magnitude of a disaster if a GLOF nonetheless occurs despite our best efforts. We will also present the prospects for the future of Imja Lake, including an outline of possible steps that could further reduce the hazards faced by downstream communities and infrastructure. Key words: Glacier Lakes; GLOF; Hydropower; Imja lake; lake lowering

Intervention Costs From Communities Putting Prevention to Work

PubMed Central

Khavjou, Olga A.; Bradley, Christina; Neuwahl, Simon; Hoerger, Thomas J.; Bellard, David; Cash, Amanda J.

2016-01-01

Introduction 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. Methods 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. Results 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. Conclusions 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. PMID:27468157

Program Planners’ Perspectives of Promotora Roles, Recruitment, and Selection

PubMed Central

Koskan, Alexis; Hilfinger Messias, DeAnne K.; Friedman, Daniela B.; Brandt, Heather M.; Walsemann, Katrina M.

2013-01-01

Objective Program planners work with promotoras (the Spanish term for female community health workers) to reduce health disparities among underserved populations. Based on the Role-Outcomes Linkage Evaluation Model for Community Health Workers (ROLES) conceptual model, we explored how program planners conceptualized the promotora role and the approaches and strategies they used to recruit, select, and sustain promotoras. Design We conducted semi-structured, in-depth interviews with a purposive convenience sample of 24 program planners, program coordinators, promotora recruiters, research principal investigators, and other individuals who worked closely with promotoras on United States-based health programs for Hispanic women (ages 18 and older). Results Planners conceptualized the promotora role based on their personal experiences and their understanding of the underlying philosophical tenets of the promotora approach. Recruitment and selection methods reflected planners’ conceptualizations and experiences of promotoras as paid staff or volunteers. Participants described a variety of program planning and implementation methods. They focused on sustainability of the programs, the intended health behavior changes or activities, and the individual promotoras. Conclusion To strengthen health programs employing the promotora delivery model, job descriptions should delineate role expectations and boundaries and better guide promotora evaluations. We suggest including additional components such as information on funding sources, program type and delivery, and sustainability outcomes to enhance the ROLES conceptual model. The expanded model can be used to guide program planners in the planning, implementing, and evaluating of promotora health programs. PMID:23039847

Development and evaluation of a genomics training program for community health workers in Texas.

PubMed

Chen, Lei-Shih; Zhao, Shixi; Stelzig, Donaji; Dhar, Shweta U; Eble, Tanya; Yeh, Yu-Chen; Kwok, Oi-Man

2018-01-04

PurposeGenomics services have the potential to reduce incidence and mortality of diseases by providing individualized, family health history (FHH)-based prevention strategies to clients. These services may benefit from the involvement of community health workers (CHWs) in the provision of FHH-based genomics education and services, as CHWs are frontline public health workers and lay health educators, who share similar ethnicities, languages, socioeconomic statuses, and life experiences with the communities they serve. We developed, implemented, and evaluated the FHH-based genomics training program for CHWs.MethodsThis theory- and evidence-based FHH-focused genomics curriculum was developed by an interdisciplinary team. Full-day workshops in English and Spanish were delivered to 145 Texas CHWs (91.6% were Hispanic/black). Preworkshop, postworkshop, and 3-month follow-up data were collected.ResultsCHWs significantly improved their attitudes, intention, self-efficacy, and knowledge regarding adopting FHH-based genomics into their practice after the workshops. At 3-month follow-up, these scores remained higher, and there was a significant increase in CHWs' genomics practices.ConclusionThis FHH-based genomics training successfully educated Texas CHWs, and the outcomes were promising. Dissemination of training to CHWs in and outside of Texas is needed to promote better access to and delivery of personalized genomics services for the lay and underserved communities.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.236.

The NCI Community Oncology Research Program: what every clinician needs to know.

PubMed

McCaskill-Stevens, Worta; Lyss, Alan P; Good, Marge; Marsland, Thomas; Lilenbaum, Rogerio

2013-01-01

Research in the community setting is essential for the translation of advances in cancer research into practice and improving cancer care for all populations. The National Cancer Institute is proposing a new community-based program, NCI Community Oncology Research Program (NCORP), which is the alignment of two existing programs, the Community Clinical Oncology Program, Minority-Based Community Clinical Oncology Program, and their Research Bases, and the National Cancer Institute's Community Cancer Centers Program. NCROP will support cancer control, prevention, treatment, and screening clinical trials and expand its research scope to include cancer care delivery research. Cancer disparities research will be integrated into studies across the continuum of NCORP research. Input from current NCI-funded community investigators provides critical insight into the challenges faced by oncology practices within various organizational structures. Furthermore, these investigators identify the resources, both administrative and clinical, that will be required in the community setting to support cancer care delivery research and to meet the requirements for a new generation of clinical research. The American Society for Clinical Oncology (ASCO) has initiated a forum to focus on the conduct of clinical research in the community setting. Resources are being developed to help practices in managing cancer care in community settings.

Strategies used by interdisciplinary rural health training programs to assure community responsiveness and recruit practitioners.

PubMed

Slack, Marion K; Cummings, Doyle M; Borrego, Matthew E; Fuller, Kathi; Cook, Sherrie

2002-05-01

In this article, the strategies used by five US rural interdisciplinary training grant programs to respond to local needs and to promote recruitment in rural communities are described. The programs provide training to 17 health care disciplines and serve disadvantaged Hispanic, African-American, Amish, Native American, and Anglo populations. Four programs are based in academic institutions; one is based in a community health center. The programs provide services to the rural communities through individual clinical or case management services, population-level interventions, and collaborative research. All programs use specific mechanisms (e.g. case conferences or participation in local coalitions) to facilitate collaboration with residents and to link student activities with community or individual needs. Unique strategies include the use of problem-based learning and community health workers on the interdisciplinary team to increase responsiveness. The programs also provide educational support to students while they work in the rural communities. Finally, the primary strategy used to promote recruitment is the training experience in rural communities. The programs also appear to indirectly improve the environment of rural practice.

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

PubMed

de Vries, Daniel H; Pool, Robert

2017-01-01

Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs). So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability. This review includes peer-reviewed articles which meet three eligibility criteria: 1) specific focus on CLHWs or equivalent; 2) randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3) description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result of this lack of data we are unable to derive an evidence-based conclusion to our propositions. Instead, our results indicate a larger problem, namely the complete absence of indicators measuring community relationships with the programs studied. Studies pay attention only to gender and peer roles, along with limited demographic information about the recruits. The historicity of the health worker and the community s/he belongs to is absent in most studies reviewed. None of the studies discuss or test for the possibility that motivation emanates from the community. Only a few studies situate attrition and retention as an issue enabled by the community. The results were limited by a focus on low-income countries and English, peer-reviewed published articles only. Published, peer-reviewed studies evaluating the effectiveness and sustainability of CLHW interventions in health programs have not yet adequately tested for the potential of utilizing existing community health roles or social networks for the development of effective and sustainable (retentive) CLHW programs. Community relationships are generally seen as a "black box" represented by an interchangeable CLHW labor unit. This disconnect from community relationships and resources may have led to a systematic and chronic undervaluing of community agency in explanations of programmatic effectiveness and sustainability.

Community responses to violence.

PubMed

Elliott, B A

1993-06-01

Community level efforts are effective in the reduction of violence. Community-level interventions have three goals: to prevent the escalation of risk for violence among the families in the community, to assist families at risk of or using violence, and to protect victims of abuse. To prevent violence or reduce its prevalence, community groups need to collaborate to reduce the community-level risk factors. Assisting families and protecting victims of violence requires coordination of community services, including law enforcement, schools, therapists, courts, child care, and social services. All of these goals can best be achieved through the efforts of a community level, multidisciplinary council or board that directs the programs. A community process to establish an integrated program involves several steps. The leaders that are identified need to represent all the disciplines and the entire geographic area involved in the project. Once the leaders start meeting, the baseline information and plan can be developed. Then the project itself can be undertaken, with the support of the media and other appropriate organizations. Several examples of effective projects document this process and its success; the best efforts involve coalitions of private and governmental agencies working together. Physicians are integral to this process. The practice of medicine provides opportunities every day to prevent and intervene in potential cases of abuse and violence. Also, by participating actively in the community, physicians can be effective leaders to change attitudes and behaviors and institute programs toward reducing violence.

Reducing quality-of-care disparities in childhood asthma: La Red de Asma Infantil intervention in San Juan, Puerto Rico.

PubMed

Lara, Marielena; Ramos-Valencia, Gilberto; González-Gavillán, Jesús A; López-Malpica, Fernando; Morales-Reyes, Beatriz; Marín, Heriberto; Rodríguez-Sánchez, Mario H; Mitchell, Herman

2013-03-01

Although children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions. We describe our experience in adapting and implementing 2 previously tested asthma evidence-based interventions: the Yes We Can program and the Inner-City Asthma Study intervention. We assessed the feasibility of combining key components of the 2 interventions to reduce asthma symptoms and estimated the potential cost savings associated with reductions in asthma-related hospitalizations and emergency department visits. A total of 117 children with moderate and severe asthma participated in the 12-month intervention in 2 housing projects in San Juan, Puerto Rico. A community-academic team with the necessary technical and cultural competences adapted and implemented the intervention. Our case study revealed the feasibility of implementing the combined intervention, henceforth referred to as La Red intervention, in the selected Puerto Rican communities experiencing a disproportionately high level of asthma burden. After 1-year follow-up, La Red intervention significantly reduced asthma symptoms and exceeded reductions of the original interventions. Asthma-related hospitalizations and emergency department use, and their associated high costs, were also significantly reduced. Asthma evidence-based interventions can be adapted to improve quality of care for children with asthma in a different cultural community setting.

An Evaluation of the Police Liaison Program. Research Report 81-08.

ERIC Educational Resources Information Center

Hunter, Susanne; LaTorre, Ronald

The Police Liaison Program (PLP) was established in Vancouver, British Columbia (Canada) elementary and secondary schools to improve police-community relationships; to increase understanding of the police role and of the individual's responsibilities in the community; and ultimately, to reduce juvenile delinquency. In 1981, the program was…

Economic Impact of the Critical Access Hospital Program on Kentucky's Communities

ERIC Educational Resources Information Center

Ona, Lucia; Davis, Alison

2011-01-01

Context: In 1997, the Medicare Rural Hospital Flexibility Grant Program created the Critical Access Hospital (CAH) Program as a response to the financial distress of rural hospitals. It was believed that this program would reduce the rate of rural hospital closures and improve access to health care services in rural communities. Objective: The…

[The social role of the faculties of medicine: physicians' perception of the dominant orientation of their medical studies and social involvement].

PubMed

Dopelt, Keren; Yahav, Zehava; Urkin, Jacob; Bachner, Yaacov; Davidovitch, Nadav

2014-02-01

Medical education, based on the principles of social medicine, has the ability to contribute to reducing health disparities through the "creation" of doctors who are more involved in community programs. To compare the social and community orientation of graduates from the various medical schools. An online cross-sectional survey among 12,000 physicians who are graduates of Israeli medical schools was conducted in May 2011. The study encompassed 1,050 physicians, Israeli medical school graduates living in Israel and practicing medicine: 36% were Hebrew University graduates, 26% were Tel Aviv University graduates, 22% were Technion graduates and 16% were Ben-Gurion University (BGU) graduates. Higher rates of physicians who studied at the Technion and BGU are working or have worked in the periphery (approximately 50% vs. approximately 30% average of Hebrew and Tel-Aviv University schools). Among BGU graduates, 47% are active in community programs vs. 34-38% in other schools. Among physicians active in community programs, 32% of BGU alumni estimated that their medical education greatly influenced their community involvement vs. 8-15% in other schools. Hebrew University alumni graded their studies as having a higher research orientation. In contrast, BGU graduates graded their studies as having a higher social orientation, and had more positive attitudes on the role of the physician in reducing health disparities. Medical education with a social orientation will induce a socialization process that reinforces human values regarding the doctor-patient relationship and produce positive attitudes among future doctors regarding their social involvement. The findings emphasize the need to develop educational programs with a social orientation and to strengthen medical schools in the periphery.

Fostering Sociopolitical Consciousness with Minoritized Youth: Insights from Community-Based Arts Programs

ERIC Educational Resources Information Center

Ngo, Bic; Lewis, Cynthia; Maloney Leaf, Betsy

2017-01-01

In this chapter, we review the literature on community-based arts programs serving minoritized youth to identify the conditions and practices for fostering sociopolitical consciousness. Community-based arts programs have the capacity to promote teaching and learning practices in ways that engage youth in the use of academic skills to pursue…

45 CFR 2517.300 - Who may participate in a community-based service-learning program?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Who may participate in a community-based service-learning program? 2517.300 Section 2517.300 Public Welfare Regulations Relating to Public Welfare... Eligibility To Participate § 2517.300 Who may participate in a community-based service-learning program...

Promoting physical activity among youth through community-based prevention marketing.

PubMed

Bryant, Carol A; Courtney, Anita H; McDermott, Robert J; Alfonso, Moya L; Baldwin, Julie A; Nickelson, Jen; McCormack Brown, Kelli R; Debate, Rita D; Phillips, Leah M; Thompson, Zachary; Zhu, Yiliang

2010-05-01

Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

An Ethics Framework for Public Health

PubMed Central

Kass, Nancy E.

2001-01-01

More than 100 years ago, public health began as an organized discipline, its purpose being to improve the health of populations rather than of individuals. Given its population-based focus, however, public health perennially faces dilemmas concerning the appropriate extent of its reach and whether its activities infringe on individual liberties in ethically troublesome ways. In this article a framework for ethics analysis of public health programs is proposed. To advance traditional public health goals while maximizing individual liberties and furthering social justice, public health interventions should reduce morbidity or mortality; data must substantiate that a program (or the series of programs of which a program is a part) will reduce morbidity or mortality; burdens of the program must be identified and minimized; the program must be implemented fairly and must, at times, minimize preexisting social injustices; and fair procedures must be used to determine which burdens are acceptable to a community. PMID:11684600

Fall Prevention for Older Adults Receiving Home Healthcare.

PubMed

Bamgbade, Sarah; Dearmon, Valorie

2016-02-01

Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

Evaluation of a shared-work program for reducing assistance provided to supported workers with severe multiple disabilities.

PubMed

Parsons, Marsha B; Reid, Dennis H; Green, Carolyn W; Browning, Leah B; Hensley, Mary B

2002-01-01

Concern has been expressed recently regarding the need to enhance the performance of individuals with highly significant disabilities in community-based, supported jobs. We evaluated a shared-work program for reducing job coach assistance provided to three workers with severe multiple disabilities in a publishing company. Following systematic observations of the assistance provided as each worker worked on entire job tasks, steps comprising the tasks were then re-assigned across workers. The re-assignment involved assigning each worker only those task steps for which the respective worker received the least amount of assistance (e.g., re-assigning steps that a worker could not complete due to physical disabilities), and ensuring the entire tasks were still completed by combining steps performed by all three workers. The shared-work program was accompanied by reductions in job coach assistance provided to each worker. Work productivity of the supported workers initially decreased but then increased to a level equivalent to the higher ranges of baseline productivity. These results suggested that the shared-work program appears to represent a viable means of enhancing supported work performance of people with severe multiple disabilities in some types of community jobs. Future research needs discussed focus on evaluating shared-work approaches with other jobs, and developing additional community work models specifically for people with highly significant disabilities.

A Summary of Actinide Enrichment Technologies and Capability Gaps

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

Patton, Bradley D.; Robinson, Sharon M.

2017-01-01

The evaluation performed in this study indicates that a new program is needed to efficiently provide a national actinide radioisotope enrichment capability to produce milligram-to-gram quantities of unique materials for user communities. This program should leverage past actinide enrichment, the recent advances in stable isotope enrichment, and assessments of the future requirements to cost effectively develop this capability while establishing an experience base for a new generation of researchers in this vital area. Preliminary evaluations indicate that an electromagnetic isotope separation (EMIS) device would have the capability to meet the future needs of the user community for enriched actinides. Themore » EMIS technology could be potentially coupled with other enrichment technologies, such as irradiation, as pre-enrichment and/or post-enrichment systems to increase the throughput, reduce losses of material, and/or reduce operational costs of the base EMIS system. Past actinide enrichment experience and advances in the EMIS technology applied in stable isotope separations should be leveraged with this new evaluation information to assist in the establishment of a domestic actinide radioisotope enrichment capability.« less

School and Community Predictors of Smoking: A Longitudinal Study of Canadian High Schools

PubMed Central

Watts, Allison; Brown, K. Stephen; Lee, Derrick; Sabiston, Catherine; Nykiforuk, Candace; Eyles, John; Manske, Steve; Campbell, H. Sharon; Thompson, Mary

2013-01-01

Objectives. We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time. Methods. We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence. Results. Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income. Conclusions. Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking. PMID:23237165

Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients.

PubMed

Castañeda, Sheila F; Giacinto, Rebeca E; Medeiros, Elizabeth A; Brongiel, Ilana; Cardona, Olga; Perez, Patricia; Talavera, Gregory A

2016-06-01

This collaborative study sought to address Latina breast cancer (BC) disparities by increasing health literacy (HL) in a community health center situated on the US-Mexico border region of San Diego County. An academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention with 109 individuals. The Spanish language program, entitled Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life), included six sessions targeting HL, women's health, BC risk reduction, and patient-provider communication; sessions include cooking demonstrations of recipes with cancer-risk-reducing ingredients. A pilot study with 47 community health center Latina patients was conducted to examine the program's acceptability, feasibility, and ability to impact knowledge and skills. Pre- and post-analyses demonstrated that participants improved their self-reported cancer screening, BC knowledge, daily fruit and vegetable intake, and ability to read a nutrition label (p < 0.05). Results of the pilot study demonstrate the importance of utilizing patient-centered culturally appropriate noninvasive means to educate and empower Latina patients.

School and community predictors of smoking: a longitudinal study of Canadian high schools.

PubMed

Lovato, Chris; Watts, Allison; Brown, K Stephen; Lee, Derrick; Sabiston, Catherine; Nykiforuk, Candace; Eyles, John; Manske, Steve; Campbell, H Sharon; Thompson, Mary

2013-02-01

We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time. We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence. Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income. Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.

Reducing Distance through Distance Learning: The Community College Leadership Doctoral Program at Colorado State University.

ERIC Educational Resources Information Center

Davies, Timothy Gray; Quick, Don

2001-01-01

Reports that the Community College Leadership program at Colorado State University creates a community among its nontraditional doctoral students using a blend of different learning modalities, including face-to-face experiences and synchronous and asynchronous online discussions. Discusses three types of support necessary for distance learning…

Firewise forever? Voluntary community participation and retention in Firewise programs

Treesearch

Michele Steinberg

2011-01-01

Firewise Communities/USA® is a national program designed to encourage residents of wildfire-prone areas to take action to reduce wildfire risks to their homes and neighborhoods. Residents of homeowner associations and small communities who are interested in improving their wildfire safety work with state forestry and fire professionals and follow a simple,...

Challenges to Superfund Community Nutrition Programs in Kentucky

PubMed Central

Gaetke, Lisa; Gaetke, Kara; Bowen, Christa

2008-01-01

Since 2000, the University of Kentucky's (UK's) Superfund Basic Research Program (SBRP) Community Outreach Core has provided support and guidance through Superfund Community Action through Nutrition (SCAN) programs, which meet the needs of individuals and communities affected by environmental contaminants. It has been shown that nutrition may modulate the toxicity of Superfund chemicals. SCAN programs integrate nutrition education, nutrition science research, and health communication to increase understanding of health risks associated with residing near Superfund sites. Two critical tasks must be accomplished. SCAN personnel must identify and recruit affected community members, and then, offer meaningful programs. Certain quantitative outcome measures and legal issues presented both challenges and opportunities. Community members preferred qualitative evaluation discussions, which showed increased knowledge and improved attitudes following SCAN programs. SCAN, in full partnership with affected communities, translates safe, effective nutrition information to reduce health risks associated with exposure to Superfund pollutants. PMID:18443657

Challenges to superfund community nutrition programs in kentucky.

PubMed

Gaetke, Lisa; Gaetke, Kara; Bowen, Christa

2008-03-01

Since 2000, the University of Kentucky's (UK's) Superfund Basic Research Program (SBRP) Community Outreach Core has provided support and guidance through Superfund Community Action through Nutrition (SCAN) programs, which meet the needs of individuals and communities affected by environmental contaminants. It has been shown that nutrition may modulate the toxicity of Superfund chemicals. SCAN programs integrate nutrition education, nutrition science research, and health communication to increase understanding of health risks associated with residing near Superfund sites. Two critical tasks must be accomplished. SCAN personnel must identify and recruit affected community members, and then, offer meaningful programs. Certain quantitative outcome measures and legal issues presented both challenges and opportunities. Community members preferred qualitative evaluation discussions, which showed increased knowledge and improved attitudes following SCAN programs. SCAN, in full partnership with affected communities, translates safe, effective nutrition information to reduce health risks associated with exposure to Superfund pollutants.

The Community Leadership Educator's Perspective on Program Sustainability

ERIC Educational Resources Information Center

Stoecker, Randy; Willis, Catherine; Lersch, Art

2009-01-01

Those who work to develop and manage community-based leadership programs have long been concerned with how to sustain them--to keep them healthy and useful. But focusing on how to sustain programs requires exploring what sustainability means. This paper reports on interviews with 41 community-based leadership education program coordinators. In…

"Bringing It All Back Home": An Interdisciplinary Model for Community-Based Learning

ERIC Educational Resources Information Center

Schwartz, Earl

2015-01-01

Leaders of community-based learning programs must prove the worth of their programs to community hosts, while engaging students at appropriate levels of learning. Pitfalls multiply when programs are interdisciplinary, involve multiple sites, and/or deal with questions of social equity. Such programs must effectively match and prepare students and…

Design of a comparative effectiveness randomized controlled trial testing a faith-based Diabetes Prevention Program (WORD DPP) vs. a Pacific culturally adapted Diabetes Prevention Program (PILI DPP) for Marshallese in the United States.

PubMed

McElfish, Pearl Anna; Long, Christopher R; Kaholokula, Joseph Keawe'aimoku; Aitaoto, Nia; Bursac, Zoran; Capelle, Lucy; Laelan, Melisa; Bing, Williamina Ioanna; Riklon, Sheldon; Rowland, Brett; Ayers, Britni L; Wilmoth, Ralph O; Langston, Krista N; Schootman, Mario; Selig, James P; Yeary, Karen Hye-Cheon Kim

2018-05-01

Pacific Islander populations, including Marshallese, face a disproportionately high burden of health disparities relative to the general population. A community-based participatory research (CBPR) approach was utilized to engage Marshallese participants in a comparative effectiveness trial testing 2 Diabetes Prevention Program (DPP) interventions designed to reduce participant's weight, lower HbA1c, encourage healthy eating, and increase physical activity. To compare the effectiveness of the faith-based (WORD) DPP to the culturally adapted (Pacific Culturally Adapted Diabetes Prevention Program [PILI]) DPP, a clustered randomized controlled trial (RCT) with 384 Marshallese participants will be implemented in 32 churches located in Arkansas, Kansas, Missouri, and Oklahoma. Churches will be randomly assigned to WORD DPP arm or to PILI DPP arm. WORD DPP focuses on connecting faith and health to attain a healthy weight, eat healthy, and be more physically active. In contrast, PILI DPP is a family and community focused DPP curriculum specifically adapted for implementation in Pacific Islander communities. PILI focuses on engaging social support networks to maintain a healthy weight, eat healthy, and be more physically active. All participants are assessed at baseline, immediate post intervention, and 12 months post intervention. Both interventions aim to cause weight loss through improving physical activity and healthy eating, with the goal of preventing the development of T2D. The clustered RCT will determine which intervention is most effective with the Marshallese population. The utilization of a CBPR approach that involves local stakeholders and engages faith-based institutions in Marshallese communities will increase the potential for success and sustainability. This study is registered at clinicaltrials.gov (NCT03270436).

Design of a comparative effectiveness randomized controlled trial testing a faith-based Diabetes Prevention Program (WORD DPP) vs. a Pacific culturally adapted Diabetes Prevention Program (PILI DPP) for Marshallese in the United States

PubMed Central

McElfish, Pearl Anna; Long, Christopher R.; Kaholokula, Joseph Keawe‘aimoku; Aitaoto, Nia; Bursac, Zoran; Capelle, Lucy; Laelan, Melisa; Bing, Williamina Ioanna; Riklon, Sheldon; Rowland, Brett; Ayers, Britni L.; Wilmoth, Ralph O.; Langston, Krista N.; Schootman, Mario; Selig, James P.; Yeary, Karen Hye-cheon Kim

2018-01-01

Abstract Background: Pacific Islander populations, including Marshallese, face a disproportionately high burden of health disparities relative to the general population. Objectives: A community-based participatory research (CBPR) approach was utilized to engage Marshallese participants in a comparative effectiveness trial testing 2 Diabetes Prevention Program (DPP) interventions designed to reduce participant's weight, lower HbA1c, encourage healthy eating, and increase physical activity. Design: To compare the effectiveness of the faith-based (WORD) DPP to the culturally adapted (Pacific Culturally Adapted Diabetes Prevention Program [PILI]) DPP, a clustered randomized controlled trial (RCT) with 384 Marshallese participants will be implemented in 32 churches located in Arkansas, Kansas, Missouri, and Oklahoma. Churches will be randomly assigned to WORD DPP arm or to PILI DPP arm. Methods: WORD DPP focuses on connecting faith and health to attain a healthy weight, eat healthy, and be more physically active. In contrast, PILI DPP is a family and community focused DPP curriculum specifically adapted for implementation in Pacific Islander communities. PILI focuses on engaging social support networks to maintain a healthy weight, eat healthy, and be more physically active. All participants are assessed at baseline, immediate post intervention, and 12 months post intervention. Summary: Both interventions aim to cause weight loss through improving physical activity and healthy eating, with the goal of preventing the development of T2D. The clustered RCT will determine which intervention is most effective with the Marshallese population. The utilization of a CBPR approach that involves local stakeholders and engages faith-based institutions in Marshallese communities will increase the potential for success and sustainability. This study is registered at clinicaltrials.gov (NCT03270436). PMID:29742712

HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity.

PubMed

Flattum, Colleen; Draxten, Michelle; Horning, Melissa; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Kubik, Martha Y; Story, Mary

2015-04-29

Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity. The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis. The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities. Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity. NCT01538615.

The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program.

PubMed

Oser, Carrie; Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-08-01

Women's substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative's National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n=217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings.

Environmental Approaches to Prevention in College Settings

PubMed Central

Saltz, Robert F.

2011-01-01

Because of concerns regarding drinking among college students and its harmful consequences, numerous prevention efforts have been targeted to this population. These include individual-level and community-level interventions, as well as other measures (e.g., online approaches). Community-level interventions whose effects have been evaluated in college populations include programs that were developed for the community at large as well as programs aimed specifically at college students, such as A Matter of Degree, the Southwest DUI Enforcement Project, Neighborhoods Engaging With Students, the Study to Prevent Alcohol-Related Consequences, and Safer California Universities. Evaluations of these programs have found evidence of their effectiveness in reducing college drinking and related consequences. The most effective approaches to reducing alcohol consumption among college students likely will blend individual-, group-, campus-, and community-level prevention components. PMID:22330219

Power of Peer Support to Change Health Behavior to Reduce Risks for Heart Disease and Stroke for African American Men in a Faith-Based Community.

PubMed

Lee, Sohye; Schorr, Erica; Hadidi, Niloufar Niakosari; Kelley, Robin; Treat-Jacobson, Diane; Lindquist, Ruth

2018-02-01

Peer support has powerful potential to improve outcomes in a program of health behavior change; yet, how peer support is perceived by participants, its role, and how it contributes to intervention efficacy is not known, especially among African Americans. The purpose of this study was to identify the subjectively perceived experience and potential contributions of peer support to the outcomes of a peer group behavioral intervention designed to change health behavior to reduce risks for heart disease and stroke in African American men in a faith-based community. A peer support group intervention was implemented to increase health knowledge and to improve health behaviors in line with the American Heart Association's Life Simple 7 domains (get active, control cholesterol, eat better, manage blood pressure, lose weight, reduce blood sugar, and stop smoking). Fourteen peer group sessions and eight follow-up interviews with program participants were recorded, transcribed, and analyzed. Seven key themes emerged, including (1) enhancing access to health behavior information and resources, (2) practicing and applying problem-solving skills with group feedback and support, (3) discussing health behavior challenges and barriers, (4) sharing health behavior changes, (5) sharing perceived health outcome improvements and benefits, (6) feelings of belonging and being cared for, and (7) addressing health of family and community. Qualitative findings revealed a positive perception of peer support and greater understanding of potential reasons why it may be an effective strategy for African American men.

Characteristics of Sports-Based Youth Development Programs

ERIC Educational Resources Information Center

Perkins, Daniel F.; Noam, Gil G.

2007-01-01

The term "sports-based youth development programs" is coined and defined in the context of the community youth development framework. Sports-based youth development programs are out-of-school-time programs that use a particular sport to facilitate learning and life skill development in youth. Community youth development programs use a community…

Impact of the Social Café Meals program: a qualitative investigation.

PubMed

Allen, Louise; O'Connor, Jacklin; Amezdroz, Emily; Bucello, Pieta; Mitchell, Hannah; Thomas, Arabella; Kleve, Sue; Bernardi, Anthony; Wallis, Liza; Palermo, Claire

2014-01-01

Social Café Meals Programs aim to reduce food insecurity and social exclusion by providing participants access to subsidised meals in mainstream local cafés. This study aimed to explore the program's ability to address social exclusion and food insecurity and the impact of the program on the community. A qualitative evaluation approach was utilised whereby in-depth interviews were conducted with café owners, café staff and current program members of two Social Café Meals Programs operating in the south-eastern suburbs of Melbourne. Twelve program members and six café staff completed an in-depth interview at the local cafés. Data were analysed using a thematic analysis approach focusing on the lived experience of the café owners, staff and program members. Four key themes were identified. The program (i) improved food access for vulnerable groups and (ii) created community cohesiveness. (iii) The café environment was important in facilitating program use by community members. (iv) Café owners felt rewarded for their community contribution via the program. Social Café Meals Programs may provide a solution to improving food security and reducing social exclusion and may be considered as a strategy for improving nutrition and social health for at-risk and vulnerable groups.

Reducing inequities among children with asthma in the island of Puerto Rico: experiences of a community-based, trans-sectoral effort.

PubMed

Lara, Marielena; Valencia, Gilberto Ramos; Gavillán, Jesús A González Gavillán; Reyes, Beatriz Morales; Arabía, Carmen; Malpica, Fernando López; Freytes, Dharma M; Rodríguez-Sánchez, Mario H; Chinman, Matthew

2009-01-01

Children living in the Commonwealth of Puerto Rico have the highest poverty and asthma prevalence rates of all U.S. children. Since 2000, a group of community, health care, education, housing, and academic representatives have been collaborating in a project to improve quality of life and reduce disparities among children with asthma in very poor communities in Puerto Rico. To date the project has implemented a successful intervention in the Luis Lloréns Torres Housing Project, aimed at adapting evidence-based interventions to improve the social and physical environment of children with asthma. The program has recently been extended to another San Juan housing area, the Manuel A. Pérez Housing Project. Using implementation theory, the authors report and reflect on the project's experience to date, provide recommendations, and discuss implications of lessons learned to address inequities in asthma care throughout other underserved areas in the U.S., Latin America, and the Caribbean.

Adult Health Learning and Transformation: A Case Study of a Canadian Community-Based Program

ERIC Educational Resources Information Center

Coady, Maureen

2013-01-01

This article describes a case study of adult learning in a Canadian multisite Community Cardiovascular Hearts in Motion program. The researcher highlights the informal learning of 40 adult participants in this 12-week community-based cardiac rehabilitation/education program in five rural Nova Scotia communities. The effects of this learning and…

Collecting costs of community prevention programs: communities putting prevention to work initiative.

PubMed

Khavjou, Olga A; Honeycutt, Amanda A; Hoerger, Thomas J; Trogdon, Justin G; Cash, Amanda J

2014-08-01

Community-based programs require substantial investments of resources; however, evaluations of these programs usually lack analyses of program costs. Costs of community-based programs reported in previous literature are limited and have been estimated retrospectively. To describe a prospective cost data collection approach developed for the Communities Putting Prevention to Work (CPPW) program capturing costs for community-based tobacco use and obesity prevention strategies. A web-based cost data collection instrument was developed using an activity-based costing approach. Respondents reported quarterly expenditures on labor; consultants; materials, travel, and services; overhead; partner efforts; and in-kind contributions. Costs were allocated across CPPW objectives and strategies organized around five categories: media, access, point of decision/promotion, price, and social support and services. The instrument was developed in 2010, quarterly data collections took place in 2011-2013, and preliminary analysis was conducted in 2013. Preliminary descriptive statistics are presented for the cost data collected from 51 respondents. More than 50% of program costs were for partner organizations, and over 20% of costs were for labor hours. Tobacco communities devoted the majority of their efforts to media strategies. Obesity communities spent more than half of their resources on access strategies. Collecting accurate cost information on health promotion and disease prevention programs presents many challenges. The approach presented in this paper is one of the first efforts successfully collecting these types of data and can be replicated for collecting costs from other programs. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Integrating Interprofessional Education and Cultural Competency Training to Address Health Disparities.

PubMed

McElfish, Pearl Anna; Moore, Ramey; Buron, Bill; Hudson, Jonell; Long, Christopher R; Purvis, Rachel S; Schulz, Thomas K; Rowland, Brett; Warmack, T Scott

2018-01-01

Many U.S. medical schools have accreditation requirements for interprofessional education and training in cultural competency, yet few programs have developed programs to meet both of these requirements simultaneously. Furthermore, most training programs to address these requirements are broad in nature and do not focus on addressing health disparities. The lack of integration may reduce the students' ability to apply the knowledge learned. Innovative programs that combine these two learning objectives and focus on disenfranchised communities are needed to train the next generation of health professionals. A unique interprofessional education program was developed at the University of Arkansas for Medical Sciences Northwest. The program includes experiential learning, cultural exposure, and competence-building activities for interprofessional teams of medicine, nursing, and pharmacy students. The activities include (a) educational seminars, (b) clinical experiential learning in a student-led clinic, and (c) community-based service-learning through health assessments and survey research events. The program focuses on interprofessional collaboration to address the health disparities experienced by the Marshallese community in northwest Arkansas. The Marshallese are Pacific Islanders who suffer from significant health disparities related to chronic and infectious diseases. Comparison tests revealed statistically significant changes in participants' retrospectively reported pre/posttest scores for Subscales 1 and 2 of the Readiness for Interpersonal Learning Scale and for the Caffrey Cultural Competence in Healthcare Scale. However, no significant change was found for Subscale 3 of the Readiness for Interpersonal Learning Scale. Qualitative findings demonstrated a change in students' knowledge, attitudes, and behavior toward working with other professions and the underserved population. The program had to be flexible enough to meet the educational requirements and class schedules of the different health professions' education programs. The target community spoke limited English, so providing interpretation services using bilingual Marshallese community health workers was integral to the program's success.

Switch for Good Community Program

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

Crawford, Tabitha; Amran, Martha

2013-11-19

Switch4Good is an energy-savings program that helps residents reduce consumption from behavior changes; it was co-developed by Balfour Beatty Military Housing Management (BB) and WattzOn in Phase I of this grant. The program was offered at 11 Navy bases. Three customer engagement strategies were evaluated, and it was found that Digital Nudges (a combination of monthly consumption statements with frequent messaging via text or email) was most cost-effective. The program was delivered on-time and on-budget, and its success is based on the teamwork of local BB staff and the WattzOn team. The following graphic shows Switch4Good “by the numbers”, e.g.more » the scale of operations achieved during Phase I.« less

Healthy Families America state systems development: an emerging practice to ensure program growth and sustainability.

PubMed

Friedman, Lori; Schreiber, Lisa

2007-01-01

In an era of fiscal constraints and increased accountability for social service programs, having a centralized and efficient infrastructure is critical. A well-functioning infrastructure helps a state reduce duplication of services, creates economies of scale, coordinates resources, supports high-quality site development and promotes the self-sufficiency and growth of community-based programs. Throughout the Healthy Families America home visitation network, both program growth and contraction have been managed by in-state collaborations, referred to as "state systems." This article explores the research base that supports the rationale for implementing state systems, describes the evolution of state systems for Healthy Families America, and discusses the benefits, challenges and lessons learned of utilizing a systems approach.

Including fall prevention for older adults in your trauma injury prevention program--introducing Farewell to Falls.

PubMed

Corman, Ellen

2009-01-01

With data showing that more than 50% of visits to our trauma center for older adults 65 years and older are due to falls, injury prevention programs in trauma centers should be paying more attention to the area of fall prevention for older adults. Farewell to Falls, a free, home-based program of Stanford Hospital and Clinic's trauma service, utilizes a multifaceted approach to help reduce falls. In addition to improving the lives of seniors, the program fulfills a community benefit goal and provides strong hospital marketing opportunities. This program is a benefit to hospitals and the older adults they serve.

Examining the influence of the Enforcing Underage Drinking Laws (EUDL) program on alcohol-related outcomes in five communities surrounding Air Force bases.

PubMed

Spera, Christopher; Barlas, Frances; Szoc, Ronald Z; Prabhakaran, Jyothsna; Cambridge, Milton H

2012-04-01

In 2006, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) awarded discretionary grants to five communities as part of the Enforcing Underage Drinking Laws (EUDL) initiative to implement an environmental strategy approach to reduce drinking and associated misconducts among Air Force members. The evaluation design was a within-site, pre-test/post-test intervention comparison of baseline data to out-year data. Four of the five communities had significant decreases in one or more of the outcomes of interest from pre-test to post-test. Two communities (Great Falls, MT and Tucson, AZ) had a significant decline in the compliance check failure rate of local establishments that sell alcohol. One community (Great Falls, MT) had a significant decline in arrests for possession of alcohol by a minor. Four communities (Great Falls, MT; Tucson, AZ; Phoenix, AZ; Honolulu, HI) had a significant decline in DUI/DWI arrests. These findings build on results reported in an earlier article which provided evidence to suggest that the EUDL program had an influence on self-reported drinking behaviors in three of the five communities. These two articles, in combination, provide evidence to suggest for the first time that community-level programs using an environmental strategy approach can be successful in targeting military members. Copyright © 2011 Elsevier Ltd. All rights reserved.

Third Microgravity Fluid Physics Conference

NASA Technical Reports Server (NTRS)

1996-01-01

The conference's purpose was to inform the fluid physics community of research opportunities in reduced-gravity fluid physics, present the status of the existing and planned reduced gravity fluid physics research programs, and inform participants of the upcoming NASA Research Announcement in this area. The plenary sessions provided an overview of the Microgravity Fluid Physics Program, present and future areas of emphasis, information on NASA's ground-based and space-based flight research facilities-especially use of the International Space Station, and the process by which future investigators enter the program. An international forum offered participants an opportunity to hear from Russian speakers about their microgravity research programs. Three keynote speakers provided broad technical overviews on the history and future development of the moon and on multiphase flow and complex fluids research. One keynote paper and an extended abstract are included in the proceedings. One hundred and thirty-two technical papers were presented in 28 sessions. Presenters briefed their peers on the scientific results of their ground-based and flight research. One hundred and twenty-two papers are included here.

CSM: Profamilia's approach in Colombia.

PubMed

Samuel, S

1982-03-01

Colombia's PROFAMILIA has successfully operated a contraceptive social marketing (CSM) program since 1973. Beginning with 1 salesperson distributing primarily to Cajas de Subsideio, the CSM program is now distributed through 70-80% of the 6000 registered pharmacies in the country, as well as pharmacy counters of several supermakets in urban areas. During 1981, PROFAMILIA's 5 salespersons accountd for commerical sales of oral contraceptives (OCs) to 225,000 couples and sales of barrier methods to another 75,000. Program sales of contraceptives and other products generated approximately US $1.7 million in revenue for the same year. PROFAMILIA's marketing approach is unique in its product and promotinal characteristics. Supplies are obtained directly from local and foreign manufacturers and are resold without any repackaging. While it is generally believed that CSM programs expand the market for contraceptives, data analysis and analysis of PROFAMILIA's distribution system suggests that the PROFAMILIA CSM program has simply absorbed some of the previously existing commerical market. Total commerical market sales of oral contraceptives (OCs) have grown at an annual rate of 3-4% since 1975. During the same period, direct sales of Schering, Wyeth, and other competitors have declined. PROFAMILIA's community-based program operates mainly among urban and semi-rural lower income populations. It sells products through established retail outlets rather than through institutional or non-retail outlets. PROFAMILIA's community-based program in all respects but its use of a staff of 112 salaried "instructoras" is as much a marketing program as PROFAMILIA's sales through pharmacies. Taken together, the 2 program expanded the commerical makert by about 1/2 since 1975. The contraceptive social marketing or pharmacy sales program appears to excel at generation of revenue and delivery of products to higher income clients. The community-based program excels at delivery of information and sales to lower income clients. PROFAMILIA CSM and community-based program sales are in a period of relative stagnation. Sales projections show only modest increases between 1981-85, despite the fact that a significant number of potential consumers remain unserved. Ultimately, PROFAMILIA may be faced with the need to reduce their number markedly as sales revenue is eroded by inflation while costs rise. A shift in duties back to motivation rather than distribution, combined with increased media promotion seems the clearest short-term response to the problem of unserved consumers.

What does a Performance Measurement System Tell Us about the National Comprehensive Cancer Control Program?

PubMed Central

Townsend, Julie S.; Moore, Angela R.; Mulder, Tiffani N.; Boyd, Mary

2015-01-01

Context The National Comprehensive Cancer Control Program (NCCCP) performance measurement system seeks to understand both the processes that funded programs undertake with their respective coalitions to implement the objectives of their cancer plans and outcomes of those efforts. Objective To identify areas of achievement and technical assistance needs of NCCCP awardees. Design Program performance was assessed through surveys completed by program directors on performance indicators in 2009 and 2010 and queries from a web-based management information system in 2011 and 2012. Setting Programs funded by CDC’s NCCCP. Participants 69 programs. Main Outcome Measure(s) The key performance measures assessed were: inclusion of diverse partners and key sectors in cancer coalitions; partners’ involvement in activities; receiving in-kind resources from partners; using evidence-based interventions and data for setting priorities; conducting program evaluation; using community- or organization-level strategies to address cancer control efforts; and demonstrating progress toward achieving health outcomes. Results Most programs reported having active coalitions that represent diverse organizational sectors. Nearly all programs routinely assess the burden of cancer. In-kind resources to implement activities peaked at $64,716 in the second year of a five year funding cycle, and declined in subsequent project years. By year 3, over 70% of programs reported having an evaluation plan. While programs reported that nearly two-thirds of their interventions were evidence-based, some programs implemented non-evidence-based interventions. A majority of programs successfully used at least one community- or organization-level change strategy. However, many programs did not incorporate objectives linked to health outcomes as they reported progress in implementing interventions. Conclusions: While NCCCP programs were strong at building and maintaining infrastructure, some programs may need additional technical assistance to increase the adoption of evidence-based interventions, develop solid and responsive evaluation plans, and better link efforts to population-based measures that demonstrate impact toward reducing the burden of cancer. PMID:25136936

Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

PubMed Central

Li, Fuzhong; Harmer, Peter; Glasgow, Russell; Mack, Karin A.; Sleet, David; Fisher, K. John; Kohn, Melvin A.; Millet, Lisa M.; Mead, Jennifer; Xu, Junheng; Lin, Mei-Li; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn

2008-01-01

Tai Chi—Moving for Better Balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the RE-AIM framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings. PMID:18511723

Adapting and Implementing an Evidence-Based Sun-Safety Education Program in Rural Idaho, 2012

PubMed Central

Gonzales, Melanie; Krebill, Hope

2014-01-01

Background Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke’s Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. Community Context As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. Methods The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. Outcome MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. Interpretation Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support. PMID:24809363

Factors That Predict Financial Sustainability of Community Coalitions: Five Years of Findings from the PROSPER Partnership Project

PubMed Central

Greenberg, Mark T.; Feinberg, Mark E.; Johnson, Lesley E.; Perkins, Daniel F.; Welsh, Janet A.; Spoth, Richard L.

2014-01-01

This study is a longitudinal investigation of the PROSPER partnership model designed to evaluate the level of sustainability funding by community prevention teams, including which factors impact teams’ generation of sustainable funding. Community teams were responsible for choosing, implementing with quality, and sustaining evidence-based programs (EBPs) intended to reduce substance misuse and promote positive youth and family development. Fourteen US rural communities and small towns were studied. Data were collected from PROSPER community team members (N=164) and Prevention Coordinators (N=10), over a 5-year period. Global and specific aspects of team functioning were assessed over 6 waves. Outcome measures were the total funds (cash and in-kind) raised to implement prevention programs. All 14 community teams were sustained for the first five years. However, there was substantial variability in the amount of funds raised and these differences were predicted by earlier and concurrent team functioning and by team sustainability planning. Given the sufficient infrastructure and ongoing technical assistance provided by the PROSPER partnership model, local sustainability of EBPs is achievable. PMID:24706195

Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study.

PubMed

Ramalho, Fátima; Santos-Rocha, Rita; Branco, Marco; Moniz-Pereira, Vera; André, Helô-Isa; Veloso, António P; Carnide, Filomena

2018-01-01

Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program. A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15) and in a non-periodized exercise group (N=13). The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention. Both programs were tailored to older adults' functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging.

The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

PubMed

Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

2015-09-01

Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. © 2015 The Population Council, Inc.

The Power Within: Institution-Based Leadership Development Programs in Rural Community Colleges in Illinois

ERIC Educational Resources Information Center

Sherbini, Jaleh T.

2012-01-01

The purpose of this study was to examine institution-based leadership development programs in rural community colleges in Illinois, and the impact of these programs in supporting and preparing future community college leaders. The study also explored the efficacy of these programs and whether their implementation aligns with the institutions'…

Healthy options: a community-based program to address food insecurity.

PubMed

Dailey, Amy B; Hess, Audrey; Horton, Camille; Constantian, Emily; Monani, Salma; Wargo, Betsy; Davidson, Kim; Gaskin, Kathy

2015-01-01

The objectives of this study are to better understand the lived experience of food insecurity in our community and to examine the impact of a community-based program developed to increase access to local, healthy foods. Participants were given monthly vouchers to spend at local farmers' markets and invited to engage in a variety of community activities. Using a community-based participatory research framework, mixed methods were employed. Survey results suggest that most respondents were satisfied with the program and many increased their fruit and vegetable consumption. However, over 40% of respondents reported a higher level of stress over having enough money to buy nutritious meals at the end of the program. Photovoice results suggest that the program fostered cross-cultural exchanges, and offered opportunities for social networking. Building on the many positive outcomes of the program, community partners are committed to using this research to further develop policy-level solutions to food insecurity.

75 FR 473 - Community Express Pilot Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... SMALL BUSINESS ADMINISTRATION Community Express Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Notice of extension of the Community Express Pilot Program. SUMMARY: This notice extends the Community Express Pilot Program in its current form through December 31, 2010. Based upon the...

ACCLAIM: A Model for Leading the Community.

ERIC Educational Resources Information Center

Vaughan, George B.; Gillett-Karam, Rosemary

1993-01-01

Advocates an approach to community college leadership based on community-based programming. Describes North Carolina State University's Academy for Community College Leadership Advancement, Innovation, and Modeling (ACCLAIM) and its components (i.e., continuing education, fellows program, information development/dissemination, and university…

University of Idaho's FCS Extension Educators Develop Leaders to Serve in Public Office

ERIC Educational Resources Information Center

Hoffman, Katie; Cummins, Melissa; Hansen, Lyle; Petty, Barbara; Tifft, Kathee; Laumatia, Laura

2013-01-01

In order to meet clientele needs and strengthen family and consumer sciences (FCS) programming, University of Idaho Extension educators expanded their roles through the Horizons program--a community leadership program, funded by the Northwest Area Foundation, aimed at reducing poverty in small rural and reservation communities. This study measured…

Lessons for Health Promotion from Selected Community-Based Heart Disease Prevention Programs.

ERIC Educational Resources Information Center

Sharma, Manoj; Galletly, Carol

1997-01-01

Discusses four key community-based coronary heart disease prevention interventions, elaborating on some of the challenges they encountered. The four interventions are the Stanford Three Community Study, Stanford Five-City Project, Minnesota Heart Health Program, and Pawtucket (Rhode Island) Heart Health Program. (SM)

Community Education and the Community College: A Success Story in Southwest Michigan

ERIC Educational Resources Information Center

Martin, Gerald C.; And Others

1975-01-01

A series of three viewpoints on the community education program at Kellogg Community College. Initial competition between community education directors and the college director of community education has changed to cooperation, resulting in increased enrollments and reduced advertising costs. (DC)

The EPA's Human Exposure Research Program for Assessing Cumulative Risk in Communities

EPA Science Inventory

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available...

Environmental equity: Reducing risk for all communities. Volume 2. Supporting document

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

NONE

1992-06-01

In targeting its protection efforts to reduce the most serious risks, the Agency has begun to examine how the patterns of environmental problems converge on different places, how the people who live in those places are affected, and how environmental programs should be refined to address identified differences. A community surrounded by Multiple sources of air pollution, ringed by waste treatment facilities and landfills, and whose residences contain lead-based paint clearly faces higher than average potential environmental risks. It is in this context that concerns have been raised about the relative risk burden borne by low-income and racial minority communities.more » Examination of these differences in risk burden and how government agencies respond is known as environmental equity. Although there are many types of equity, this report focuses on racial and socioeconomic equity.« less

A social marketing theory-based diet-education program for women ages 54 to 83 years improved dietary status.

PubMed

Francis, Sarah L; Taylor, Martha L

2009-12-01

Social Marketing Theory is a comprehensive approach of program development encompassing the needs and preferences of the intended audience. It was hypothesized a Social Marketing Theory-based, registered dietitian-led, in-home, cardiovascular disease-targeted diet-education program would improve the dietary status of community-residing older women. Using a randomized control group design, this 90-day program in two North Carolina counties included 58 women (30 control; 28 intervention) ages 54 to 83 years. Data were collected using the Mini Nutritional Assessment, three 3-day food records, and program evaluations. The intervention group received two individual registered dietitian-led in-home education sessions and the control group received education material mailings (Visits 2 and 3). Pretested education materials were used. Visits/mailings were scheduled 28 to 30 days apart. Variables measured included cardiovascular disease-related dietary practices and dietary status (Mini Nutritional Assessment). Data were analyzed using descriptive statistics, paired sample t tests, multivariant analyses, and independent t tests. Intervention and control Mini Nutritional Assessment scores improved (P=0.0001). Intervention subjects consumed more fiber than control (P=0.013) and reduced sodium intake (P=0.02). Controls reduced energy (P=0.01) and cholesterol intakes (P=0.029), likely because of the decreased food intake. The majority (n=51, 87.9%) rated the program as good to excellent and almost all (n=55, 94.8%) would recommend the program to a friend. The most popular features of the program were the individualized sessions (n=20, 34.5%) and diet analyses (n=11, 19%). These results suggest that cardiovascular disease diet-education materials utilizing Social Marketing Theory principles can lead to improved dietary status among community-residing older women.

Free To Grow: Head Start Partnerships to Promote Substance-Free Communities. Program Results Report

ERIC Educational Resources Information Center

De Milto, Lori

2012-01-01

"Free To Grow"--a national program of the Robert Wood Johnson Foundation (RWJF)--supported efforts by Head Start agencies and their community partners to strengthen the families and neighborhood environments of high-risk preschool children living in low-income communities. The goal was to reduce the children's vulnerability to substance…

Talking about Mental Illness: A Guide for Developing an Awareness Program for Youth. Community Guide.

ERIC Educational Resources Information Center

2001

This guide contains all of the information, support and tools that community members need to implement "Talking About Mental Illness" in their community--an awareness program proven to be effective in bringing about positive change in young people's knowledge about mental illness, and in reducing stigma that surrounds mental illness. The…

Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis.

PubMed

Burnim, Michael; Ivy, Julianne A; King, Charles H

2017-10-01

The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement. This review was registered prospectively with PROSPERO (CRD 42015017656). Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%), followed by community-based programs (72%). School-based programs had both the lowest median coverage of children overall (49%) and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups. This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results, a combined community and school-based delivery system should maximize coverage for both in- and out-of-school children, especially when combined with interventions such as snacks for treated children, educational campaigns, incentives for drug distributors, and active inclusion of marginalized groups. ClinicalTrials.gov CRD42015017656.

Effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies: our experience over the decade.

PubMed

Salihu, Hamisu M; August, Euna M; Jeffers, Delores F; Mbah, Alfred K; Alio, Amina P; Berry, Estrellita

2011-06-01

To evaluate the effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies in a disadvantaged community. An ecological study that compares trends in teen pregnancy in the catchment area in which the community-based intervention was administered with two ecologic controls: the county (Hillsborough) and the state (Florida). Our catchment area is East Tampa, a socio-economically disadvantaged community in Hillsborough County, Florida. Preconception care targeted teenagers between the ages of 10 and 19 years. Interconception care involved young mothers under the age of 20 with a previous birth. The population was comprised primarily of African Americans. Preconception care services for primary teen pregnancy reduction offered sex education, family planning, drug and violence prevention education, and communication and negotiation skills acquisition. Interconception care service offered young women health education through monthly home visitation or monthly peer support group meetings addressing a range of topics using the life course perspective as framework. Reduction in primary teen pregnancy and repeat teen pregnancy among adolescents. The decline in primary teen pregnancy in the catchment area was 60% and 80% greater than the reduction experienced at the county level and at the state level respectively over the period of the study. However, efforts to prevent repeat pregnancy were not successful. The Federal Healthy Start Preconception Care program, in collaboration with community partners, contributed to the prevention of first-time teen pregnancy in a community faced with significant social and economic challenges. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

The Community Pulling Together: A Tribal Community-University Partnership Project to Reduce Substance Abuse and Promote Good Health in a Reservation Tribal Community

PubMed Central

Thomas, Lisa R.; Donovan, Dennis M.; Sigo, Robin LW.; Austin, Lisette; Marlatt, G. Alan

2010-01-01

Alcohol and drug abuse are major areas of concern for many American Indian/Alaska Native communities. Research on these problems has often been less than successful, in part because many researchers are not sensitive to the culture and traditions of the tribes and communities with which they are working. They also often fail to incorporate tribal customs, traditions, and values into the interventions developed to deal with substance abuse. We describe the use of Community-Based Participatory Research (CBPR) and Tribal Participatory Research (TPR) approaches to develop a culturally sensitive substance abuse prevention program for Native youth. This project, The Community Pulling Together: Healing of the Canoe, is a collaboration between the Suquamish Tribe and the Alcohol and Drug Abuse Institute at the University of Washington. PMID:20157631

Program Sustainability: Hearing Loss and Tinnitus Prevention in American Indian Communities.

PubMed

Martin, William Hal; Sobel, Judith L; Griest, Susan E; Howarth, Linda C; Becker, Thomas M

2017-03-01

An important goal of any health promotion effort is to have it maintained in delivery and effectiveness over time. The purpose of this study was to establish a community-based noise-induced hearing loss and tinnitus prevention program in three different types of American Indian communities and evaluate them for evidence of long-term sustainability. The target population was fourth- and fifth-grade students from three different models of American Indian communities. The evidenced-based Dangerous Decibels ® program was adapted to include local media, classroom education, family and community outreach, and web-based activities. Sustainability was attempted by promoting funding stability, political support, partnerships, organizational capacity, program adaptation, program evaluation, communications, public health impacts, and strategic planning. Currently, there is evidence suggesting that the hearing health promotion program is self-sustaining in all three American Indian communities. The intervention was effective at changing knowledge, attitudes, beliefs, and behaviors in the target population, but program adoption and self-sustenance faced challenges that required patience, persistence, and creativity by the program team. Components of the intervention continue to be delivered by local members of each community. Critical factors that led to self-sustaining programs included approval of community leaders and engagement of community members in the design, administration, and evaluation of the effort; use of a well-developed, evidence-based intervention; and high-level training of local participants who could confidently and effectively continue delivering the program following a gradual transition to independence. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

PubMed

Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

2016-07-15

As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

The Impact of Community Violence on School-Based Research.

PubMed

Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K; Dean, Kyle C; Scott, Darrick; Gross, Israel M; Romeo, Edna

2015-12-01

Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines the impact of community violence on a school-based research program. It is also a brief summary of the detrimental effects of exposure to community violence on psychological and academic functioning and health outcomes. An example of the impact of community violence on the implementation of a school-based asthma program will be addressed. Implications for school nurses will be discussed. © The Author(s) 2015.

Integrating Faith-based and Community-based Participatory Research Approaches to Adapt the Korean Parent Training Program.

PubMed

Kim, Eunjung; Boutain, Doris; Kim, Sangho; Chun, Jin-Joo; Im, Hyesang

Faith and community based inquiry approaches are rarely used to develop research interventions. The purpose of this article is to present how a research team worked with six Korean American Christian churches to revise the prototype Korean Parent Training Program (KPTP), based upon the Bright Futures Parenting Program. The collaboration was sought to better integrate and align the KPTP with Korean culture and faith. The KPTP was developed to promote positive parenting practices and decrease mental health disparities of Korean American children. Sixteen church participants completed a Delphi survey, a workshop series, Community Theaters, and focus groups. The participants suggested adding Korean traditional parenting virtues, Christian parenting principles, and revising the standardized parent training and program philosophy. Revisions made KPTP sensitive to Korean culture and faith, and promoted program acceptability. The process demonstrated the importance of working with church volunteers to develop faith-based and community-based health promotion interventions targeting Korean American faith communities. This research presents significant and meaningful implications for working with other faith communities from minority backgrounds. Copyright © 2017 Elsevier Inc. All rights reserved.

Community Modeling Program for Space Weather: A CCMC Perspective

NASA Technical Reports Server (NTRS)

Hesse, Michael

2009-01-01

A community modeling program, which provides a forum for exchange and integration between modelers, has excellent potential for furthering our Space Weather modeling and forecasting capabilities. The design of such a program is of great importance to its success. In this presentation, we will argue that the most effective community modeling program should be focused on Space Weather-related objectives, and that it should be open and inclusive. The tremendous successes of prior community research activities further suggest that the most effective implementation of a new community modeling program should be based on community leadership, rather than on domination by individual institutions or centers. This presentation will provide an experience-based justification for these conclusions.

Experimental control of Triatoma infestans in poor rural villages of Bolivia through community participation

PubMed Central

Lardeux, Frédéric; Depickère, Stéphanie; Aliaga, Claudia; Chavez, Tamara; Zambrana, Lilian

2015-01-01

Background Triatoma infestans is the main vector of Chagas disease in the southern cone countries. Present control strategies based on indoor and outdoor residual insecticide spraying are not sufficient to control disease transmission, particularly in Bolivia. Techniques based on the management of the human environment may be good alternatives or supplements. Methods Social and entomological surveys were carried out in four villages of Bolivia situated in the dry inter-Andean Valleys and the Chaco region. Risk factors for house infestation by T. infestans were identified, and an eco-health intervention based on education and community participation was carried out to reduce the risks of house infestation. It consisted of implementing simple and low cost vector control techniques such as coating of mud walls, cleaning activities and removal of poultry that enter rooms to lay eggs. Results The eco-health intervention significantly reduced the number of infested bedrooms, the mean abundance of T. infestans in bedrooms and beds, especially in the Chaco region. Mud wall coating was well accepted and could be proposed as a supplementary tool to the National Program of Chagas Disease Control to enhance the effects of insecticide sprayings. Conclusions Even if cleaning activities were still neglected, community participation proved to be effective in reducing house infestation. PMID:25604766

Pioneering and Interprofessional Pediatric Dentistry Programs Aimed at Reducing Oral Health Disparities.

PubMed

Ramos-Gomez, Francisco; Askaryar, Hamida; Garell, Cambria; Ogren, Jennifer

2017-01-01

Early Childhood Caries (ECC) is the most chronic childhood disease and more predominant in low-income and underserved children. Although easily transmitted, ECC is entirely preventable. Dr. Ramos-Gomez and his team at the University of California, Los Angeles put together an interprofessional curriculum where both medical and dental knowledge and practice is integrated to prepare dentists and primary care providers to more cost effectively address ECC and thereby reduce disparities in oral health. The curriculum, known as the Strategic Partnership for Interprofessional Collaborative Education in Pediatric Dentistry (SPICE-PD), consists of nine evidence-based training modules: applied statistics and research, community partners, interprofessional education/training, quality improvement, policy and advocacy, disease management/risk assessment, ethics/professionalism, cultural competency and children with special heath-care needs. SPICE aims to prepare pediatric dental residents and primary care providers to provide preventive, culturally competent, and minimally invasive oral care for underserved, low income, and special needs children. Additionally, the Infant Oral Care Program (IOCP), located at a local community health clinic, provides culturally sensitive preventive oral health care for children aged 0-5 years. The medical-dental integration model utilized at IOCP helps reduce oral health disparities by providing a systems-based and cost-effective approach to combat the burden of ECC. To track the progress of SPICE, a comprehensive evaluation framework has been designed, which aligns goals and objectives with program activities, desired outcomes, and measured indicators.

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases⋆

PubMed Central

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2010-01-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women’s empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n = 110) compared to a control community (n = 106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention’s impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000–2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study’s results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs. PMID:19716639

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

PubMed

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2009-10-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study's results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs.

Lessons from the polybrominated diphenyl ethers (PBDEs): precautionary principle, primary prevention, and the value of community-based body-burden monitoring using breast milk.

PubMed

Hooper, Kim; She, Jianwen

2003-01-01

Levels of chemicals in humans (body burdens) are useful indicators of environmental quality and of community health. Chemical body burdens are easily monitored using breast milk samples collected from first-time mothers (primiparae) with infants 2-8 weeks of age. Currently, there is no body-burden monitoring program using breast milk in the United States, although ad hoc systems operate successfully in several European countries. In this article we describe the value of such monitoring and important considerations of how it might be accomplished, drawing from our experiences with pilot monitoring projects. Breast milk has several advantages as a sampling matrix: It is simple and noninvasive, with samples collected by the mother. It monitors body burdens in reproductive-age women and it estimates in utero and nursing-infant exposures, all important to community health. Time-trend data from breast milk monitoring serve as a warning system that identifies chemicals whose body burdens and human exposures are increasing. Time trends also serve as a report card on how well past regulatory actions have reduced environmental chemical exposures. Body-burden monitoring using breast milk should include educational programs that encourage breast-feeding. Finally, and most important, clean breast milk matters to people and leads to primary prevention--the limiting of chemical exposures. We illustrate these advantages with polybrominated diphenyl ethers (PBDEs), a formerly obscure group of brominated flame retardants that rose to prominence and were regulated in Sweden when residue levels were found to be rapidly increasing in breast milk. A community-based body-burden monitoring program using breast milk could be set up in the United States in collaboration with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC has a large number of lactating first-time mothers: It has 6,000 clinics nationwide and serves almost half (47%) the infants born in the United States. Educational programs (e.g., those run by WIC) are needed that encourage breast-feeding, especially in lower-income communities where breast-feeding rates are low and where breast-feeding may help protect the infant from the effects of environmental chemical exposures. Education is also needed about reducing chemical body burdens. A body-burden monitoring program would provide valuable data on time trends, background levels, and community hot spots in need of mitigation and follow-up health studies; develop analytic methods for new chemicals of concern; and archive breast milk samples for future analyses of other agents.

Evaluating a culturally tailored peer-mentoring and education pilot intervention among Chinese breast cancer survivors using a mixed-methods approach.

PubMed

Lu, Qian; You, Jin; Man, Jenny; Loh, Alice; Young, Lucy

2014-11-01

To evaluate a social support intervention that was culturally tailored for Chinese Americans who face many challenges because of cultural and linguistic barriers. Intervention with a one-group pre- or post-test design, mixed methods, and a community-based participatory research (CBPR) approach. Southern California. 14 Chinese American breast cancer survivors post-treatment and eight breast cancer peer mentors. The intervention was a 10-week program to provide emotional and informational support through peer mentoring and education. Health outcomes were assessed before and after the intervention. Eight weekly process evaluations and two focus group interviews also were conducted. Depressive and anxiety symptoms. The program was associated with a decrease in depressive symptoms. Participants valued the program highly. Inductive analysis suggested possible mechanisms for effectiveness, such as reducing stigma, empowerment, and increased sense of belonging. The peer-mentoring and education program has the potential to serve as a model intervention for ethnic minorities. Mixed methods and CBPR are valuable in evaluating pilot interventions with minorities. Focusing on relationships may be fruitful for designing novel interventions for cancer survivors from collectivistic cultures. Peer-mentoring and education programs can be integrated into communities and clinics to improve care for underserved minority cancer survivors and to reduce health disparities.

A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs.

PubMed

Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

2013-06-01

African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.

Reducing Hispanic Teenage Pregnancy and Family Poverty: A Replication Guide. Final Version.

ERIC Educational Resources Information Center

Perez, Sonia M.; Duany, Luis A.

This guide was designed to help Hispanic American community-based organizations develop and establish a teenage pregnancy prevention or teenage parenting program for Hispanic American adolescents. The guide does not assume prior knowledge of the scope of the teenage pregnancy problem in the United States, but it does underscore the critical role…

National Dissemination of StrongWomen–Healthy Hearts: A Community-Based Program to Reduce Risk of Cardiovascular Disease Among Midlife and Older Women

PubMed Central

Seguin, Rebecca A.; Chui, Kenneth K. H.; Clark, Valerie; Corbin, Marilyn A.; Goldberg, Jeanne P.; Heidkamp-Young, Eleanor; Lichtenstein, Alice H.; Wiker, Nancy; Nelson, Miriam E.

2015-01-01

Objectives. We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation. Methods. In a 2010 to 2014 collaboration between the StrongWomen program and the National Extension Association of Family and Consumer Sciences, we assessed reach, adoption, implementation, and maintenance using survey methods, and we assessed effectiveness using a pretest–posttest within-participants design, with weight change as the primary outcome. Results. Overall reach into the population was 15 per 10 000. Of 85 trained leaders, 41 (48%) adopted the program. During the 12-week intervention, weight decreased by 0.5 kilograms, fruit and vegetable intake increased by 2.1 servings per day, and physical activity increased by 1238 metabolic equivalent (MET)-minutes per week (all P < .001). Average fidelity score was 4.7 (out of possible 5). Eleven of 41 adopting leaders (27%) maintained the program. Conclusions. The StrongWomen–Healthy Hearts program can be implemented with high fidelity in a variety of settings while remaining effective. These data provide direction for program modification to improve impact as dissemination continues. PMID:26469644

Characteristics of sports-based youth development programs.

PubMed

Perkins, Daniel F; Noam, Gil G

2007-01-01

The term "sports-based youth development programs" is coined and defined in the context of the community youth development framework. Sports-based youth development programs are out-of-school-time programs that use a particular sport to facilitate learning and life skill development in youth. Community youth development programs use a community youth development approach to create opportunities for youth to connect to others, develop skills, and use those skills to contribute to their communities. This, in turn, increases their ability to succeed. The authors describe how sports-based youth development programs can be contexts that promote positive youth development. The features of positive developmental settings for youth from the work of the National Research Council and the Institute of Medicine, as well as the features identified by other researchers, are presented in the context of sports-based youth development programs. For example, a sports program that provides appropriate structure has delineated clear rules, expectations, and responsibilities for youth, parents, coaches, officials, and other organizers.

Community-Based Summer Learning Programs for School- Age Children: Research-to-Policy Resources

ERIC Educational Resources Information Center

Stephens, Samuel A.

2016-01-01

Summer learning experiences for school-age children can be provided in a variety of ways and settings, including summer school programs (often remedial), community-based programs (often a continuation of afterschool programs), and home-based programs (in which families are provided with information and resources to encourage reading, often run by…

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

PubMed Central

Pool, Robert

2017-01-01

Background Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs). So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability. Methods and Findings This review includes peer-reviewed articles which meet three eligibility criteria: 1) specific focus on CLHWs or equivalent; 2) randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3) description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result of this lack of data we are unable to derive an evidence-based conclusion to our propositions. Instead, our results indicate a larger problem, namely the complete absence of indicators measuring community relationships with the programs studied. Studies pay attention only to gender and peer roles, along with limited demographic information about the recruits. The historicity of the health worker and the community s/he belongs to is absent in most studies reviewed. None of the studies discuss or test for the possibility that motivation emanates from the community. Only a few studies situate attrition and retention as an issue enabled by the community. The results were limited by a focus on low-income countries and English, peer-reviewed published articles only. Conclusion Published, peer-reviewed studies evaluating the effectiveness and sustainability of CLHW interventions in health programs have not yet adequately tested for the potential of utilizing existing community health roles or social networks for the development of effective and sustainable (retentive) CLHW programs. Community relationships are generally seen as a “black box” represented by an interchangeable CLHW labor unit. This disconnect from community relationships and resources may have led to a systematic and chronic undervaluing of community agency in explanations of programmatic effectiveness and sustainability. PMID:28095475

Patient-centered health care using pharmacist-delivered medication therapy management in rural Mississippi.

PubMed

Ross, Leigh Ann; Bloodworth, Lauren S

2012-01-01

To describe and provide preliminary clinical and economic outcomes from a pharmacist-delivered patient-centered health care (PCHC) model implemented in the Mississippi Delta. Mississippi between July 2008 and June 2010. 13 community pharmacies in nine Mississippi Delta counties. This PCHC model implements a comprehensive medication therapy management (MTM) program with pharmacist training, individualized patient encounters and group education, provider outreach, integration of pharmacists into health information technology, and on-site support in community pharmacies in a medically underserved region with a large burden of chronic disease and health disparities. The program also expands on traditional MTM services through initiatives in health literacy/cultural competency and efforts to increase the provider network and improve access to care. Criteria-based clinical outcomes, quality indicator reports, cost avoidance. PCHC services have been implemented in 13 pharmacies in nine counties in this underserved region, and 78 pharmacists and 177 students have completed the American Pharmacists Association's MTM Certificate Training Program. Preliminary data from 468 patients showed 681 encounters in which 1,471 drug therapy problems were identified and resolved. Preliminary data for clinical indicators and economic outcome measures are trending in a positive direction. Preliminary data analyses suggest that pharmacist-provided PCHC is beneficial and has the potential to be replicated in similar rural communities that are plagued with chronic disease and traditional primary care provider shortages. This effort aligns with national priorities to reduce medication errors, improve health outcomes, and reduce health care costs in underserved communities.

Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial.

PubMed

Messier, Stephen P; Callahan, Leigh F; Beavers, Daniel P; Queen, Kate; Mihalko, Shannon L; Miller, Gary D; Losina, Elena; Katz, Jeffrey N; Loeser, Richard F; Quandt, Sara A; DeVita, Paul; Hunter, David J; Lyles, Mary F; Newman, Jovita; Hackney, Betsy; Jordan, Joanne M

2017-02-22

Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m 2 ) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA. clinicaltrials.gov Identifier: NCT02577549 October 12, 2015.

A review of global progress toward the Millennium Development Goal 1 Hunger Target.

PubMed

Fanzo, Jessica C; Pronyk, Paul M

2011-06-01

The hunger component of the first Millennium Development Goal (MDG) aims to reduce the proportion of people who suffer from hunger by half between 1990 and 2015. In low- and middle-income countries, progress has been mixed, with approximately 925 million people hungry and 125 million and 195 million children underweight and stunted, respectively. To assess global progress on the hunger component of MDG1 and evaluate the success of interventions and country programs in reducing undernutrition. We review global progress on the hunger component of MDG1, examining experience from 40 community-based programs as well as national efforts to move interventions to scale drawn from the published and gray literature, alongside personal interviews with representatives of governments and development agencies. Based on this review, most strategies being implemented and scaled are focusing on treatment of malnutrition and rooted within the health sector. While critical, these programs generally address disease-related effects and emphasize the immediate determinants of undernutrition. Other major strategies to tackle undernutrition rely on the production of staple grains within the agriculture sector. These programs address hunger, as opposed to improving the quality of diets within communities. Strategies that adopt multisectoral programming as crucial to address longer-term determinants of undernutrition, such as poverty, gender equality, and functioning food and health systems, remain underdeveloped and under-researched. This review suggests that accelerating progress toward the MDG1 targets is less about the development of novel innovations and new technologies and more about putting what is already known into practice. Success will hinge on linking clear policies with effective delivery systems in working towards an evidence-based and contextually relevant multisectoral package of interventions that can rapidly be taken to scale.

Enhancing Diabetes Self-care Among Rural African Americans With Diabetes

PubMed Central

Williams, Ishan C.; Utz, Sharon W.; Hinton, Ivora; Yan, Guofen; Jones, Randy; Reid, Kathryn

2015-01-01

Purpose The purpose of this study is to test the feasibility of conducting a community-based randomized controlled trial evaluating a culturally tailored community-based group diabetes self-management education (DSME) program among rural African Americans. Methods Thirty-two African American rural adults with type 2 diabetes were recruited and 25 adults were retained and participated in an interventional study designed to test the effectiveness of the “Taking Care of Sugar” DSME program for the 2-year follow-up. Participants were selected from rural central Virginia. Primary outcomes variables included average blood sugar levels, cardiovascular risk factors, and general physical and mental health. These outcomes were assessed at baseline, 3 months, 6 months, and 12 months post baseline. Results From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Given the small sample size, hypothesis testing was limited. Results show change from baseline over time, illustrating that the primary outcome of A1C decreased, although not significant. Additionally, participants reported more knowledge about diabetes self-management and personal care skills (ie, exercise and foot care) that persisted over time. The feasibility of the culturally tailored DSME was established, and participation with the program was high. Conclusions A community-based group DSME program using storytelling is feasible. This research will help to inform clinicians and health policymakers as to the types of interventions that are feasible in a larger rural population. If such a program is carried out, we can improve knowledge, reduce complications, and improve quality of life among rural African Americans. PMID:24478047

Housing First and Photovoice: Transforming Lives, Communities, and Systems

PubMed Central

Barile, John P.; Ogawa, Terry Yasuko; Peralta, Nelson; Bugg, Reumell; Lau, John; Lamberton, Thomas; Hall, Corazon; Mori, Victor

2018-01-01

This article presents findings from a community-based participatory evaluation of a Housing First program on the Island of O’ahu. In this study, clients in a Housing First program used Photovoice to evaluate the program and to advocate for progressive housing policies. Written together by members of the Housing First Photovoice group, this collaborative article describes the outcomes from both the Housing First program and the Photovoice project and demonstrates the ways in which participatory program evaluations can interact with client-driven programs like Housing First to produce a cumulative, transformative impact. Findings suggest that community psychologists hoping to re-engage with community mental health systems through enacting transformative change should consider taking a community-based participatory approach to program evaluation because increased client voice in community mental health programs and their evaluations can have far-reaching, transformative impacts for research, practice, and policy. PMID:29323410

Children's Readiness Gains in Publically Funded, Community-Based Pre-Kindergarten Programs for 4 Year Olds and Preschool for 3 Year Olds

ERIC Educational Resources Information Center

Goldstein, Peggy; Warde, Beverly; Peluso, Paul

2013-01-01

Background: Many states provide public funding to facilitate school readiness for community-based pre-K and preschool programs for 4 year old children and "at risk" 3 year old children. Little research exists on the school readiness gains of children participating in these "garden variety" community-based programs. Objective:…

Teaching and Learning Technology and New Media in a Community-Based Program: Adult Educators and Older Learners' Experiences

ERIC Educational Resources Information Center

Hernandez, Regina

2016-01-01

This qualitative case study documented the experiences of two adult educators and four older learners' teaching and learning technology and new media in a community-based program in Texas. The research questions guiding this study included: (1) What can we learn from looking at the educational efforts of a community-based programs offering…

Reducing Youth Gun Violence. Part One--An Overview [and] Part Two--Prevention and Intervention Programs.

ERIC Educational Resources Information Center

McEvoy, Alan, Ed.

1996-01-01

This document contains two issues of a journal on reducing youth gun violence, reprinted from a report by the U.S. Department of Justice. The first issue, part one, provides an overview of programs and initiatives. The second issue, part two, describes prevention and intervention programs. To reduce violence and build healthy communities requires…

Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).

PubMed

Jones, Charlotte A; Nanji, Alykhan; Mawani, Shefina; Davachi, Shahnaz; Ross, Leanne; Vollman, Ardene; Aggarwal, Sandeep; King-Shier, Kathryn; Campbell, Norman

2013-02-21

South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population. South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures). Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing screening wait times and increasing numbers of project staff. SA-CHAMP demonstrated the feasibility and value of implementing a lay volunteer-led, culturally adapted, sustainable community-based CVD risk factor screening program in South Asian places of worship in Calgary, Alberta, Canada. Subsequent screening and CDM programs were refined based on the learnings from this study. Further research is needed to determine physician and patient factors associated with uptake of and adherence to risk reduction strategies.

Linking Air Quality and Human Health Effects Models: An Application to the Los Angeles Air Basin.

PubMed

Stewart, Devoun R; Saunders, Emily; Perea, Roberto A; Fitzgerald, Rosa; Campbell, David E; Stockwell, William R

2017-01-01

Proposed emission control strategies for reducing ozone and particulate matter are evaluated better when air quality and health effects models are used together. The Community Multiscale Air Quality (CMAQ) model is the US Environmental Protection Agency's model for determining public policy and forecasting air quality. CMAQ was used to forecast air quality changes due to several emission control strategies that could be implemented between 2008 and 2030 for the South Coast Air Basin that includes Los Angeles. The Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) was used to estimate health and economic impacts of the different emission control strategies based on CMAQ simulations. BenMAP-CE is a computer program based on epidemiologic studies that link human health and air quality. This modeling approach is better for determining optimum public policy than approaches that only examine concentration changes.

Adapting and implementing an evidence-based sun-safety education program in rural Idaho, 2012.

PubMed

Cariou, Charlene; Gonzales, Melanie; Krebill, Hope

2014-05-08

Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke's Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support.

Factors that predict financial sustainability of community coalitions: five years of findings from the PROSPER partnership project.

PubMed

Greenberg, Mark T; Feinberg, Mark E; Johnson, Lesley E; Perkins, Daniel F; Welsh, Janet A; Spoth, Richard L

2015-01-01

This study is a longitudinal investigation of the Promoting School-community-university Partnerships to Enhance Resilience (PROSPER) partnership model designed to evaluate the level of sustainability funding by community prevention teams, including which factors impact teams' generation of sustainable funding. Community teams were responsible for choosing, implementing with quality, and sustaining evidence-based programs (EBPs) intended to reduce substance misuse and promote positive youth and family development. Fourteen US rural communities and small towns were studied. Data were collected from PROSPER community team members (N = 164) and prevention coordinators (N = 10) over a 5-year period. Global and specific aspects of team functioning were assessed over six waves. Outcome measures were the total funds (cash and in-kind) raised to implement prevention programs. All 14 community teams were sustained for the first 5 years. However, there was substantial variability in the amount of funds raised, and these differences were predicted by earlier and concurrent team functioning and by team sustainability planning. Given the sufficient infrastructure and ongoing technical assistance provided by the PROSPER partnership model, local sustainability of EBPs is achievable.

A rural, community-based suicide awareness and intervention program.

PubMed

Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

2015-01-01

Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

PubMed

Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

2011-11-24

It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000890932.

Randomized Controlled Trial of Nuevo Amanecer: A Peer-delivered Stress Management Intervention for Spanish-speaking Latinas with Breast Cancer

PubMed Central

Nápoles, Anna María; Santoyo-Olsson, Jasmine; Ortiz, Carmen; Gregorich, Steven; Lee, Howard E.; Duron, Ysabel; Graves, Kristi; Luce, Judith A.; McGuire, Peggy; Díaz-Méndez, Marynieves; Stewart, Anita L.

2014-01-01

Background Latinas with breast cancer suffer symptom and psychosocial health disparities. Effective interventions have not been developed for or tested in this population. Purpose We describe community-based participatory research methods used to develop and implement the Nuevo Amanecer program, a culturally tailored, peer-delivered cognitive-behavioral stress management intervention for low-income Spanish-speaking Latinas with breast cancer, and unique considerations in implementing a randomized controlled trial to test the program in community settings. Methods We applied an implementation science framework to delineate the methodological phases used to develop and implement the Nuevo Amanecer program and trial, emphasizing community engagement processes. Results In phase 1, we established project infrastructure: academic and community Co-Principal Investigators, community partners, community advisory board, steering committee, and funding. In phase 2, we identified three program inputs: formative research, a community best practices model, and an evidence-based intervention tested in non-Latinas. In phase 3, we created the new program by integrating and adapting intervention components from the three sources, making adaptations to accommodate low-literacy, Spanish language, cultural factors, community context, and population needs. In phase 4, we built community capacity for the program and trial by training field staff (recruiters and interventionists embedded in community sites), compensating field staff, and creating a system for identifying potential participants. In phase 5, we implemented and monitored the program and trial. Engaging community partners in all phases has resulted in a new, culturally tailored program that is suitable for newly diagnosed Latinas with breast cancer and a trial that is acceptable and supported by community and clinical partners. Lessons Learned Engagement of community-based organizations and cancer survivors as research partners and hiring recruiters and interventionists from the community were critical to successful implementation in community settings. Having culturally and linguistically competent research staff with excellent interpersonal skills facilitated implementation. Facilitating and maintaining excellent communication among community partners was imperative to troubleshoot implementation issues. Randomization was challenging due to community concerns about assigning women to a control group. Patient privacy regulations and the need for extensive outreach to establish relationships between community partners and clinical sites hampered initial recruitment. Limitations These were resource-intensive processes to develop and implement the program that need to be compared to less intensive alternatives. Conclusions Engaging community members in design and implementation of community-based programs and trials enhances cultural appropriateness and congruence with the community context. If the randomized trial demonstrates that the intervention is effective, it will fill a gap in evidence-based programs to address ethnic disparities in quality of life among Spanish-speaking Latinas with breast cancer. PMID:24577971

Using multilevel, multisource needs assessment data for planning community interventions.

PubMed

Levy, Susan R; Anderson, Emily E; Issel, L Michele; Willis, Marilyn A; Dancy, Barbara L; Jacobson, Kristin M; Fleming, Shirley G; Copper, Elizabeth S; Berrios, Nerida M; Sciammarella, Esther; Ochoa, Mónica; Hebert-Beirne, Jennifer

2004-01-01

African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.

Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design.

PubMed

McDonald, Elizabeth; Cunningham, Teresa; Slavin, Nicola

2015-11-27

The No Germs on Me (NGoM) Social Marketing Campaign to promote handwashing with soap to reduce high rates of infection among children living in remote Australian Aboriginal communities has been ongoing since 2007. Recently three new television commercials were developed as an extension of the NGoM program. This paper reports on the mass media component of this program, trialling an evaluation design informed by the Theory of Planned Behaviour (TPB). A survey questionnaire taking an ecological approach and based on the principals and constructs of the TPB was developed. Surveys were completed in six discrete Aboriginal communities immediately before and on completion of four weeks intensive televising of the three new commercials. Across the six communities access in the home to a television that worked ranged from 49 to 83 % (n = 415). Seventy-seven per cent (n = 319) of participants reported having seen one or more of the new commercials. Levels of acceptability and comprehension of the content of the commercials was high (97 % n = 308). Seventy-five per cent (n = 651) of participants reported they would buy more soap, toilet paper and facial tissues if these were not so expensive in their communities. For TPB constructs demonstrated to have good internal reliability the findings were mixed and these need to be interpreted with caution due to limitations in the study design. Cultural, social-economic and physical barriers in remote communities make it challenging to promote adults and children wash their hands with soap and maintain clean faces such that these behaviours become habit. Low levels of access to a television in the home illustrate the extreme level of disadvantage experienced in these communities. Highlighting that social marketing programs have the potential to increase disadvantage if expensive items such as television sets are needed to gain access to information. This trial of a theory informed evaluation design allowed for new and rich information to be obtained about community members' beliefs, attitudes and intentions towards teaching and assisting children so safe hygiene behaviours become habit. Findings will support an evidence-based approach is taken to plan future NGoM program activities.

Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

PubMed

Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M

2013-09-01

Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

Using Promotores Programs to Improve Latino Health Outcomes: Implementation Challenges for Community-based Nonprofit Organizations

PubMed Central

Twombly, Eric C.; Holtz, Kristen D.; Stringer, Kimberly

2012-01-01

Promotores are community lay health workers, who provide outreach and services to Latinos. Little research on the promotores programs exists and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program telephone interviews were conducted with ten promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations are made which highlight promotores recruitment and retention strategies, and the development of a clearinghouse of programmatic implementation information for community-based nonprofits. PMID:23188929

Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

PubMed

Kingston, Beverly; Bacallao, Martica; Smokowski, Paul; Sullivan, Terri; Sutherland, Kevin

2016-04-01

This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

Exemplary Practice in Manitoba. Models of Quality in Literacy Programming.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg. Literacy and Continuing Education Branch.

This document profiles seven exemplary literacy programs in Manitoba, Canada: the Open Doors program in Winnipeg (a community-based program conducted in a school setting); the Brandon Friendship Centre literacy program (a community-based program conducted in a friendship center in rural Manitoba); the Flin Flon Friendship Centre literacy program…

Reconsidering community-based health promotion: promise, performance, and potential.

PubMed

Merzel, Cheryl; D'Afflitti, Joanna

2003-04-01

Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

PubMed Central

Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

2011-01-01

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

The Adoption of Wraparound Services among Substance Abuse Treatment Organizations Serving Criminal Offenders: The Role of a Women-Specific Program

PubMed Central

Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

2009-01-01

Women’s substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative’s National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n = 217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings. PMID:19181457

Community Participation in Tribal Diabetes Programs

ERIC Educational Resources Information Center

Smith-Morris, Carolyn

2006-01-01

In the past five years, there has been a surge in the attention shown to community and community-based health programs among Native Americans, particularly for chronic health problems such as diabetes. Community participation in health programming--from the efforts of community health workers (CHWs), to participatory research, to the impact of…

Impacting Home Health Care Services--A Community-Based Approach

ERIC Educational Resources Information Center

Andrews, Hans A.; And Others

1978-01-01

Describes a community-based alternative to institutionalization of the elderly. Calhoun County, Michigan's home health care services depend on community college resources and a growing model program training health care aides in a 150-clock-hour certificate program. Trained aides are readily absorbed into the community employment market. (TR)

The effect of medical mathematics retention strategies in decreasing attrition rate among African American licensed practical nursing students in a community college.

PubMed

Barra, Maryanne

2013-01-01

This education evidence based study examined African American students entering the Practical Nursing program and the strategies of medical mathematics bridge and tutoring programs to reduce attrition. To increase retention in the fundamentals of nursing courses, augmenting the program completion rate. DATA/OBSERVATIONS: Two groups of students (n = 105) participated for this one-year study over three semesters. Data revealed passing rates of 87%-92% for the nursing course and 75%-92% on medical mathematics when consistently attending programs. The attrition rate plummeting to 8% -34% contrasting previous years 43%-65%. Retention intervention programs can have a positive impact on minority students' academic performance.

Promising Parenting Programs for Reducing Adolescent Problem Behaviors

PubMed Central

Haggerty, Kevin P.; McGlynn-Wright, Anne; Klima, Tali

2013-01-01

Purpose Adolescent problem behaviors (substance use, delinquency, school dropout, pregnancy, and violence) are costly not only for individuals, but for entire communities. Policymakers and practitioners that are interested in preventing these problem behaviors are faced with many programming options. In this review, we discuss two criteria for selecting relevant parenting programs, and provide five examples of such programs. Design/methodology/approach The first criterion for program selection is theory based. Well-supported theories, such as the social development model, have laid out key family-based risk and protective factors for problem behavior. Programs that target these risk and protective factors are more likely to be effective. Second, programs should have demonstrated efficacy; these interventions have been called “evidence-based programs” (EBP). This review highlights the importance of evidence from rigorous research designs, such as randomized clinical trials, in order to establish program efficacy. Findings Nurse-Family Partnership, The Incredible Years, Positive Parenting Program, Strengthening Families 10–14, and Staying Connected with Your Teen are examined. The unique features of each program are briefly presented. Evidence showing impact on family risk and protective factors, as well as long-term problem behaviors, is reviewed. Finally, a measure of cost effectiveness of each program is provided. Originality/value We propose that not all programs are of equal value, and suggest two simple criteria for selecting a parenting program with a high likelihood for positive outcomes. Furthermore, although this review is not exhaustive, the five examples of EBPs offer a good start for policymakers and practitioners seeking to implement effective programs in their communities. Thus, this paper offers practical suggestions for those grappling with investments in child and adolescent programs on the ground. PMID:24416068

The “Translators”: Engaging Former Drug Users as Key Research Staff to Design and Implement a Risk Reduction Program for Rural Cocaine Users

PubMed Central

Stewart, Katharine E.; Wright, Patricia B.; Sims, Desi; Tyner, Kathy Russell; Montgomery, Brooke E. E.

2013-01-01

This manuscript describes lessons learned in the development and implementation of a clinical behavioral trial to reduce sexual risk among African-American cocaine users in rural Arkansas, from the perspectives of a multidisciplinary investigative team and community staff members with a history as local drug users who served as “translators.” Recommendations for investigators doing community-based research with active substance users are provided in the following domains: (a) engaging the community during formative research, (b) establishing bidirectional trust, (c) ensuring community voices are heard, and (d) managing conflict. The “translator’s” role is critical to the success of such projects. PMID:22428822

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study.

PubMed

Li, Fuzhong; Harmer, Peter

2014-05-26

Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers. The study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance. This study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults. ClinicalTrials.gov Identifier: NCT01854931.

Factors related to leader implementation of a nationally disseminated community-based exercise program: a cross-sectional study

PubMed Central

Seguin, Rebecca A; Palombo, Ruth; Economos, Christina D; Hyatt, Raymond; Kuder, Julia; Nelson, Miriam E

2008-01-01

Background The benefits of community-based health programs are widely recognized. However, research examining factors related to community leaders' characteristics and roles in implementation is limited. Methods The purpose of this cross-sectional study was to use a social ecological framework of variables to explore and describe the relationships between socioeconomic, personal/behavioral, programmatic, leadership, and community-level social and demographic characteristics as they relate to the implementation of an evidence-based strength training program by community leaders. Eight-hundred fifty-four trained program leaders in 43 states were invited to participate in either an online or mail survey. Corresponding community-level characteristics were also collected. Programmatic details were obtained from those who implemented. Four-hundred eighty-seven program leaders responded to the survey (response rate = 57%), 78% online and 22% by mail. Results Of the 487 respondents, 270 implemented the program (55%). One or more factors from each category – professional, socioeconomic, personal/behavioral, and leadership characteristics – were significantly different between implementers and non-implementers, determined by chi square or student's t-tests as appropriate. Implementers reported higher levels of strength training participation, current and lifetime physical activity, perceived support, and leadership competence (all p < 0.05). Logistic regression analysis revealed a positive association between implementation and fitness credentials/certification (p = 0.003), program-specific self-efficacy (p = 0.002), and support-focused leadership (p = 0.006), and a negative association between implementation and educational attainment (p = 0.002). Conclusion Among this sample of trained leaders, several factors within the professional, socioeconomic, personal/behavioral, and leadership categories were related to whether they implemented a community-based exercise program. It may benefit future community-based physical activity program disseminations to consider these factors when selecting and training leaders. PMID:19055821

Frontline over ivory tower: key competencies in community-based curricula.

PubMed

Millar, Adam; Malcolm, Janine; Cheng, Alice; Fine, Rebecca; Wong, Rene

2015-01-01

The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties. Presently there is wide variability in community endocrine experiences across Canadian training programs. This is complicated by the paucity of literature providing guidance on what constitutes a 'community' rotation. A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round. The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates. Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum. The experts considered the "Manager" role best taught in the community, while they considered the community least suitable to learn the "Medical Expert" competency. To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada. These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role. The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs.

Electronic Clinical Trial Protocol Distribution via the World-Wide Web

PubMed Central

Afrin, Lawrence B.; Kuppuswamy, Valarmathi; Slater, Barbara; Stuart, Robert K.

1997-01-01

Clinical trials today typically are inefficient, paper-based operations. Poor community physician awareness of available trials and difficult referral mechanisms also contribute to poor accrual. The Physicians Research Network (PRN) web was developed for more efficient trial protocol distribution and eligibility inquiries. The Medical University of South Carolina's Hollings Cancer Center trials program and two community oncology practices served as a testbed. In 581 man-hours over 18 months, 147 protocols were loaded into PRN. The trials program eliminated all protocol hardcopies except the masters, reduced photocopier use 59%, and saved 1.0 full-time equivalents (FTE), but 1.0 FTE was needed to manage PRN. There were no known security breaches, downtime, or content-related problems. Therefore, PRN is a paperless, user-preferred, reliable, secure method for distributing protocols and reducing distribution errors and delays because only a single copy of each protocol is maintained. Furthermore, PRN is being extended to serve other aspects of trial operations. PMID:8988471

Teens, Crime, and Rural Communities. How Youth in Rural America Can Help Reduce Violent and Property Crimes.

ERIC Educational Resources Information Center

Donovan, Erin; O'Neil, Jean F., Ed.

Featuring the Teens, Crime, and Community (TCC) program, this monograph focuses on youth crime and crime prevention in rural settings. TCC actively involves teens and adults in a partnership designed to reduce teen victimization and to encourage teens to be catalysts of change for community safety. The guide provides teachers, administrators, and…

Financing Residency Training Redesign.

PubMed

Carney, Patricia A; Waller, Elaine; Green, Larry A; Crane, Steven; Garvin, Roger D; Pugno, Perry A; Kozakowski, Stanley M; Douglass, Alan B; Jones, Samuel; Eiff, M Patrice

2014-12-01

Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known. Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P(4)) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign. A total of 6 university-based programs in the study collectively received $5,240,516 over the entire study period, compared with $4,718,943 received by 8 community-based programs. Most of the funding for both settings came from grants, which accounted for 57.8% and 86.9% of funding for each setting, respectively. Department revenue represented 3.4% of university-based support and 13.1% of community-based support. The total average revenue (all years combined) per program for university-based programs was just under $875,000, and the average was nearly $590,000 for community programs. The vast majority of funds were dedicated to salary support (64.8% in university settings versus 79.3% in community-based settings). Based on the estimated ratio of new funding relative to the annual costs of training using national data for a 3-year program with 7 residents per year, training redesign added 3% to budgets for university-based programs and about 2% to budgets for community-based programs. Residencies undergoing training redesign used a variety of approaches to fund these changes. The costs of innovations marginally increased the estimated costs of training. Federal and local funding sources were most common, and costs were primarily salary related. More research is needed on the costs of transforming residency training.

Parenting While Incarcerated: Tailoring the Strengthening Families Program for Use with Jailed Mothers.

PubMed

Miller, Alison L; Weston, Lauren E; Perryman, Jamie; Horwitz, Talia; Franzen, Susan; Cochran, Shirley

2014-09-01

Most incarcerated women are mothers. Parenting programs may benefit women, children and families, yet effectively intervening in correctional settings is a challenge. An evidence-based parenting intervention (the Strengthening Families Program) was tailored and implemented with women in a jail setting. Goals were to assess mothers' needs and interests regarding parenting while they were incarcerated, adapt the program to address those needs, and establish intervention delivery and evaluation methods in collaboration with a community-based agency. Women reported wanting to know more about effective communication; how children manage stress; finances; drug and alcohol use; self-care; and stress reduction. They reported high program satisfaction and reported reduced endorsement of corporal punishment after the intervention. Barriers to implementation included unpredictable attendance from session to session due to changing release dates, transfer to other facilities, and jail policies (e.g., lock-down; commissary hours). Implications for sustainable implementation of parenting programs in jail settings are discussed.

Childhood obesity in America.

PubMed

Van Grouw, Jacqueline M; Volpe, Stella L

2013-10-01

To provide an overview of the current advances in childhood obesity physiology, intervention, and prevention. Structural and functional brain impairments are present in obese adolescents with metabolic syndrome (MetS). Aerobic training for 20 or 40 min per day produced similar affects on metabolic risk factors. Vitamin D supplementation has been shown to improve the metabolic risk factors in obese children; however, obese children require greater doses to treat vitamin D deficiency. A 10-week community-based exergaming weight management program significantly decreased the BMI in obese children. There is surmounting research on MetS and its associated risk factors in obese children. Gaining a comprehensive overview of the factors associated with obesity in children is crucial in developing the most effective intervention strategies. Community-based and family-centered interventions have generated positive results in reducing children's BMI and improving MetS risk factors. In addition to obesity intervention efforts, ongoing prevention initiatives are imperative to reduce the prevalence of childhood obesity.

Continental Scientific Drilling Program Data Base

NASA Astrophysics Data System (ADS)

Pawloski, Gayle

The Continental Scientific Drilling Program (CSDP) data base at Lawrence Livermore National Laboratory is a central repository, cataloguing information from United States drill holes. Most holes have been drilled or proposed by various federal agencies. Some holes have been commercially funded. This data base is funded by the Office of Basic Energy Sciences of t he Department of Energy (OBES/DOE) to serve the entire scientific community. Through the unrestricted use of the database, it is possible to reduce drilling costs and maximize the scientific value of current and planned efforts of federal agencies and industry by offering the opportunity for add-on experiments and supplementing knowledge with additional information from existing drill holes.

Employee Retention: A Challenge of the Nineties.

ERIC Educational Resources Information Center

Zeiss, Tony

1990-01-01

Considers ways in which community colleges can help employers implement programs to improve the work environment and retain trained workers. Presents a model for employee retention that has worked effectively in Pueblo, Colorado. Describes Pueblo Community College's cooperative program with the Wats Marketing Group to help reduce employee…

76 FR 24537 - Paperwork Reduction Act; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

...: ONDCP directs the Drug Free Communities (DFC) Program in partnership with the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention. The DFC Program has two primary goals: To reduce youth substance abuse, and to support community anti-drug coalitions by establishing...

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

PubMed

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

2016-01-01

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

A community's response to suicide through public art: stakeholder perspectives from the Finding the Light Within project.

PubMed

Mohatt, Nathaniel V; Singer, Jonathan B; Evans, Arthur C; Matlin, Samantha L; Golden, Jane; Harris, Cathy; Burns, James; Siciliano, Catherine; Kiernan, Guy; Pelleritti, Margaret; Tebes, Jacob Kraemer

2013-09-01

Suicide is a preventable public health problem and a leading cause of death in the United States. Despite recognized need for community-based strategies for suicide prevention, most suicide prevention programs focus on individual-level change. This article presents seven first person accounts of Finding the Light Within, a community mobilization initiative to reduce the stigma associated with suicide through public arts participation that took place in Philadelphia, Pennsylvania from 2011 through 2012. The stigma associated with suicide is a major challenge to suicide prevention, erecting social barriers to effective prevention and treatment and enhancing risk factors for people struggling with suicidal ideation and recovery after losing a loved one to suicide. This project engaged a large and diverse audience and built a new community around suicide prevention through participatory public art, including community design and production of a large public mural about suicide, storytelling and art workshops, and a storytelling website. We present this project as a model for how arts participation can address suicide on multiple fronts-from raising awareness and reducing stigma, to promoting community recovery, to providing healing for people and communities in need.

Coalition building by drug user and sex worker community-based organizations in Vietnam can lead to improved interactions with government agencies: a qualitative study.

PubMed

Le, Leah T; Grau, Lauretta E; Nguyen, Huong H; Khuat, Oanh Hai T; Heimer, Robert

2015-10-16

Drug users and female sex workers are among the groups most vulnerable to HIV infection in Vietnam. To address the HIV epidemic within these communities, former drug users and sex workers established the first community-based organizations (CBOs) in 2009. The study provides a focused assessment of CBOs' expanding efforts to advocate for their members that identifies existing collaborations with Vietnamese government programs. This assessment explores the barriers to and facilitators of expansion in order to propose recommendations to improve the working relationship between CBOs and government programs. Thirty-two individuals from drug user and sex worker CBOs (n = 24) and relevant government programs (n = 8) participated in face-to-face interviews in Hanoi, Ho Chi Minh City, and Hai Phong. Coded interview transcripts were analyzed qualitatively concerning the purpose of CBOs, the interactions between CBOs and government programs, and the perceived barriers, facilitators, and feasibility of future CBO-government program collaborations. Services provided by the CBOs were considered to improve members' quality of life. The formation of coalitions among CBOs increased efficiency in meeting members' specific service needs, in addition to internal capacity building. Government field staff interacted with CBOs by providing CBOs with technical and legal support. CBOs and methadone maintenance treatment (MMT) clinics collaborated to help the clinics meet patient enrollment quotas and facilitate entry into treatment for CBO members. Barriers to CBO-government program collaboration included perceived conflicting missions on how to address drug use and sex work in the community, limited CBO-government program communication, CBO mistrust of the MMT system, and lack of legal status for CBOs. To reduce these barriers, we recommend (1) introduction of CBO consultative services at government healthcare centers, (2) enlistment of CBO outreach to ensure full access to the imminent scaled-up MMT program, and (3) establishment of standards by which CBOs can obtain legal status.

A Randomized Trial of a Multimodal Community-Based Prisoner Reentry Program Emphasizing Substance Abuse Treatment

ERIC Educational Resources Information Center

Grommon, Eric; Davidson, William S., II; Bynum, Timothy S.

2013-01-01

Prisoner reentry programs continue to be developed and implemented to ease the process of transition into the community and to curtail fiscal pressures. This study describes and provides relapse and recidivism outcome findings related to a randomized trial evaluating a multimodal, community-based reentry program that prioritized substance abuse…

Overcoming diabetes-related stigma in Iran: A participatory action research.

PubMed

Doosti-Irani, Mehri; Abdoli, Samereh; Parvizy, Soroor; Fatemi, Naimeh Seyed

2017-08-01

The study aimed to overcome diabetes-related stigma in individuals living with type 1 Diabetes Mellitus (T1DM) in Iran. The study proposed that if individuals with T1DM and the community work together to develop and implement an anti-stigma program, diabetes-related stigma in individuals with T1DM can be reduced. This study was conducted as a participatory action research study based on Kemmis and McTaggert's (2000) Model to design and implement an anti-stigma program for T1DM. Participants were selected among individuals with T1DM, their family members, health care providers, and residents without diabetes in Isfahan, Iran. Data collection was conducted using interviews, focus groups, emails, and text messages. Content analysis was used to analyze the data to develop anti-stigma interventions. Interventions were prioritized based on the Suitability, Feasibility and Flexibility (SFF) Matrix. Anti-stigma interventions were implemented in different levels in Isfahan, Iran, from 2011 to 2014. The effect of the program was evaluated based on interviews, feedback, and focus groups at the individual level. However, interventions were implemented in different levels including community, organization, family, and individual. Participants with T1DM experienced significant empowerment during the project to overcome diabetes-related stigma. The three main themes indicating this feeling of empowerment are "from doubt to trust", "from shadow to light", and "from me to us". Participatory action research can be an effective way to reduce diabetes-related stigma in individuals living with T1DM. It integrates the voices of the marginalized group reducing stigma and discrimination against diabetes. Copyright © 2017. Published by Elsevier Inc.

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model.

PubMed

Frye, Victoria; Paige, Mark Q; Gordon, Steven; Matthews, David; Musgrave, Geneva; Kornegay, Mark; Greene, Emily; Phelan, Jo C; Koblin, Beryl A; Taylor-Akutagawa, Vaughn

2017-08-01

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and "pop-up" street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team's experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related "space" as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming. Copyright © 2017. Published by Elsevier Ltd.

School Dropout Prevention: What Arts-Based Community and Out-of-School-Time Programs Can Contribute

ERIC Educational Resources Information Center

Charmaraman, Linda; Hall, Georgia

2011-01-01

Out-of-school-time programs, especially arts-based programs, can be critical players in a community's efforts to prevent school dropout. This research review suggests the following approaches for arts-based programs: (1) recruitment and retention of target populations with multiple risk factors; (2) long-term skill development that engages youth…

Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis

PubMed Central

Burnim, Michael; Ivy, Julianne A.

2017-01-01

Background The mainstay of current schistosomiasis control programs is mass preventive chemotherapy of school-aged children with praziquantel. This treatment is delivered through school-based, community-based, or combined school- and community-based systems. Attaining very high coverage rates for children is essential in mass schistosomiasis treatment programs, as is ensuring that there are no persistently untreated subpopulations, a potential challenge for school-based programs in areas with low school enrollment. This review sought to compare the different treatment delivery methods based both on their coverage of school-aged children overall and on their coverage specifically of non-enrolled children. In addition, qualitative community or programmatic factors associated with high or low coverage rates were identified, with suggestions for overall coverage improvement. Methodology/Principal findings This review was registered prospectively with PROSPERO (CRD 42015017656). Five hundred forty-nine publication of potential relevance were identified through database searches, reference lists, and personal communications. Eligible studies included those published before October 2015, written in English or French, containing quantitative or qualitative data about coverage rates for MDA of school-aged children with praziquantel. Among the 22 selected studies, combined community- and school-based programs achieved the highest median coverage rates (89%), followed by community-based programs (72%). School-based programs had both the lowest median coverage of children overall (49%) and the lowest coverage of the non-enrolled subpopulation of children. Qualitatively, major factors affecting program success included fear of side effects, inadequate education about schistosomiasis, lack of incentives for drug distributors, and inequitable distribution to minority groups. Conclusions/Significance This review provides an evidence-based framework for the development of future schistosomiasis control programs. Based on our results, a combined community and school-based delivery system should maximize coverage for both in- and out-of-school children, especially when combined with interventions such as snacks for treated children, educational campaigns, incentives for drug distributors, and active inclusion of marginalized groups. Trial registration ClinicalTrials.gov CRD42015017656 PMID:29077723

A capacity building approach to increase sports participation in disadvantaged urban communities: a multilevel analysis.

PubMed

Marlier, Mathieu; Cardon, Greet; De Bourdeaudhuij, Ilse; Willem, Annick

2014-12-01

Recent evidence showed that community capacity building is one of the key methods to reach health improvements within disadvantaged communities. Physical activity and sports participation are important means to reach health improvements. This study investigates a capacity building method which aims at increasing sports participation in the community, especially for individuals at higher risk of sports deprivation. The main aims of the present study, are the following: (1) to examine differences in sports participation between individuals living in communities implementing a sports-based capacity building program and individuals living in communities without such capacity building program and (2) to investigate if the community sports program reaches the individuals known to experience higher barriers to engage in sports. In Flanders, Belgium, five disadvantaged urban communities implementing the community capacity building program (program communities) and four without (control communities) were selected based on similarity of sociodemographic and environmental characteristics. Two hundred adults (aged 18-56 years) per community were randomly selected and visited at home to fill out a questionnaire on sociodemographics, sports participation, and the community sports program. A sample of 414 adults participated in the study. Results showed that adults from program communities reported on average 96 min/week more participation in sports than their counterparts living in control communities. Furthermore, 61.3% of the individuals of program communities indicated to engage in sports, whereas in control communities, this was only 42.4%. Respondents at higher risk of sports deprivation also engaged in significantly more sports participation in program communities than those in control communities. This difference was also noted for groups that are not related with sports deprivation. These results are promising and plead for a community capacity building approach to increase sports participation in disadvantaged communities.

Opportunities and capacity for community-based forest carbon sequestration and monitoring in Ghana

Treesearch

J. Schelhas; S. Samar; Cassandra Johnson; K. Asumadu; F. Tease; J. Stanturf; D. Blay

2010-01-01

International efforts to address global climate change will certainly include Africa’s forests, for example through efforts to reduce emissions from deforestation and forest degradation (REDD)(Sandker et al. 2010). Whether these efforts harm or provide new opportunities for rural people will depend on how programs are designed. In Ghana, as in many developing countries...

Promoting Physical Activity among Youth through Community-Based Prevention Marketing

ERIC Educational Resources Information Center

Bryant, Carol A.; Courtney, Anita H.; McDermott, Robert J.; Alfonso, Moya L.; Baldwin, Julie A.; Nickelson, Jen; Brown, Kelli R. McCormack; DeBate, Rita D.; Phillips, Leah M.; Thompson, Zachary; Zhu, Yiliang

2010-01-01

Background: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age)…

Current trends in community-based clinical teaching programs in U.K.and Ireland dental schools.

PubMed

Lynch, Christopher D; Ash, Peter J; Chadwick, Barbara L

2013-05-01

Community-based clinical teaching/outreach programs using a variety of approaches have been established in many predoctoral dental schools around the world. The aim of this article is to report current trends in the teaching of community-based clinical teaching/outreach teaching in dental schools in the United Kingdom and Ireland. In late 2010-early 2011, a questionnaire was distributed by e-mail to deans of the eighteen established dental schools in the United Kingdom and Ireland. The questionnaire included both open and closed questions relating to current and anticipated trends in community-based clinical teaching. Fourteen responses were received (response rate=78 percent). All fourteen responding schools reported inclusion of a community-based clinical teaching program. Ten schools indicated that their program was based on total patient (comprehensive) care including the treatment of child patients. In nine schools, the program is directed by a senior clinical academic in restorative dentistry. As well as student dentists, ten schools and seven schools include teaching of student dental therapists and student dental hygienists, respectively. There is a varied experience within the schools surveyed in terms of the extent, nature, and content of these programs. Overall, however, community-based clinical teaching was seen as part of the future of dental school education in many schools as an ideal way of preparing graduates for Dental Foundation Training and subsequent independent practice.

[Managing concerns about falls in older people: evaluation of the implementation of an evidence-based program].

PubMed

Zijlstra, G A R; Du Moulin, M F M T; van Haastregt, J C M; de Jonge, M; Kempen, G I J M; van der Poel, A

2013-12-01

A cognitive behavioral program reduced concerns about falling and related avoidance behavior among older community-dwelling adults in a randomized controlled trial. In the current study we examined the effects and acceptability of the program after nation-wide implementation into home care organizations in The Netherlands. In a one-group pretest-posttest study with data collection before the start of the program and at 2 and 4 months, the effects and acceptability of the program were assessed in 125 community-dwelling older people. The outcomes of the effect evaluation included concerns about falls, related avoidance behavior, falls, fall-related medical attention, feelings of anxiety, symptoms of depression, and loneliness. Pretest-posttest analyses with the Wilcoxon signed-rank test and the paired t-test showed significant improvements at 4 months for concerns about falls, activity avoidance, number of falls in the past 2 months, feelings of anxiety, and symptoms of depression. No significant differences were shown for the other outcomes. After implementation in home care organizations, the outcomes indicate positive program effects on concerns about falls, avoidance behavior, and falls in community-dwelling older people. Given the similarity in results, i.e. between those of the previously performed randomized controlled trial and those of the current pretest-posttest study, we conclude that the program can be successfully implemented in practice. This article is an adjusted, Dutch version of Zijlstra GA, van Haastregt JC, Du Moulin MF, de Jonge MC, van der Poel A, Kempen GI. Effects of the implementation of an evidenc-based program to manage concerns about falls in older adults. The Gerontologist 2013;53(5):839-849; doi: 10.1093/geront/gns142.

Community Health Workers as Drivers of a Successful Community-Based Disease Management Initiative

PubMed Central

Peretz, Patricia J.; Matiz, Luz Adriana; Findley, Sally; Lizardo, Maria; Evans, David; McCord, Mary

2012-01-01

In 2005, local leaders in New York City developed the Washington Heights/Inwood Network for Asthma Program to address the burden of asthma in their community. Bilingual community health workers based in community organizations and the local hospital provided culturally appropriate education and support to families who needed help managing asthma. Families participating in the yearlong care coordination program received comprehensive asthma education, home environmental assessments, trigger reduction strategies, and clinical and social referrals. Since 2006, 472 families have enrolled in the yearlong program. After 12 months, hospitalizations and emergency department visits decreased by more than 50%, and caregiver confidence in controlling the child's asthma increased to nearly 100%. Key to the program's success was the commitment and involvement of community partners from program inception to date. PMID:22515859

Community health workers as drivers of a successful community-based disease management initiative.

PubMed

Peretz, Patricia J; Matiz, Luz Adriana; Findley, Sally; Lizardo, Maria; Evans, David; McCord, Mary

2012-08-01

In 2005, local leaders in New York City developed the Washington Heights/Inwood Network for Asthma Program to address the burden of asthma in their community. Bilingual community health workers based in community organizations and the local hospital provided culturally appropriate education and support to families who needed help managing asthma. Families participating in the yearlong care coordination program received comprehensive asthma education, home environmental assessments, trigger reduction strategies, and clinical and social referrals. Since 2006, 472 families have enrolled in the yearlong program. After 12 months, hospitalizations and emergency department visits decreased by more than 50%, and caregiver confidence in controlling the child's asthma increased to nearly 100%. Key to the program's success was the commitment and involvement of community partners from program inception to date.

Soil microbial community restoration in conservation reserve program semi-arid grasslands

USDA-ARS?s Scientific Manuscript database

The Conservation Reserve Program (CRP) in the Southern High Plains (SHP) is known to play a crucial role in maintaining ecosystem health by reducing soil erosion. However, the restoration of its soil biological health (biological community and its function) over time have not been clearly elucidated...

Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013-2014.

PubMed

Jones, Dina L; Starcher, Rachael W; Eicher, Jennifer L; Wilcox, Sara

2016-07-14

Translating evidence-based, community-delivered, fall-prevention exercise programs into new settings is a public health priority. Older adults (aged ≥65 y) are at high risk for falls. We conducted a community engagement project in West Virginia to evaluate the adoption of a tai chi exercise program, Tai Ji Quan: Moving for Better Balance, by rural faith-based organizations (FBOs) and exercise instructors by recruiting 20 FBOs and 20 or more exercise instructors and by obtaining input from key stakeholders (representatives of FBOs, community representatives, exercise instructors) regarding potential barriers and facilitators to program adoption. We used both multistage, purposeful random sampling and snowball sampling to recruit FBOs and exercise instructors in 7 West Virginia counties. Two forums were held with stakeholders to identify barriers and facilitators to program adoption. We calculated separate adoption rates for organizations and exercise instructors. It took up to 3 months to recruit each FBO with an adoption rate of 94%. We made 289 telephone calls, sent 193 emails and 215 letters, distributed brochures and flyers to 69 FBOs, held 118 meetings, and made 20 trips over a period of 31 days (8,933 miles traveled). Nineteen of 22 trained exercise instructors started classes, an instructor adoption rate of 86%. Key issues regarding adoption were the age requirement for participants, trust, education, and competing priorities. Although we had recruitment challenges, our adoption rates were similar to or higher than those reported in other studies, and the objectives of the community engagement project were met. Clustering the FBOs and having them located closer geographically to our location may have reduced our resource use, and using a recruitment coordinator from the local community may have enabled us to gain the trust of congregants and clergy support.

Evidence-based HIV/STD prevention intervention for black men who have sex with men.

PubMed

Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

2014-04-18

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Building a community-based culture of evaluation.

PubMed

Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

2017-12-01

In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived Impact of a Land and Property Rights Program on Violence Against Women in Rural Kenya: A Qualitative Investigation

PubMed Central

Hilliard, Starr; Bukusi, Elizabeth; Grabe, Shelly; Lu, Tiffany; Hatcher, Abigail M.; Kwena, Zachary; Mwaura-Muiru, Esther; Dworkin, Shari L.

2017-01-01

The current study focuses on a community-led land and property rights program in two rural provinces in western Kenya. The program was designed to respond to women’s property rights violations to reduce violence against women and HIV risks at the community level. Through in-depth interviews with 30 women, we examine the perceived impact that this community-level property rights program had on violence against women at the individual and community level. We also examine perceptions as to how reductions in violence were achieved. Finally, we consider how our findings may aid researchers in the design of structural violence-prevention strategies. PMID:26951306

Perceived Impact of a Land and Property Rights Program on Violence Against Women in Rural Kenya: A Qualitative Investigation.

PubMed

Hilliard, Starr; Bukusi, Elizabeth; Grabe, Shelly; Lu, Tiffany; Hatcher, Abigail M; Kwena, Zachary; Mwaura-Muiru, Esther; Dworkin, Shari L

2016-03-06

The current study focuses on a community-led land and property rights program in two rural provinces in western Kenya. The program was designed to respond to women's property rights violations to reduce violence against women and HIV risks at the community level. Through in-depth interviews with 30 women, we examine the perceived impact that this community-level property rights program had on violence against women at the individual and community level. We also examine perceptions as to how reductions in violence were achieved. Finally, we consider how our findings may aid researchers in the design of structural violence-prevention strategies. © The Author(s) 2016.

Building Rural Communities through School-Based Agriculture Programs

ERIC Educational Resources Information Center

Martin, Michael J.; Henry, Anna

2012-01-01

The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…

Adult Literacy: A Study of Community Based Literacy Programs. Revised and Updated. Volume II: Program Profiles.

ERIC Educational Resources Information Center

Association for Community Based Education, Washington, DC.

This volume accompanies a study of community-based approaches to literacy education for adults. It provides profiles of 26 community-based educational institutions that provided study data. Each profile provides name, address, and telephone number; contact; other project sites; institutional description; mission/purpose; approach; skills…

Community health navigators for breast- and cervical-cancer screening among Cambodian and Laotian women: intervention strategies and relationship-building processes.

PubMed

Ngoc Nguyen, Tu-Uyen; Tanjasiri, Sora Park; Kagawa-Singer, Marjorie; Tran, Jacqueline H; Foo, Mary Anne

2008-10-01

In recent years, there has been a growing number of programs employing health navigators to assist underserved individuals in overcoming barriers to obtaining regular and quality health care. This article describes the perspectives and experiences of community-based health navigators in the Cambodian and Laotian communities involved in a REACH 2010 project to reduce health disparities in breast and cervical cancer among Pacific Islander and Southeast Asian communities in California. These community health navigators, who have extensive training and knowledge about the cultural, historical, and structural needs and resources of their communities, are well equipped to build trusting relationships with community members traditionally ignored by the mainstream medical system. By comparing the different social support roles and intervention strategies employed by community health navigators in diverse communities, we can better understand how these valuable change agents of the health workforce are effective in improving health access and healthy behaviors for underserved communities.

Community interventions for cardiovascular disease.

PubMed

Parker, Donna R; Assaf, Annlouise R

2005-12-01

Review of the community-based CVD intervention programs suggests that a number of components have been successful using varying methods and materials for CVD risk reduction. It should be noted, however, that in multi-intervention programs it is often difficult to determine which components of the intervention were responsible for the overall success of the study. The community-based approach to CVD prevention is generalizable, cost-effective (because of the use of mass communication methods), and has the potential for modifying the environment and influencing health policies. Based on the experiences and successes of a number of community projects, recommendations have been proposed for developing future programs. Although they are not totally comprehensive, it has been suggested that a community-based intervention program should consider the following recommendations: 1) An understanding of the community: the needs and priorities of the community should be assessed, and close collaboration with individuals from the community, including community leaders, opinion leaders, community health care providers, and community organizations from various sectors of the community, should be consulted. Efforts should be focused on underserved and vulnerable populations. 2) Inclusion of community activities: these activities should be integrated within the context of the community environment, including primary health care services, voluntary organizations, grocery stores, restaurants, work sites, schools, and local media. 3) Inclusion mass media messages: the mass media can provide information and reinforcement of the behavior change. 4) Develop cost-effective interventions to assure that the community is exposed to an effective dose of the intervention. 5) Work with community organizations to help change social and physical environments to make them more conducive to health and healthy life-styles changes. 6) Develop a reliable monitoring and evaluation system: monitor the change process and conduct summary evaluations. 7) Disseminate the results to ensure that the benefits from the community program reach all communities. 8) For national implementation, the intervention program should work closely with national policy makers throughout the project.

Tools to Reduce Waste in Schools

ERIC Educational Resources Information Center

US Environmental Protection Agency, 2007

2007-01-01

This guide was produced to help schools and school districts reduce the amount of waste they generate It shows how to start a waste reduction program or expand an existing one. The booklet shows how such programs can benefit schools, communities, and the environment by reducing, reusing, and recycling waste. Each section--schools, school…

Reducing alcohol-impaired driving crashes through the use of social marketing.

PubMed

Rothschild, Michael L; Mastin, Beth; Miller, Thomas W

2006-11-01

Over the past decade there has been little decrease in the number of alcohol-related driving fatalities. During this time most interventions have been educational or legal. This paper presents the results of a field experiment that used social marketing to introduce a new ride program into three rural communities. Almost all people in the 21-34-year-old target know that they should not drive while impaired, and most agree it is not a good thing to do, but for many the opportunity to behave properly does not exist. The Road Crew program was developed using new product development techniques and implemented by developing broad coalitions within the communities. A key feature of the program included rides to, between, and home from bars in older luxury vehicles. Results showed a significant shift in riding/driving behavior, especially among 21-34-year olds, a projected 17% decline in alcohol-related crashes in the first year, no increase in drinking behavior, and large savings between the reactive cost of cleaning up after a crash and the proactive cost of avoiding a crash. Programs have become self-sustaining based on fares and tavern contributions, and have become part of the life style in the treatment communities.

PHOTOVOICE: Reducing pedestrian injuries in children.

PubMed

Van Oss, Tracy; Quinn, Danielle; Viscosi, Pauline; Bretscher, Kristen

2013-01-01

Pedestrian injury is the second leading cause of injury related death for children. The purpose of this research project was to determine the effectiveness of pedestrian and road traffic safety education with children, as part of the Walk This Way program through Safe Kids USA. Through the implementation of PHOTOVOICE, a project that captured children's narratives coinciding with a photograph, children engaged in community exploration to identify pedestrian hazards in their communities and explore possible solutions utilizing their photography and narrations. Children participated in an engaging educational session, a community fieldtrip, and reflection. Results concluded that, despite a small increase in post test scores, an increase in awareness of hazards in the community and successful identification of community hazards was achieved. The goal of this research project was determine the effectiveness of a hands-on pedestrian and road traffic safety educational program with children. The results of this research project will be integrated with similar projects completed across the country through the program Walk This Way with Safe Kids USA. Both this research project and the Walk This Way program aim to promote behavior change in children and create safer communities to reduce pedestrian related injury. The overall goal of this research project andthe Walk This Way program is to increase education on a national level in regards to pedestrian safety for children and provide a basis for lobbying for public policy changes pertaining to road and pedestrian safety.

Client-centered counseling improves client satisfaction with family planning visits: evidence from Irbid, Jordan

PubMed Central

Kamhawi, Sarah; Underwood, Carol; Murad, Huda; Jabre, Bushra

2013-01-01

ABSTRACT Background: High levels of unmet need for family planning and high contraceptive discontinuation rates persist in Jordan, prompting the Jordan Health Communication Partnership (JHCP) to initiate a client-centered family planning service program called “Consult and Choose” (CC), together with community-based activities to encourage women with unmet need to visit health centers. Methods: We held exit interviews with 461 family planning clients between November–December 2011 to assess, from the clients' perspective, whether trained providers followed the CC protocol and used the CC tools, as well as to measure client satisfaction. We also tracked referral card information from community-based activities to health centers and examined service statistics to explore trends in family planning use. Results: On average, clients reported that providers performed 5.6 of the 7 steps outlined in the CC protocol. Nearly 83% of respondents were very satisfied with their clinic visits. Logistic regression analysis found that the odds of being “very satisfied” increases by 20% with each additional counseling protocol step performed and by 70% with each increase in the number of CC materials used. Between June 2011 and August 2012, 14,490 referral cards from community-based activities were collected in health centers, 59% of which were for family planning services. Service statistic trends indicate an increase in the number of new family planning users and in couple-years of protection after starting the CC program. Conclusions: Implementation of the CC program at health centers nationally, in tandem with community-based interventions, could play a key role in attaining Jordan's goal of reducing its total fertility rate to 2.1 by 2030. Although this initiative would likely be replicated most readily in other middle-income countries, lower-resource countries could also adapt the tested CC approach. PMID:25276531

Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

PubMed

Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

2016-08-01

Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

A school-based, teacher-mediated prevention program (ERASE-Stress) for reducing terror-related traumatic reactions in Israeli youth: a quasi-randomized controlled trial.

PubMed

Gelkopf, Marc; Berger, Rony

2009-08-01

Since September 2000 Israeli children have been exposed to a large number of terrorist attacks. A universal, school-based intervention for dealing with the threat of terrorism as well as with terror-related symptoms, ERASE-Stress (ES), was evaluated in a male religious middle school in southern Israel. The program was administered by the homeroom teachers as part of the school curriculum. It consists of 12 classroom sessions each lasting 90 minutes, and included psycho-educational material, skill training and resiliency strategies delivered to the students by homeroom teachers. One hundred and fourteen 7th and 8th grade students were randomly assigned to the ES intervention or were part of a waiting list (WL). They were assessed on measures of posttraumatic symptomatology, depression, somatic symptoms and functional problems before and 3 months after the intervention or the WL period. Three months after the program ended, students in the experimental group showed significant reduction in all measures compared to the waiting-list control group. The ERASE-Stress program may help students suffering from terror-related posttraumatic symptoms and mitigate the negative effects of future traumatic experiences. Furthermore, a school-based universal program such as the ERASE-Stress may potentially serve as an important and effective component of a community mental health policy for communities affected by terrorism.

Intimate partner violence prevention program in an Asian immigrant community: integrating theories, data, and community.

PubMed

Yoshihama, Mieko; Ramakrishnan, Aparna; Hammock, Amy C; Khaliq, Mahmooda

2012-07-01

To fill an existing gap in research and practice on intimate partner violence (IPV) in immigrant communities, the authors developed an IPV prevention program, called the Shanti Project, in an Asian Indian community in the Midwest. Building on the notion of shanti (harmony/peace), a cherished value and strength of the community, we created a communications campaign that combined social marketing and community-based participatory approaches. Recognizing the interactive influences of multiple levels of social ecology, campaign activities were designed to bring about changes at the individual, relationship/family, organization, and community levels. This article presents the development of this theoretically, empirically, and community-based IPV prevention program.

Community-based participatory process--climate change and health adaptation program for Northern First Nations and Inuit in Canada.

PubMed

McClymont Peace, Diane; Myers, Erin

2012-05-08

Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies.

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

PubMed

VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Factor Analysis of the HEW National Strategy for Youth Development Model's Community Program Impact Scales.

ERIC Educational Resources Information Center

Truckenmiller, James L.

The former HEW (Health, Education, and Welfare) National Strategy for Youth Development Model proposed a community-based program to promote positive youth development and to prevent delinquency through a sequence of youth needs assessments, needs-targeted programs, and program impact evaluation. HEW Community Program Impact Scales data obtained…

Reducing Motor Vehicle-Related Injuries at an Arizona Indian Reservation: Ten Years of Application of Evidence-Based Strategies

PubMed Central

Piontkowski, Stephen R; Peabody, Jon S; Reede, Christine; Velascosoltero, José; Tsatoke, Gordon; Shelhamer, Timothy; Hicks, Kenny R

2015-01-01

Unintentional injury is a significant public health burden for American Indians and Alaska Natives and was the leading cause of death among those aged 1 to 44 years between 1999 and 2004. Of those deaths, motor vehicle-related deaths cause the most mortality, justifying the need for intervention at an American Indian Reservation in Arizona (United States). We describe motor vehicle injury prevention program operations from 2004 through 2013. This community-based approach led by a multidisciplinary team primarily comprised of environmental public health and law enforcement personnel implemented evidence-based strategies to reduce the impact of motor vehicle-related injuries and deaths, focusing on reducing impaired driving and increasing occupant restraint use. Strategies included: mass media campaigns to enhance awareness and outreach; high-visibility sobriety checkpoints; passing and enforcing 0.08% blood alcohol concentration limits for drivers and primary occupant restraint laws; and child car seat distribution and education. Routine monitoring and evaluation data showed a significant 5% to 7% annual reduction of motor vehicle crashes (MVCs), nighttime MVCs, MVCs with injuries/fatalities, and nighttime MVCs with injuries/fatalities between 2004 and 2013, but the annual percent change in arrests for driving under the influence (DUI) was not significant. There was also a 144% increase in driver/front seat passenger seat belt use, from 19% in 2011 before the primary occupant restraint law was enacted to 47% during the first full year of enforcement (2013). Car seat checkpoint data also suggested a 160% increase in car seat use, from less than 20% to 52% in 2013. Implementation of evidence-based strategies in injury prevention, along with employment of key program approaches such as strong partnership building, community engagement, and consistent staffing and funding, can narrow the public health disparity gap experienced among American Indian and Alaska Native communities. PMID:26681708

Challenges With Research Contract Negotiations in Community-Based Cancer Research.

PubMed

Thompson, Michael A; Hurley, Patricia A; Faller, Bryan; Longinette, Jean; Richter, Katie; Stewart, Teresa L; Robert, Nicholas

2016-06-01

Community-based research programs face many barriers to participation in clinical trials. Although the majority of people with cancer are diagnosed and treated in the community setting, only roughly 3% are enrolled onto clinical trials. Research contract and budget negotiations have been consistently identified as time consuming and a barrier to participation in clinical trials. ASCO's Community Research Forum conducted a survey about specific challenges of research contract and budget negotiation processes in community-based research settings. The goal was to ultimately identify potential solutions to these barriers. A survey was distributed to 780 community-based physician investigators and research staff. The survey included questions to provide insight into contract and budget negotiation processes and perceptions about related barriers. A total of 77% of the 150 respondents acknowledged barriers in the process. Respondents most frequently identified budget-related issues (n = 133), inefficiencies in the process (n = 80), or legal review and negotiation issues (n = 70). Of the respondents, 44.1% indicated that contract research organizations made the contract negotiations process harder for their research program, and only 5% believed contract research organizations made the process easier. The contract negotiations process is perceived to be impeded by sponsors through underestimation of costs, lack of flexibility with the contract language, and excessive delays. Improving clinical trial activation processes and reducing inefficiencies would be beneficial to all interested stakeholders, including patients who may ultimately stand to benefit from participation in clinical trials. The following key recommendations were made: standardization of contracts and negotiation processes to promulgate transparency and efficiencies, improve sponsor processes to minimize burden on sites, create and promote use of contract templates and best practices, and provide education and consultation. Copyright © 2016 by American Society of Clinical Oncology.

Guidelines for Programs To Reduce Child Victimization: A Resource for Communities When Choosing a Program To Teach Personal Safety to Children.

ERIC Educational Resources Information Center

Hawkins, Mary

The National Center for Missing and Exploited Children (NCMEC) compiled this guide for schools, community groups, and individuals who are choosing programs that teach personal safety to children. A task force of eight other organizations contributed to the guide. The guide defines child victimization as sexual abuse and assault, abduction,…

Integrating children with psychiatric disorders in the classroom: a systematic review.

PubMed

Cossu, Giulia; Cantone, Elisa; Pintus, Mirra; Cadoni, Michela; Pisano, Anna; Otten, Roy; Kuijpers, Rowella; Pintus, Elisa; Sancassiani, Federica; Moro, Maria Francesca; Holzinger, Anita; Mereu, Alessandra; Preti, Antonio; Carta, Mauro Giovanni

2015-01-01

The school setting may be the optimal context for early screening of and intervention on child mental health problems, because of its large reach and intertwinement with various participants (child, teacher, parent, other community services). But this setting also exposes children to the risk of stigma, peer rejection and social exclusion. This systematic literature review investigates the efficacy of mental health interventions addressed to children and adolescents in school settings, and it evaluates which programs explicitly take into account social inclusion indicators. Only randomized controlled trials conducted on clinical populations of students and carried out in school settings were selected: 27 studies overall. Most studies applied group Cognitive Behavioural Therapy or Interpersonal Psychotherapy. Findings were suggestive of the effectiveness of school-based intervention programs in reducing symptoms of most mental disorders. Some evidence was found about the idea that effective studies on clinical populations may promote the social inclusion of children with an ongoing mental disorder and avoid the risk of being highly stigmatized. School programs are still needed that implement standardized models with verifiable and evidence-based practices involving the whole school community.

Alternatives for Revitalizing Student Services Programs.

ERIC Educational Resources Information Center

Deegan, William L.

1984-01-01

Reviews alternatives for revitalizing the programs and management of community college student services. As program development models, considers Miami-Dade Community College's computer-based instructional management system; entrepreneurial fee-based services; and divestment of situational or special-interest services to student groups. In…

Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation.

PubMed

McNamara, Renae J; McKeough, Zoe J; Mo, Laura R; Dallimore, Jamie T; Dennis, Sarah M

2016-01-01

Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers. The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists.

Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program

ERIC Educational Resources Information Center

Gil, Elizabeth

2017-01-01

The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

Community-Based Urban Teacher Education: Theoretical Frameworks and Practical Considerations for Developing Promising Practices

ERIC Educational Resources Information Center

Noel, Jana

2016-01-01

Traditional campus-based teacher education programs, located on college or university campuses, have been criticized for being removed from the "real world" of community life, and a number of programs have moved directly into urban communities in order for preservice teachers to become immersed in the life of the community. This article…

Cervical Cancer Control for Hispanic Women in Texas: Effective Strategies from Research and Practice

PubMed Central

Fernandez, Maria E.; Savas, Lara S.; Lipizzi, Erica; Smith, Jennifer S.; Vernon, Sally W.

2014-01-01

Purpose Hispanic women in Texas have among the highest rates of cervical cancer incidence and mortality in the country. Increasing regular Papanicolaou test screening and HPV vaccination are crucial to reduce the burden of cervical cancer among Hispanics. This paper presents lessons learned from community-based cervical cancer control programs in Texas and highlights effective intervention programs, methods and strategies. Methods We reviewed and summarized cervical cancer control efforts targeting Hispanic women in Texas, focusing on interventions developed by researchers at the University of Texas, School of Public Health. We identified commonalities across programs, highlighted effective methods, and summarized lessons learned to help guide future intervention efforts. Results Community-academic partnerships were fundamental in all steps of program development and implementation. Programs reviewed addressed psychosocial, cultural, and access barriers to cervical cancer control among low-income Hispanic women. Intervention approaches included lay health worker (LHW) and navigation models and used print media, interactive tailored media, photonovellas, client reminders, one-on-one and group education sessions. Conclusions Small media materials combined with LHW and navigation approaches were effective in delivering Pap test screening and HPV vaccination messages and in linking women to services. Common theoretical methods included in these approaches were modeling, verbal persuasion, and facilitating access. Adaptation of programs to an urban environment revealed that intensive navigation was needed to link women with multiple access barriers to health services. Collectively, this review reveals 1) the importance of using a systematic approach for planning and adapting cervical cancer control programs; 2) advantages of collaborative academic-community partnerships to develop feasible interventions with broad reach; 3) the use of small media and LHW approaches and the need for tailored phone navigation in urban settings; and 4) coordination and technical assistance of community-based efforts as a way to maximize resources. PMID:24398135

Inner-city asthma: the role of the community.

PubMed

Persky, Victoria; Turyk, Mary; Piorkowski, Julie; Coover, Lenore; Knight, John; Wagner, Cynthia; Hernandez, Eva; Eldeirawi, Kamal; Fitzpatrick, Anne

2007-11-01

Asthma morbidity and mortality are disproportionately high in low-income minority populations. Variations in environmental exposures, stress, and access to appropriate health care all contribute to these disparities. The complex nature of asthma with strong contributions from environmental, psychosocial, and biological factors suggest that community-based approaches focused on the unique needs of high-risk populations may be effective. The few previous randomized trials suggest that case management with professionals and/or community health educators may reduce asthma morbidity. Health-educator programs should be lodged in stable infrastructures with training and funding for community health workers to obtain long-term sustainability. Factors not amenable to individual intervention, however, such as poor condition of homes, outdoor pollution, and lack of access to appropriate care, will require collaborative efforts of community groups, academic professionals, public agencies, and health-care providers.

A methodology for evaluating organizational change in community-based chronic disease interventions.

PubMed

Hanni, Krista D; Mendoza, Elsa; Snider, John; Winkleby, Marilyn A

2007-10-01

In 2003, the Monterey County Health Department, serving Salinas, California, was awarded one of 12 grants from the Steps to a HealthierUS Program to implement a 5-year, multiple-intervention community approach to reduce diabetes, asthma, and obesity. National adult and youth surveys to assess long-term outcomes are required by all Steps sites; however, site-specific surveys to assess intermediate outcomes are not required. Salinas is a medically underserved community of primarily Mexican American residents with high obesity rates and other poor health outcomes. The health department's Steps program has partnered with traditional organizations such as schools, senior centers, clinics, and faith-based organizations as well as novel organizations such as employers of agricultural workers and owners of taquerias. The health department and the Stanford Prevention Research Center developed new site-specific, community-focused partner surveys to assess intermediate outcomes to augment the nationally mandated surveys. These site-specific surveys will evaluate changes in organizational practices, policies, or both following the socioecological model, specifically the Spectrum of Prevention. Our site-specific partner surveys helped to 1) identify promising new partners, select initial partners from neighborhoods with the greatest financial need, and identify potentially successful community approaches; and 2) provide data for evaluating intermediate outcomes matched to national long-term outcomes so that policy and organizational level changes could be assessed. These quantitative surveys also provide important context-specific qualitative data, identifying opportunities for strengthening community partnerships. Developing site-specific partner surveys in multisite intervention studies can provide important data to guide local program efforts and assess progress toward intermediate outcomes matched to long-term outcomes from nationally mandated surveys.

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

PubMed

Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

Accounting for institutional change in health economic evaluation: a program to tackle HIV/AIDS and gender violence in Southern Africa.

PubMed

Jan, Stephen; Pronyk, Paul; Kim, Julia

2008-02-01

There has been growing interest in the application of institutionalist perspectives in the health economics literature. This paper investigates the institutionalist notion of social value and its use in economic evaluation with particular reference to a program to address HIV/AIDS and gender violence in Southern Africa (IMAGE). Institutions are the rules that govern the conduct between individuals, groups and organisations. Their social value stems from their capacity to reduce the uncertainty in human interactions thereby both reducing transaction costs and, importantly, enabling the initiation and sustainability of various activities (instrumental value). Furthermore, institutions tend to be formed around certain ethical positions and as a consequence, act in binding future decision making to these positions (intrinsic value). Incorporating such notions of social value within a conventional welfare-based measure of benefit is problematic as institutional development is not necessarily consistent with individual utility. An institutionalist approach allows for these additional domains to be factored into economic evaluation. IMAGE is an intervention to reduce gender violence and HIV through microfinance, health education and community development, and involves significant initial investment in institution-building activities, notably through training activities with program staff and community members. The key to employing an institutionalist approach to the evaluation of IMAGE is in understanding the nature of those actions that can be seen as institution-building and determining: (1) the instrumental value of follow-up activities by appropriate amortisation of transaction costs over an horizon that reflects the economies gained from the intervention; and (2) the intrinsic value of any transformation in the community through a cost-consequences approach informed by an a priori conceptual model. This case study highlights how health sector interventions can effect institutional changes and how these are captured within a theory-based economic evaluation framework.

Experimental control of Triatoma infestans in poor rural villages of Bolivia through community participation.

PubMed

Lardeux, Frédéric; Depickère, Stéphanie; Aliaga, Claudia; Chavez, Tamara; Zambrana, Lilian

2015-02-01

Triatoma infestans is the main vector of Chagas disease in the southern cone countries. Present control strategies based on indoor and outdoor residual insecticide spraying are not sufficient to control disease transmission, particularly in Bolivia. Techniques based on the management of the human environment may be good alternatives or supplements. Social and entomological surveys were carried out in four villages of Bolivia situated in the dry inter-Andean Valleys and the Chaco region. Risk factors for house infestation by T. infestans were identified, and an eco-health intervention based on education and community participation was carried out to reduce the risks of house infestation. It consisted of implementing simple and low cost vector control techniques such as coating of mud walls, cleaning activities and removal of poultry that enter rooms to lay eggs. The eco-health intervention significantly reduced the number of infested bedrooms, the mean abundance of T. infestans in bedrooms and beds, especially in the Chaco region. Mud wall coating was well accepted and could be proposed as a supplementary tool to the National Program of Chagas Disease Control to enhance the effects of insecticide sprayings. Even if cleaning activities were still neglected, community participation proved to be effective in reducing house infestation. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.

A Review of Economic Evaluations of Tobacco Control Programs

PubMed Central

Kahende, Jennifer W.; Loomis, Brett R.; Adhikari, Bishwa; Marshall, LaTisha

2009-01-01

Each year, an estimated 443,000 people die of smoking-related diseases in the United States. Cigarette smoking results in more than $193 billion in medical costs and productivity losses annually. In an effort to reduce this burden, many states, the federal government, and several national organizations fund tobacco control programs and policies. For this report we reviewed existing literature on economic evaluations of tobacco control interventions. We found that smoking cessation therapies, including nicotine replacement therapy (NRT) and self-help are most commonly studied. There are far fewer studies on other important interventions, such as price and tax increases, media campaigns, smoke free air laws and workplace smoking interventions, quitlines, youth access enforcement, school-based programs, and community-based programs. Although there are obvious gaps in the literature, the existing studies show in almost every case that tobacco control programs and policies are either cost-saving or highly cost-effective. PMID:19440269

The Key to Life Nutrition Program: results from a community-based dietary sodium reduction trial

PubMed Central

Robare, Joseph F; Milas, N Carole; Bayles, Constance M; Williams, Kathy; Newman, Anne B; Lovalekar, Mita T; Boudreau, Robert; McTigue, Kathleen; Albert, Steven M; Kuller, Lewis H

2016-01-01

Objective Evaluation of a dietary Na reduction trial in a community setting. Design Community-based randomized trial. Ten-week nutrition intervention activities focused on lifestyle modification to decrease dietary Na intake, under the supervision of a registered dietitian. Twenty-four hour urine specimens were collected at baseline and follow-up visits to determine 24 h urinary Na excretion. Setting The University of Pittsburgh Center for Healthy Aging, Key to Life Nutrition Program. Subjects Hypertensive adults at least 65 years of age. Results Mean age of participants was 75 years. Twenty-four hour mean urinary Na excretion at baseline was 3174 mg/d. This reduced to 2944 mg/d (P = 0·30) and 2875 mg/d (P ≤ 0·03) at 6-and 12-month follow-ups, respectively. In a sub-sample (urine volume of ≥ 1000 ml, baseline to 12 months), mean urinary Na excretion decreased from 3220 mg/d to 2875 mg/d (P ≤ 0·02). Conclusions Significant reductions in mean 24 h urinary Na were reported, but results fell short of the recommended guidelines of 1500 mg/d for at-risk individuals. Our results reiterate the difficulty in implementing these guidelines in community-based programmes. More aggressive public health efforts, food industry support and health policy changes are needed to decrease Na levels in older adults to the recommended guidelines. PMID:19781124

Methods and initial findings from the Durham Diabetes Coalition: Integrating geospatial health technology and community interventions to reduce death and disability.

PubMed

Spratt, Susan E; Batch, Bryan C; Davis, Lisa P; Dunham, Ashley A; Easterling, Michele; Feinglos, Mark N; Granger, Bradi B; Harris, Gayle; Lyn, Michelle J; Maxson, Pamela J; Shah, Bimal R; Strauss, Benjamin; Thomas, Tainayah; Califf, Robert M; Miranda, Marie Lynn

2015-03-01

The Durham Diabetes Coalition (DDC) was established in response to escalating rates of disability and death related to type 2 diabetes mellitus, particularly among racial/ethnic minorities and persons of low socioeconomic status in Durham County, North Carolina. We describe a community-based demonstration project, informed by a geographic health information system (GHIS), that aims to improve health and healthcare delivery for Durham County residents with diabetes. A prospective, population-based study is assessing a community intervention that leverages a GHIS to inform community-based diabetes care programs. The GHIS integrates clinical, social, and environmental data to identify, stratify by risk, and assist selection of interventions at the individual, neighborhood, and population levels. The DDC is using a multifaceted approach facilitated by GHIS to identify the specific risk profiles of patients and neighborhoods across Durham County. A total of 22,982 patients with diabetes in Durham County were identified using a computable phenotype. These patients tended to be older, female, African American, and not covered by private health insurance, compared with the 166,041 persons without diabetes. Predictive models inform decision-making to facilitate care and track outcomes. Interventions include: 1) neighborhood interventions to improve the context of care; 2) intensive team-based care for persons in the top decile of risk for death or hospitalization within the coming year; 3) low-intensity telephone coaching to improve adherence to evidence-based treatments; 4) county-wide communication strategies; and 5) systematic quality improvement in clinical care. To improve health outcomes and reduce costs associated with type 2 diabetes, the DDC is matching resources with the specific needs of individuals and communities based on their risk characteristics.

A school-based public health model to reduce oral health disparities.

PubMed

Dudovitz, Rebecca N; Valiente, Jonathan E; Espinosa, Gloria; Yepes, Claudia; Padilla, Cesar; Puffer, Maryjane; Slavkin, Harold C; Chung, Paul J

2018-12-01

Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four hundred ninety-one parents received oral health education and 89 served as community oral health volunteers; 3,399 screenings and fluoride applications were performed on 2,776 children. Sixty-six percent of children had active dental disease, 27 percent had visible tooth decay, and 6 percent required emergent care. Of the 623 students who participated for two consecutive years, 56 percent had fewer or no visible caries at follow-up, while only 17 percent had additional disease. Annual program cost was $69.57 per child. Using a broad based, oral health coalition, a school-based universal screening and fluoride varnishing program can improve the oral health of children with a high burden of untreated dental diseases. © 2017 American Association of Public Health Dentistry.

A Community’s Response to Suicide Through Public Art: Stakeholder Perspectives from the Finding the Light Within Project

PubMed Central

Singer, Jonathan B.; Evans, Arthur C.; Matlin, Samantha L.; Golden, Jane; Harris, Cathy; Burns, James; Siciliano, Catherine; Kiernan, Guy; Pelleritti, Margaret; Tebes, Jacob Kraemer

2013-01-01

Suicide is a preventable public health problem and a leading cause of death in the United States. Despite recognized need for community-based strategies for suicide prevention, most suicide prevention programs focus on individual-level change. This article presents seven first person accounts of Finding the Light Within, a community mobilization initiative to reduce the stigma associated with suicide through public arts participation that took place in Philadelphia, Pennsylvania from 2011 through 2012. The stigma associated with suicide is a major challenge to suicide prevention, erecting social barriers to effective prevention and treatment and enhancing risk factors for people struggling with suicidal ideation and recovery after losing a loved one to suicide. This project engaged a large and diverse audience and built a new community around suicide prevention through participatory public art, including community design and production of a large public mural about suicide, storytelling and art workshops, and a storytelling website. We present this project as a model for how arts participation can address suicide on multiple fronts—from raising awareness and reducing stigma, to promoting community recovery, to providing healing for people and communities in need. PMID:23743604

Modifying a Social Problem-Solving Program With the Input of Individuals With Intellectual Disabilities and Their Staff

PubMed Central

Ailey, Sarah H.; Friese, Tanya R.; Nezu, Arthur M.

2016-01-01

Social problem-solving programs have shown success in reducing aggressive/challenging behaviors among individuals with intellectual disabilities in clinical settings, but have not been adapted for health promotion in community settings. We modified a social problem-solving program for the community setting of the group home. Multiple sequential methods were used to seek advice from community members on making materials understandable and on intervention delivery. A committee of group home supervisory staff gave advice on content and delivery. Cognitive interviews with individuals with intellectual disabilities and residential staff provided input on content wording and examples. Piloting the program provided experience with content and delivery. The process provides lessons on partnering with vulnerable populations and community stakeholders to develop health programs. PMID:22753149

Safe Passages through Adolescence: Communities Protecting the Health and Hopes of Youth. Lessons Learned from W. K. Kellogg Foundation Programming.

ERIC Educational Resources Information Center

Kellogg Foundation, Battle Creek, MI.

This is the third in a series of reports summarizing the investment of the W. K. Kellogg Foundation in community-based health programming. It addresses the health issues confronting young people in U.S. society by profiling eight different community-based approaches to adolescent health. The programs described, all sponsored by the Kellogg…

The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies

ERIC Educational Resources Information Center

Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce

2015-01-01

Many community-based sport and physical activity programs take a positive youth development approach when operating in underserved communities around the world (Forneris, Whitley, & Barker, 2013). However, one of the biggest challenges for these programs is sustainability (Lindsey, 2008). The purpose of this article is to present the 3…

School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-Like Illness Emergency Care Visits

PubMed Central

Tran, Cuc H.; Sugimoto, Jonathan D.; Pulliam, Juliet R. C.; Ryan, Kathleen A.; Myers, Paul D.; Castleman, Joan B.; Doty, Randell; Johnson, Jackie; Stringfellow, Jim; Kovacevich, Nadia; Brew, Joe; Cheung, Lai Ling; Caron, Brad; Lipori, Gloria; Harle, Christopher A.; Alexander, Charles; Yang, Yang; Longini, Ira M.; Halloran, M. Elizabeth; Morris, J. Glenn; Small, Parker A.

2014-01-01

Background School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits. Methods For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida. Results Vaccination of ∼50% of 5–17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0–4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13. Conclusion Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities. PMID:25489850

School-located influenza vaccination reduces community risk for influenza and influenza-like illness emergency care visits.

PubMed

Tran, Cuc H; Sugimoto, Jonathan D; Pulliam, Juliet R C; Ryan, Kathleen A; Myers, Paul D; Castleman, Joan B; Doty, Randell; Johnson, Jackie; Stringfellow, Jim; Kovacevich, Nadia; Brew, Joe; Cheung, Lai Ling; Caron, Brad; Lipori, Gloria; Harle, Christopher A; Alexander, Charles; Yang, Yang; Longini, Ira M; Halloran, M Elizabeth; Morris, J Glenn; Small, Parker A

2014-01-01

School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits. For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida. Vaccination of ∼50% of 5-17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0-4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13. Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities.

Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute’s Community Networks Program

PubMed Central

Fagan, Pebbles; Cooper, Leslie; Canto, Maria; Carroll, William; Foster-Bey, John; Hébert, James R.; Lopez-Class, Maria; Ma, Grace X.; Nez Henderson, Patricia; Pérez-Stable, Eliseo J.; Santos, LorrieAnn; Smith, Justin H.; Tan, Yin; Tsoh, Janice; Chu, Kenneth

2015-01-01

Introduction: In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. Methods: We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005–2009. Two authors categorized the tobacco-related activities and publications within the framework. Results: Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas “Psychosocial Research,” “Surveillance,” “Epidemiology,” and “Treatment of Nicotine Addiction.” Thirteen CNPs participated in tobacco control policymaking in mainstream efforts that affected their local community and populations, and 24 CNPs conducted 1147 tobacco-related educational outreach activities. CNP activities that aimed to build research and infrastructure capacity included nine tobacco-related pilot projects representing 16% of all CNP cancer-related pilot projects, and 17 publications acknowledging leveraged partnerships with other organizations, a strategy encouraged by the CNP. Conclusions: The CNP is a promising academic-community model for working to eliminate tobacco-related health disparities. Future efforts may address scientific gaps, consider collaboration across groups, assess the extent of operationalizing community-based participatory research, and improve common tracking measures. PMID:26180215

Smoking cessation and its predictors: results from a community-based pharmacy tobacco cessation program in New Mexico.

PubMed

Khan, Nasreen; Anderson, Joe R; Du, Juan; Tinker, Dale; Bachyrycz, Amy M; Namdar, Rocsanna

2012-09-01

The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.

Perceived barriers in accessing food among recent Latin American immigrants in Toronto

PubMed Central

2013-01-01

Objective In Canada, recent immigrant households experience more food insecurity than the general population, but limited information is available about the personal, cultural, and social factors that contribute to this vulnerability. This study focused on recent Latin American (LA) immigrants to explore their perceived barriers in acquiring safe, nutritious, and culturally-appropriate food. Design A cross-sectional mixed-method design was applied to collect information from a convenience sample of 70 adult Spanish/Portuguese speakers who had arrived in Toronto within the last five years. Face-to-face interviews were conducted with primary household caregivers to obtain responses about barriers to acquiring food for their households; data were analyzed using a thematic analysis technique. Results Four main categories of barriers were identified: limited financial resources; language difficulty; cultural food preferences; and poor knowledge of available community-based food resources and services. Inadequate income was the main impediment in accessing adequate food, and was related to affordability of food items, accessibility of food outlets and transportation cost, and limited time for grocery shopping due to work conditions. Language barriers affected participants’ ability to obtain well-paid employment and their awareness about and access to available community-based food resources. Cultural barriers were related to food preferences and limited access to culturally-appropriate foods and resources. Conclusion The main barrier to food security among our sample of LA newcomers to Toronto is limited financial resources, highlighting the need for policies and strategies that could improve their financial power to purchase sufficient, nutritious, and culturally-acceptable food. Linguistic barriers and limited information among newcomers suggest the need to provide linguistically- and culturally-appropriate information related to community-based food programs and resources, as well as accessible subsidized English language programs, in the community and at workplaces. Participatory community-based food programs can augment, in a socially acceptable manner, food resources and reduce the social stigma attached to food charity. Finally, it is crucial to monitor and evaluate existing social and community-based services for their accessibility, cultural appropriateness and diversity, and effectiveness. PMID:23286318

The 'Healthy Dads, Healthy Kids' community effectiveness trial: study protocol of a community-based healthy lifestyle program for fathers and their children

PubMed Central

2011-01-01

Background The 'Healthy Dads, Healthy Kids' program was designed to help overweight fathers lose weight and positively influence the health behaviors of their children. The aim of the current study was to evaluate the previously established program in a community setting, in a large effectiveness trial. Methods/Design The Healthy Dads, Healthy Kids community trial consists of three stages: (i) Stage 1 - program refinement and resource development (ii) Stage 2 - community randomized controlled trial (iii) Stage 3 - community effectiveness trial. The program will be evaluated in five Local Government Areas in the Hunter Valley Region of NSW, Australia. For the community randomized controlled trial, 50 overweight/obese men (aged 18-65 years) from one Local Government Area with a child aged between 5-12 years of age will be recruited. Families will be randomized to either the program or a 6-month wait-list control group. Fathers and their children will be assessed at baseline, post-intervention (3-months) and 6-months. Inclusion criteria are: body mass index 25-40 kg/m2; no participation in other weight loss programs during the study; pass a health-screening questionnaire; and access to a computer with Internet facilities. In the community trial, the program will be evaluated using a non-randomized, prospective design in five Local Government Areas. The exclusion criteria is body mass index < 25 kg/m2 or lack of doctor's approval. Measures will be collected at baseline, 3-, 6- and 12-months. The program involves fathers attending seven face-to-face group sessions (three with children) over 3-months. Measures: The primary outcome is fathers' weight. Secondary outcomes for both fathers and children include: waist circumference, blood pressure, resting heart rate, physical activity, sedentary behaviors and dietary intake. Father-only measures include portion size, alcohol consumption, parenting for physical activity and nutrition and parental engagement. Process evaluation will determine the fidelity, dose (delivered and received), reach, recruitment and context of the program. Discussion As a unique approach to reducing obesity prevalence in men and improving lifestyle behaviours in children, our findings will provide important evidence relating to the translation of Healthy Dads, Healthy Kids, which will enable it to be delivered on a larger scale. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000608066 PMID:22099889

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

PubMed

Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P < .002) under dual-task condition in the intervention group, compared with the delayed intervention control group. Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Revenue Diversification: A New Source of Funds for Community Colleges.

ERIC Educational Resources Information Center

Brightman, Richard W.

In this period of financial austerity in education, community colleges can diversify their sources of revenue as an alternative to reducing or eliminating programs or accepting a decline in the quality of education. One such approach involves the colleges in commercial activities undertaken to support educational programs and services. Although…

Social isolation in community-dwelling seniors: an evidence-based analysis.

PubMed

2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE OF THE EVIDENCE-BASED ANALYSIS: The objective was to systematically review interventions aimed at preventing or reducing social isolation and loneliness in community-dwelling seniors, that is, persons ≥ 65 years of age who are not living in long-term care institutions. The analyses focused on the following questions: Are interventions to reduce social isolation and/or loneliness effective?Do these interventions improve health, well-being, and/or quality of life?Do these interventions impact on independent community living by delaying or preventing functional decline or disability?Do the interventions impact on health care utilization, such as physician visits, emergency visits, hospitalization, or admission to long-term care? TARGET POPULATION AND CONDITION Social and family relationships are a core element of quality of life for seniors, and these relationships have been ranked second, next to health, as the most important area of life. Several related concepts-reduced social contact, being alone, isolation, and feelings of loneliness-have all been associated with a reduced quality of life in older people. Social isolation and loneliness have also been associated with a number of negative outcomes such as poor health, maladaptive behaviour, and depressed mood. Higher levels of loneliness have also been associated with increased likelihood of institutionalization. NOTE: It is recognized that the terms "senior" and "elderly" carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. METHODS OF THE EVIDENCE-BASED ANALYSIS: The scientific evidence base was evaluated through a systematic literature review. The literature searches were conducted with several computerized bibliographic databases for literature published between January 1980 and February 2008. The search was restricted to English-language reports on human studies and excluded letters, comments and editorials, and case reports. Journal articles eligible for inclusion in the review included those that reported on single, focused interventions directed towards or evaluating social isolation or loneliness; included, in whole or in part, community-dwelling seniors (≥ 65 years); included some quantitative outcome measure on social isolation or loneliness; and included a comparative group. Assessments of current practices were obtained through consultations with various individuals and agencies including the Ontario Community Care Access Centres and the Ontario Assistive Devices Program. An Ontario-based budget impact was also assessed for the identified effective interventions for social isolation. A systematic review of the published literature focusing on interventions for social isolation and loneliness in community-dwelling seniors identified 11 quantitative studies. The studies involved European or American populations with diverse recruitment strategies, intervention objectives, and limited follow-up, with cohorts from 10 to 15 years ago involving mainly elderly women less than 75 years of age. The studies involved 2 classes of interventions: in-person group support activities and technology-assisted interventions. These were delivered to diverse targeted groups of seniors such as those with mental distress, physically inactive seniors, low-income groups, and informal caregivers. The interventions were primarily focused on behaviour-based change. Modifying factors (client attitude or preference) and process issues (targeting methods of at-risk subjects, delivery methods, and settings) influenced intervention participation and outcomes. Both classes of interventions were found to reduce social isolation and loneliness in seniors. Social support groups were found to effectively decrease social isolation for seniors on wait lists for senior apartments and those living in senior citizen apartments. Community-based exercise programs featuring health and wellness for physically inactive community-dwelling seniors also effectively reduced loneliness. Rehabilitation for mild/moderate hearing loss was effective in improving communication disabilities and reducing loneliness in seniors. Interventions evaluated for informal caregivers of seniors with dementia, however, had limited effectiveness for social isolation or loneliness. Research into interventions for social isolation in seniors has not been broadly based, relative to the diverse personal, social, health, economic, and environmentally interrelated factors potentially affecting isolation. Although rehabilitation for hearing-related disability was evaluated, the systematic review did not locate research on interventions for other common causes of aging-related disability and loneliness, such as vision loss or mobility declines. Despite recent technological advances in e-health or telehealth, controlled studies evaluating technology-assisted interventions for social isolation have examined only basic technologies such as phone- or computer-mediated support groups. Although effective interventions were identified for social isolation and loneliness in community-dwelling seniors, they were directed at specifically targeted groups and involved only a few of the many potential causes of social isolation. Little research has been directed at identifying effective interventions that influence the social isolation and other burdens imposed upon caregivers, in spite of the key role that caregivers assume in caring for seniors. The evidence on technology-assisted interventions and their effects on the social health and well-being of seniors and their caregivers is limited, but increasing demand for home health care and the need for efficiencies warrant further exploration. Interventions for social isolation in community-dwelling seniors need to be researched more broadly in order to develop effective, appropriate, and comprehensive strategies for at-risk populations.

Evaluation of a Community-Based Aging Intervention Program

ERIC Educational Resources Information Center

Hsu, Hui-Chuan; Wang, Chun-Hou; Chen, Yi-Chun; Chang, Ming-Chen; Wang, Jean

2010-01-01

This study evaluated the outcome and process of a community-based aging intervention program for the elderly in Taiwan. The program included education on nutrition and dietary behavior and on physical activities. Outcome and process evaluations were conducted. The program may have had some effects on decreasing some dietary behavioral problems and…

Tobacco cessation intervention during pregnancy among Alaska Native women.

PubMed

Patten, Christi A

2012-04-01

This paper describes a community-based participatory research program with Alaska Native people addressing a community need to reduce tobacco use among pregnant women and children. Tobacco use during pregnancy among Alaska Native women is described along with development of a community partnership, findings from a pilot tobacco cessation intervention, current work, and future directions. Among Alaska Native women residing in the Yukon Kuskokwim Delta region of western Alaska, the prevalence of tobacco use (cigarette smoking and/or use of smokeless tobacco) during pregnancy is 79%. Results from a pilot intervention study targeting pregnant women indicated low rates of participation and less than optimal tobacco abstinence outcomes. Developing alternative strategies to reach pregnant women and to enhance the efficacy of interventions is a community priority, and future directions are offered.

Tobacco Cessation Intervention During Pregnancy Among Alaska Native Women

PubMed Central

2014-01-01

This paper describes a community-based participatory research program with Alaska Native people addressing a community need to reduce tobacco use among pregnant women and children. Tobacco use during pregnancy among Alaska Native women is described along with development of a community partnership, findings from a pilot tobacco cessation intervention, current work, and future directions. Among Alaska Native women residing in the Yukon Kuskokwim Delta region of western Alaska, the prevalence of tobacco use (cigarette smoking and/or use of smokeless tobacco) during pregnancy is 79%. Results from a pilot intervention study targeting pregnant women indicated low rates of participation and less than optimal tobacco abstinence outcomes. Developing alternative strategies to reach pregnant women and to enhance the efficacy of interventions is a community priority, and future directions are offered. PMID:22311690

Obesity prevention in children and adolescents.

PubMed

Swinburn, Boyd

2009-01-01

Childhood and adolescent obesity has been increasing in most middle- and high-income countries, and, as with adult obesity, this has been driven by increasingly obesogenic environments, especially the food environment. This constitutes a "market failure," signaling the need for government interventions with policies, programs, and social marketing. Population prevention strategies are critical, and children and adolescents should be the priority populations. Food marketing to children is a central policy issue for governments to address, and comprehensive regulations are needed to provide substantive protection for children. Community-based intervention programs show some real promise in reducing childhood obesity, but the 2 big challenges ahead are to ensure that there is substantial ongoing funding so that the community capacity to promote healthy weights can be scaled up to a national level and to ensure that policies are in place to support these efforts. The social and cultural shifts that support healthy eating and physical activity occur differentially, and special efforts are needed to reduce the socioeconomic gradients associated with childhood obesity. A positive public health approach encompassing environmental, regulatory, sociocultural, and educational strategies offer the best chance of reducing obesity without increasing disordered eating patterns.

Voluntary program to reduce soot

NASA Astrophysics Data System (ADS)

Showstack, Randy

2013-01-01

The U.S. Environmental Protection Agency (EPA) announced on 17 January that it has formulated a voluntary clean air program, Particulate Matter (PM) Advance, to help communities develop strategies to reduce fine-particle emissions, often called soot or particulate matter, that can be harmful to human health.

Preventing falls in assisted living: Results of a quality improvement pilot study.

PubMed

Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

Keeping Kids Smokefree: Lessons Learned on Community Participation

ERIC Educational Resources Information Center

Charlier, N.; Glover, M.; Robertson, J.

2009-01-01

Community participation in program decision-making and implementation is an ideal that community and academic stakeholders aspire to in participatory research. This ideal, however, can be difficult to achieve. We describe lessons learned about community participation from a quasi-experimental trial aimed at reducing the uptake of smoking among…

Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

PubMed

Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

2010-04-01

The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

Antiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning

PubMed Central

Moon, Troy D.; Ossemane, Ezequiel B.; Green, Ann F.; Ndatimana, Elisée; José, Eurico; Buehler, Charlotte P.; Wester, C. William; Vermund, Sten H.; Olupona, Omo

2014-01-01

Objective To generate maps reflecting the intersection of community-based Voluntary Counseling and Testing (VCT) delivery points with facility-based HIV program demographic information collected at the district level in three districts (Ile, Maganja da Costa and Chinde) of Zambézia Province, Mozambique; in order to guide planning decisions about antiretroviral therapy (ART) program expansion. Methods Program information was harvested from two separate open source databases maintained for community-based VCT and facility-based HIV care and treatment monitoring from October 2011 to September 2012. Maps were created using ArcGIS 10.1. Travel distance by foot within a 10 km radius is generally considered a tolerable distance in Mozambique for purposes of adherence and retention planning. Results Community-based VCT activities in each of three districts were clustered within geographic proximity to clinics providing ART, within communities with easier transportation access, and/or near the homes of VCT volunteers. Community HIV testing results yielded HIV seropositivity rates in some regions that were incongruent with the Ministry of Health’s estimates for the entire district (2–13% vs. 2% in Ile, 2–54% vs. 11.5% in Maganja da Costa, and 23–43% vs. 14.4% in Chinde). All 3 districts revealed gaps in regional disbursement of community-based VCT activities as well as access to clinics offering ART. Conclusions Use of geospatial mapping in the context of program planning and monitoring allowed for characterizing the location and size of each district’s HIV population. In extremely resource limited and logistically challenging settings, maps are valuable tools for informing evidence-based decisions in planning program expansion, including ART. PMID:25329169

Randomized, Community-Based Pharmacy Intervention to Expand Services Beyond Sale of Sterile Syringes to Injection Drug Users in Pharmacies in New York City

PubMed Central

Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

2013-01-01

Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful. PMID:23865644

The Feasibility and Acceptability of a Web-Based Alcohol Management Intervention in Community Sports Clubs: A Cross-Sectional Study

PubMed Central

Wolfenden, Luke; Wiggers, John; Tindall, Jenny; Yoong, Sze Lin; Lecathelinais, Christophe; Gillham, Karen; Sherker, Shauna; Rowland, Bosco; McLaren, Nicola; Kingsland, Melanie

2017-01-01

Background The implementation of comprehensive alcohol management strategies can reduce excessive alcohol use and reduce the risk of alcohol-related harm at sporting venues. Supporting sports venues to implement alcohol management strategies via the Web may represent an effective and efficient means of reducing harm caused by alcohol in this setting. However, the feasibility and acceptability of such an approach is unknown. Objective This study aimed to identify (1) the current access to and use of the Web and electronic devices by sports clubs; (2) the perceived usefulness, ease of use, and intention to use a Web-based program to support implementation of alcohol management policies in sports clubs; (3) the factors associated with intention to use such a Web-based support program; and (4) the specific features of such a program that sports clubs would find useful. Methods A cross-sectional survey was conducted with club administrators of community football clubs in the state of New South Wales, Australia. Perceived usefulness, ease of use and intention to use a hypothetical Web-based alcohol management support program was assessed using the validated Technology Acceptance Model (TAM) instrument. Associations between intention to use a Web-based program and club characteristics as well as perceived ease of use and usefulness was tested using Fisher’s exact test and represented using relative risk (RR) for high intention to use the program. Results Of the 73 football clubs that were approached to participate in the study, 63 consented to participate and 46 were eligible and completed the survey. All participants reported having access to the Web and 98% reported current use of electronic devices (eg, computers, iPads/tablets, smartphones, laptops, televisions, and smartboards). Mean scores (out of a possible 7) for the TAM constructs were high for intention to use (mean 6.25, SD 0.87), perceived ease of use (mean 6.00, SD 0.99), and perceived usefulness (mean 6.17, SD 0.85). Intention to use the Web-based alcohol management program was significantly associated with perceived ease of use (P=.02, RR 1.4, CI 1.0-2.9), perceived usefulness (P=.03, RR 1.5, CI 1.0-6.8) and club size (P=.02, RR 0.8, CI 0.5-0.9). The most useful features of such a program included the perceived ability to complete program requirements within users’ own time, complete program accreditation assessment and monitoring online, develop tailored action plans, and receive email reminders and prompts to complete action. Conclusions A Web-based alcohol management approach to support sports clubs in the implementation of recommended alcohol management policies appears both feasible and acceptable. Future research should aim to determine if such intended use leads to actual use and club implementation of alcohol management policies. PMID:28666977

Effects of a School-Based Nutrition Program Diffused throughout a Large Urban Community on Attitudes, Beliefs, and Behaviors Related to Fruit and Vegetable Consumption

ERIC Educational Resources Information Center

Prelip, Michael; Slusser, Wendelin; Thai, Chan L.; Kinsler, Janni; Erausquin, Jennifer T.

2011-01-01

Background: Obesity among US children has increased in recent years. Although increased fruit and vegetable consumption has not been directly linked to obesity prevalence, it has been posited that more fruits and vegetables (FV) could reduce the consumption of high-fat, energy-dense foods and may protect against childhood illnesses including…

Healthy Buddies[TM] Reduces Body Mass Index Z-Score and Waist Circumference in Aboriginal Children Living in Remote Coastal Communities

ERIC Educational Resources Information Center

Ronsley, Rebecca; Lee, Andrew S.; Kuzeljevic, Boris; Panagiotopoulos, Constadina

2013-01-01

Background: Aboriginal children are at increased risk for obesity and type 2 diabetes. Healthy Buddies [TM]-First Nations (HB) is a curriculum-based, peer-led program promoting healthy eating, physical activity, and self-esteem. Methods: Although originally designed as a pilot pre-/post-analysis of 3 remote Aboriginal schools that requested and…

Wiisokotaatiwin: development and evaluation of a community-based palliative care program in Naotkamegwanning First Nation.

PubMed

Nadin, Shevaun; Crow, Maxine; Prince, Holly; Kelley, Mary Lou

2018-04-01

Approximately 474 000 Indigenous people live in 617 First Nations communities across Canada; 125 of those communities are located in Ontario, primarily in rural and remote areas. Common rural health challenges, including for palliative care, involve quality and access. The need for culturally relevant palliative care programs in First Nations communities is urgent because the population is aging with a high burden of chronic and terminal disease. Because local palliative care is lacking, most First Nations people now leave their culture, family and community to receive care in distant hospitals or long-term care homes. Due to jurisdictional issues, a policy gap exists where neither federal nor provincial governments takes responsibility for funding palliative care in First Nations communities. Further, no Canadian program models existed for how different levels of government can collaborate to fund and deliver palliative care in First Nations communities. This article describes an innovative, community-based palliative care program (Wiisokotaatiwin) developed in rural Naotkamegwanning, and presents the results of a process evaluation of its pilot implementation. The evaluation aimed to (i) document the program's pilot implementation, (ii) assess progress toward intended program outcomes and (iii) assess the perceived value of the program. The Wiisokotaatiwin Program was developed and implemented over 5 years using participatory action research (http://www.eolfn.lakeheadu.ca). A mixed-method evaluation approach was adopted. Descriptive data were extracted from program documents (eg client registration forms). Client tracking forms documented service provision data for a 4-month sample period. Quantitative and qualitative data were collected through client and family member questionnaires (n=7) and healthcare provider questionnaires (n=22). A focus group was conducted with the program leadership team responsible for program development. Quantitative data were summarized using descriptive statistics. An inductive approach was used to identify themes in the qualitative data related to the evaluation questions. The findings demonstrated the program was implemented as intended, and that there was a need for the program, with six clients on the 10-month pilot. The findings also indicated achievement of program-level outcomes and progress toward system-level outcomes. Clients/families and healthcare providers were satisfied with the program and perceived it to be meeting its objectives. The program model was also perceived to be transferrable to other First Nations communities. The results demonstrate how a rural First Nations community can build capacity and develop a palliative care program tailored to their unique culture and context that builds upon and is integrated into existing services. The Wiisokotaatiwin Program allowed community members to receive their palliative care at home, improved client experience and enhanced service integration. This article provides a First Nations specific model for a palliative care program that overcomes jurisdictional issues at the local level, and a methodology for developing and evaluating community-based palliative care programs in rural First Nations communities. The article demonstrates how local, federal and provincial healthcare providers and organizations collaborated to build capacity, fund and deliver community-based palliative care. The described process of developing the program has applicability in other First Nations (Indigenous) communities and for healthcare decisionmakers.

Drug-Free Schools & Communities: Program Planning Guidelines & Community Inventory.

ERIC Educational Resources Information Center

Montana State Board of Crime Control, Helena.

This book is designed to provide Montana communities with the most current research-based information available concerning drug and alcohol prevention/education program planning. It also provides a concise overview of the programs being conducted in various Montana communities. It is intended for use as a resource manual, to provide readers with…

The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education.

PubMed

Duley, P; Botfield, J R; Ritter, T; Wicks, J; Brassil, A

2017-08-01

Issue addressed Aboriginal youth in Australia often experience high rates of intimate partner violence (family violence) and poorer reproductive and sexual health than their non-Aboriginal counterparts. To address some of the disparities, the Strong Family Program was developed to deliver reproductive and sexual health education to Aboriginal communities in New South Wales. Methods Development of the program was based on an extensive consultation process with Aboriginal communities. It was implemented in three communities, with two groups from each hosting Aboriginal youth and Elders in a yarning circle within the culturally respectful frameworks of 'men and boys'' and 'women and girls'' business. An evaluation was conducted to measure reproductive and sexual health knowledge and attitude changes upon program completion, using pre- and post-program surveys and yarning (focus group discussions). Results Program participants comprised 48 females and 28 males. Overall, mean knowledge and attitude scores improved upon completion of the program (from 77% to 82% and from 4.15 to 4.32 out of 5, respectively). Among participants aged 20 years and under (the youngest participant was 13 years), there was an increase in knowledge (P=0.034); among participants aged over 20 years (the oldest participant was 78 years), there was an increase in positive attitudes (P=0.001). Participants perceived the information provided to be useful and relevant, with many reporting improved knowledge and attitudes around rights and respectful relationships. Conclusions Reproductive and sexual health education in Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greater success. Continued implementation of the Strong Family Program will promote increased understanding of respectful relationships and improved health outcomes for Aboriginal young people. So what? The Strong Family Program was based on an extensive consultative process that ensured leadership and involvement from Aboriginal communities, with program content and delivery based on Aboriginal pedagogy and reflecting Aboriginal cultural values. Reproductive and sexual health promotion in Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greatest success.

Heat injury prevention practices in high school football.

PubMed

Luke, Anthony C; Bergeron, Michael F; Roberts, William O

2007-11-01

To survey high school American football programs regarding current prevention measures for reducing heat injuries during the football season. Web-based survey of 27 questions based on consensus statement guidelines by the American College of Sports Medicine on reducing heat injury risk in youth football. National (United States) and community-based. High school programs receiving survey distribution from their state athletic association and the National Federation of State High School Associations. Responses (percentage and incidence) to questions on preseason acclimatization procedures, practice modification protocols, preparticipation risk factors, hydration management strategies, rest period strategies, heat injury education and policies, and preparation for heat-related emergency care. A total of 540 high school football programs from 26 states completed the survey. The reported number of preseason heat injuries per program (1.38+/-2.08) was greater (P<0.001) compared to during the regular season (0.98+/-1.84). Programs modified equipment configurations during preseason (no helmets or pads, 31.3%; just helmets, 57.0%; helmets and shoulder pads only, 33.5%) or altered the practice schedule when there was excessive heat. Hydration management, education, and preparation for dealing with an acute heat injury varied among programs. Greater implementation of effective prevention measures to reduce the incidence of heat-related injury and death in high school American football is needed. Strategies should focus on modifying practices appropriately on a day-to-day basis to minimize heat strain and optimize hydration, identifying and educating at-risk individuals during the preparticipation period, and developing an emergency action plan for effectively managing heat injuries.

Community College Program Planning: A Method to Measure and Meet Community Need

ERIC Educational Resources Information Center

Perez-Vergara, Kelly; Lathrop, Rachel; Orlowski, Martin

2018-01-01

Offering academic programs that meet community need has long been a core mission of community colleges. However, determining which job skills and credentials are needed for employment in the community is challenging. In order to facilitate a holistic and community-based perspective, our 2-year community college developed a structured curricular…

Cost-effectiveness and budget impact analyses of a long-term hypertension detection and control program for stroke prevention.

PubMed

Yamagishi, Kazumasa; Sato, Shinichi; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Tanigawa, Takeshi; Ohira, Tetsuya; Imano, Hironori; Kondo, Masahide; Okubo, Ichiro; Ishikawa, Yoshinori; Shimamoto, Takashi; Iso, Hiroyasu

2012-09-01

The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue. The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities. The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years. The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.

An Integrated Approach to Falls Prevention: A Model for Linking Clinical and Community Interventions through the Massachusetts Prevention and Wellness Trust Fund.

PubMed

Coe, Laura J; St John, Julie Ann; Hariprasad, Santhi; Shankar, Kalpana N; MacCulloch, Patricia A; Bettano, Amy L; Zotter, Jean

2017-01-01

Older adult falls continue to be a public health priority across the United States-Massachusetts (MA) being no exception. The MA Prevention and Wellness Trust Fund (PWTF) program within the MA Department of Public Health aims to reduce the physical and economic burdens of chronic health conditions by linking evidence-based clinical care with community intervention programs. The PWTF partnerships that focused on older adult falls prevention integrated the Centers for Disease Control and Prevention's Stopping Elderly Accidents, Death and Injuries toolkit into clinical settings. Partnerships also offer referrals for home safety assessments, Tai Chi, and Matter of Balance programs. This paper describes the PWTF program implementation process involving 49 MA organizations, while highlighting the successes achieved and lessons learned. With the unprecedented expansion of the U.S. Medicare beneficiary population, and the escalating incidence of falls, widespread adoption of effective prevention strategies will become increasingly important for both public health and for controlling healthcare costs. The lessons learned from this PWTF initiative offer insights and recommendations for future falls prevention program development and implementation.

Reforming the community research program: from Community Clinical Oncology Program to the National Cancer Institute Community Oncology Research Program.

PubMed

Zon, Robin T

2014-01-01

Community research has been an integral and influential component of the National Research Program since the late 1970s. Institutionalization of community research in the Community Clinical Oncology Program (CCOP) has resulted in successful collaborations, meaningful accrual, achievement of quality standards, and translation of research into clinical practice. Although the national clinical trial system is undergoing modernization and improvement, the success of the CCOP and minority-based CCOP in cancer treatment, prevention, and control research is being extended to include cancer care delivery research in the newly created National Cancer Institute (NCI) Community Oncology Research Program. This article briefly presents a historic perspective of community involvement in federally sponsored clinical trials and introduces the continued involvement in the newly created NCI program.

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

PubMed Central

2013-01-01

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

Community Forums: A Boost for the Humanities.

ERIC Educational Resources Information Center

Eisenberg, Diane U.

Interest in the humanities is being revitalized at community and junior colleges through community forums and town meetings. The idea of melding the community forum with the humanities was at the heart of a national humanities demonstration program, in which 11 community colleges participated by developing model community forum programs based upon…

COMMUNITY-BASED WATERSHED MANAGEMENT: CREATING A TOOL FOR PROGRAM EVALUATION AND DESIGN

EPA Science Inventory

The criteria will be assembled into a manual to be used by community organizers, academics, managers, or policy makers in evaluating community-based watershed management initiatives and in designing new watershed management programs. The case study will also be added to the b...

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…

Mercury Mining in Mexico: I. Community Engagement to Improve Health Outcomes from Artisanal Mining.

PubMed

Camacho, Andrea; Van Brussel, Evelyn; Carrizales, Leticia; Flores-Ramírez, Rogelio; Verduzco, Beatriz; Huerta, Selene Ruvalcaba-Aranda; Leon, Mauricio; Díaz-Barriga, Fernando

2016-01-01

Mercury is an element that cannot be destroyed and is a global threat to human and environmental health. In Latin America and the Caribbean, artisanal and small-scale gold mining represents the main source of mercury emissions, releases, and consumption. However, another source of concern is the primary production of mercury. In the case of Mexico, in the past 2 years the informal production of mercury mining has increased 10-fold. Considering this scenario, an intervention program was initiated to reduce health risks in the mining communities. The program's final goal is to introduce different alternatives in line to stop the mining of mercury, but introducing at the same time, a community-based development program. The aim of this study was to present results from a preliminary study in the community of Plazuela, located in the municipality of Peñamiller in the State of Queretaro, Mexico. Total mercury was measured in urine and environmental samples using atomic absorption spectrometry by cold vapor technique. Urine samples were collected from children aged 6-14 years and who had lived in the selected area from birth. Urine samples were also collected from miners who were currently working in the mine. To confirm the presence of mercury in the community, mining waste, water, soil, and sediment samples were collected from those high-risk areas identified by members of the community. Children, women, and miners were heavily exposed to mercury (urine samples); and in agreement, we registered high concentrations of mercury in soils and sediments. Considering these results and taking into account that the risk perception toward mercury toxicity is very low in the community (mining is the only economic activity), an integral intervention program has started. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study.

PubMed

Taveras, Elsie M; Blaine, Rachel E; Davison, Kirsten K; Gortmaker, Steven; Anand, Shikha; Falbe, Jennifer; Kwass, Jo-Ann; Perkins, Meghan; Giles, Catherine; Criss, Shaniece; Colchamiro, Rachel; Baidal, Jennifer Woo; Land, Thomas; Smith, Lauren

2015-02-01

Childhood obesity is highly prevalent, is associated with both short- and long-term adverse outcomes, disproportionately affects racial/ethnic minority and economically deprived children, and represents a major threat to public health. Among the most promising approaches for its prevention and management are multilevel, multisector strategies. The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study was a comprehensive, systematic intervention to prevent and reduce childhood obesity among low-income children ages 2-12 years in two selected cities in Massachusetts. Building on the Obesity Chronic Care Model, MA-CORD expanded a state public health department community-level obesity prevention initiative that incorporated evidence-based interventions in primary healthcare, the Women, Infants, and Children program, early care and education, schools/afterschool programs, as well as community-wide programs to improve food, beverage, physical activity (PA), and messaging environments. The study used a combination of pre- and post-time series and quasi-experimental designs to examine the extent to which the intervention resulted in changes in BMI, individual-level lifestyle behaviors, satisfaction with healthcare services, and quality of life among children, as well as changes in health policies, programs, and environments in the two intervention cities, compared to a comparison city. The intervention period was 2 years. MA-CORD will determine the extent to which a multisetting, multilevel intervention that integrates activities in primary care with broader public health interventions in schools, early care and education, and the community at large can improve children's dietary and PA behaviors and ultimately reduce obesity in low-income children.

Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

PubMed Central

Peace, Diane McClymont; Myers, Erin

2012-01-01

Objectives Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies. PMID:22584509

Social Isolation in Community-Dwelling Seniors

PubMed Central

2008-01-01

Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective of the Evidence-Based Analysis The objective was to systematically review interventions aimed at preventing or reducing social isolation and loneliness in community-dwelling seniors, that is, persons ≥ 65 years of age who are not living in long-term care institutions. The analyses focused on the following questions: Are interventions to reduce social isolation and/or loneliness effective? Do these interventions improve health, well-being, and/or quality of life? Do these interventions impact on independent community living by delaying or preventing functional decline or disability? Do the interventions impact on health care utilization, such as physician visits, emergency visits, hospitalization, or admission to long-term care? Background: Target Population and Condition Social and family relationships are a core element of quality of life for seniors, and these relationships have been ranked second, next to health, as the most important area of life. Several related concepts—reduced social contact, being alone, isolation, and feelings of loneliness—have all been associated with a reduced quality of life in older people. Social isolation and loneliness have also been associated with a number of negative outcomes such as poor health, maladaptive behaviour, and depressed mood. Higher levels of loneliness have also been associated with increased likelihood of institutionalization. Note: It is recognized that the terms “senior” and “elderly” carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. Methods of the Evidence-Based Analysis The scientific evidence base was evaluated through a systematic literature review. The literature searches were conducted with several computerized bibliographic databases for literature published between January 1980 and February 2008. The search was restricted to English-language reports on human studies and excluded letters, comments and editorials, and case reports. Journal articles eligible for inclusion in the review included those that reported on single, focused interventions directed towards or evaluating social isolation or loneliness; included, in whole or in part, community-dwelling seniors (≥ 65 years); included some quantitative outcome measure on social isolation or loneliness; and included a comparative group. Assessments of current practices were obtained through consultations with various individuals and agencies including the Ontario Community Care Access Centres and the Ontario Assistive Devices Program. An Ontario-based budget impact was also assessed for the identified effective interventions for social isolation. Findings A systematic review of the published literature focusing on interventions for social isolation and loneliness in community-dwelling seniors identified 11 quantitative studies. The studies involved European or American populations with diverse recruitment strategies, intervention objectives, and limited follow-up, with cohorts from 10 to 15 years ago involving mainly elderly women less than 75 years of age. The studies involved 2 classes of interventions: in-person group support activities and technology-assisted interventions. These were delivered to diverse targeted groups of seniors such as those with mental distress, physically inactive seniors, low-income groups, and informal caregivers. The interventions were primarily focused on behaviour-based change. Modifying factors (client attitude or preference) and process issues (targeting methods of at-risk subjects, delivery methods, and settings) influenced intervention participation and outcomes. Both classes of interventions were found to reduce social isolation and loneliness in seniors. Social support groups were found to effectively decrease social isolation for seniors on wait lists for senior apartments and those living in senior citizen apartments. Community-based exercise programs featuring health and wellness for physically inactive community-dwelling seniors also effectively reduced loneliness. Rehabilitation for mild/moderate hearing loss was effective in improving communication disabilities and reducing loneliness in seniors. Interventions evaluated for informal caregivers of seniors with dementia, however, had limited effectiveness for social isolation or loneliness. Research into interventions for social isolation in seniors has not been broadly based, relative to the diverse personal, social, health, economic, and environmentally interrelated factors potentially affecting isolation. Although rehabilitation for hearing-related disability was evaluated, the systematic review did not locate research on interventions for other common causes of aging-related disability and loneliness, such as vision loss or mobility declines. Despite recent technological advances in e-health or telehealth, controlled studies evaluating technology-assisted interventions for social isolation have examined only basic technologies such as phone- or computer-mediated support groups. Conclusions Although effective interventions were identified for social isolation and loneliness in community-dwelling seniors, they were directed at specifically targeted groups and involved only a few of the many potential causes of social isolation. Little research has been directed at identifying effective interventions that influence the social isolation and other burdens imposed upon caregivers, in spite of the key role that caregivers assume in caring for seniors. The evidence on technology-assisted interventions and their effects on the social health and well-being of seniors and their caregivers is limited, but increasing demand for home health care and the need for efficiencies warrant further exploration. Interventions for social isolation in community-dwelling seniors need to be researched more broadly in order to develop effective, appropriate, and comprehensive strategies for at-risk populations. PMID:23074510

North of the 46° parallel: Obstacles and challenges to recycling in Ontario's rural and northern communities.

PubMed

Lakhan, Calvin

2015-10-01

This study examines the economic challenges of recycling in Ontario's rural and northern areas. Specifically, this study quantifies the economic and diversion impact of operating recycling programs in these regions. Using a systems based cost model, focus is placed on analyzing: (1) What would happen to provincial recycling costs and diversion levels if recycling programs were eliminated in "high cost" northern and rural communities? (2) Is it possible to increase the provincial recycling rate by focusing investments in low cost, high performance regions (while simultaneously eliminating recycling programs in rural and northern areas)? (3) How would the mix of material recovered change if recycling programs were eliminated in rural and northern areas? The results of this analysis show that eliminating recycling programs in high cost regions significantly decreased system costs without negatively impacting overall recycling rates. This study also found that it was possible to increase the provincial recycling rate while simultaneously reducing program costs by targeting specific regions for recovery. The findings of this study suggest that Ontario reevaluate whether rural and northern municipalities be legislatively required to operate household recycling programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multidimensional exercise for people with Parkinson's disease: a case report.

PubMed

Kluding, Patricia; McGinnis, Patricia Quinn

2006-06-01

The primary impairments associated with Parkinson's disease occur in combination with the secondary, preventable effects of immobility. A community-based fitness program may help increase activity and maintain function in people in the early or middle stages of the disease. This article describes a unique program designed to reduce fall risk and promote independent exercise for people with Parkinson's disease. Two 66-year-old males, both community ambulators and in early or middle stages of Parkinson's disease, participated in 3 months of various physical activities. Group balance classes were held twice weekly during the first month, participants joined a fitness center and self-directed their exercise program during the second month, and group Tai Chi classes were held twice weekly during the third month. At conclusion of the program, participants were given suggestions for continued physical fitness activities. After the 3-month program, improvements were noted for both individuals in functional reach, Timed Up and Go, and Berg Balance scores. Both participants continued to exercise regularly for at least 8 months following the program. Two individuals with Parkinson's disease demonstrated improvement in their balance test performance over a 3-month period. Perhaps most importantly, these participants independently continued exercising after completing this program.