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

ERIC Educational Resources Information Center

Powers, Michael D.

1986-01-01

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

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

PubMed

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

1991-11-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

ERIC Educational Resources Information Center

Minnesota Association for Rehabilitation, Education, and Training.

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

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

PubMed

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

2014-01-01

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

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

ERIC Educational Resources Information Center

Sussman, Tamara; Regehr, Cheryl

2009-01-01

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

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

PubMed

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

2013-03-01

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

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

ERIC Educational Resources Information Center

Friedman, Carli

2016-01-01

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

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

PubMed Central

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

2013-01-01

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

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

ERIC Educational Resources Information Center

Casas, Paula; Isarowong, Nucha

2015-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

The Resource Team: an innovative service delivery support model for mental health services.

PubMed

O'Sullivan, Julie; Powell, Jacinta; Gibbon, Peter; Emmerson, Brett

2009-04-01

This paper outlines the development of the Resource Team, an innovative service delivery model supporting clinical services at the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital Health Service District. The team aims to provide a base for specialist mental health support staff, improve knowledge management and support the development of meaningful community partnerships. Development of the team included a literature review and consultation with internal and external stakeholders. From this, the objectives, roles and functions of the team were clarified and disseminated to stakeholders. The team currently encompasses 12 positions and has initiated a number of programs and service developments. These include improved IT management of clinical resources and the development of partnerships with the community and non-government sectors. The Resource Team effectively coordinates specialist clinical support positions, addresses knowledge management issues and facilitates meaningful engagement with the community and non-government sectors. The model could easily be applied in other mental health and general health services.

Social support and responsiveness in online patient communities: impact on service quality perceptions.

PubMed

Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

2016-02-01

Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

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

PubMed

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

2018-01-24

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

Data near processing support for climate data analysis

NASA Astrophysics Data System (ADS)

Kindermann, Stephan; Ehbrecht, Carsten; Hempelmann, Nils

2016-04-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

Family Education and Support Services in Systems of Care

ERIC Educational Resources Information Center

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

2010-01-01

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

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

PubMed

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

2013-10-01

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

Community health workers and medicaid managed care in New Mexico.

PubMed

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

2012-06-01

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

45 CFR 1355.25 - Principles of child and family services.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Analysis of Contemporary Contingency Contracting Educational Resources

DTIC Science & Technology

2010-12-01

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

Learner Support Services for Online Students: Scaffolding for Success.

ERIC Educational Resources Information Center

Ludwig-Hardman, Stacey; Dunlap, Joanna C.

2003-01-01

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

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

PubMed

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

2015-10-01

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

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

PubMed

Skipworth, J; Humberstone, V

2002-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2013 CFR

2013-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed Central

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

2016-01-01

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

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

ERIC Educational Resources Information Center

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

2008-01-01

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

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

PubMed Central

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

2015-01-01

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

Feasibility of a rural palliative supportive service.

PubMed

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

2015-01-01

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

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

PubMed

Tseng, Winston

2005-01-01

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

Community Currency Trading Method through Partial Transaction Intermediary Process

NASA Astrophysics Data System (ADS)

Kido, Kunihiko; Hasegawa, Seiichi; Komoda, Norihisa

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

The Market for Community Services for Older People.

ERIC Educational Resources Information Center

Hereford, Russell W.

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

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

PubMed

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

2014-01-01

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

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

PubMed

Mandiberg, James M

2012-01-01

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

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

PubMed

McGinnis, Sandra L; Zoske, Frances M

2008-08-01

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

Linking case management and community development.

PubMed

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

2006-01-01

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

Drug Free Communities Support Program. Prevention Update

ERIC Educational Resources Information Center

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

2012-01-01

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

Analysis of Contemporary Contingency Contracting Educational Resources

DTIC Science & Technology

2010-11-29

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

78 FR 41088 - Solicitation for a Cooperative Agreement-Support Services for Community Services Division Networks

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

...--Support Services for Community Services Division Networks AGENCY: National Institute of Corrections, U.S... cooperative agreement will provide support services to NIC Community Services Division sponsored networks. The networks are designed for NIC to assist in meeting the needs of the field of community corrections by...

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

ERIC Educational Resources Information Center

Bartelt, David W.

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

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

ERIC Educational Resources Information Center

Wolcott, Ilene

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

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

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

PubMed

George, Tracy P; DeCristofaro, Claire

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

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

PubMed

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

2018-01-01

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

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

PubMed

Gao, Xing; He, Yao; Hu, Hongpu

2017-01-01

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

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

PubMed

Glisson, Charles; Schoenwald, Sonja K

2005-12-01

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

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

ERIC Educational Resources Information Center

Heath, Sally; McDonald, Jeanette

2012-01-01

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

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

PubMed

Awata, Shuichi

2014-01-01

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

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

PubMed

Needham, Catherine; Carr, Sarah

2015-12-01

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

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

PubMed

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

2017-06-01

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

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

PubMed

Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

2018-04-02

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

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

ERIC Educational Resources Information Center

Christopher, Rose; Horsley, Sarah

2016-01-01

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

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

PubMed

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

2013-12-10

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

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

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

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

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

NASA Astrophysics Data System (ADS)

Ivanochko, Tara; Grain, Kari

2017-04-01

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

HIV medication therapy management services in community pharmacies

PubMed Central

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

2015-01-01

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

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

PubMed

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

2018-04-01

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

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

PubMed

Hoppes, Steve; Hellman, Chan M

2007-01-01

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

42 CFR 441.353 - Supporting documentation required.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Rehabilitation Prevocational Support Services. Program Outline.

ERIC Educational Resources Information Center

Musgrove, Ann

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

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

PubMed

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

2015-08-01

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

The challenges of reshaping disease specific and care oriented community based services towards comprehensive goals: a situation appraisal in the Western Cape Province, South Africa.

PubMed

Schneider, Helen; Schaay, Nikki; Dudley, Lilian; Goliath, Charlyn; Qukula, Tobeka

2015-09-30

Similar to other countries in the region, South Africa is currently reorienting a loosely structured and highly diverse community care system that evolved around HIV and TB, into a formalized, comprehensive and integrated primary health care outreach programme, based on community health workers (CHWs). While the difficulties of establishing national CHW programmes are well described, the reshaping of disease specific and care oriented community services, based outside the formal health system, poses particular challenges. This paper is an in-depth case study of the challenges of implementing reforms to community based services (CBS) in one province of South Africa. A multi-method situation appraisal of CBS in the Western Cape Province was conducted over eight months in close collaboration with provincial stakeholders. The appraisal mapped the roles and service delivery, human resource, financing and governance arrangements of an extensive non-governmental organisation (NGO) contracted and CHW based service delivery infrastructure that emerged over 15-20 years in this province. It also gathered the perspectives of a wide range of actors - including communities, users, NGOs, PHC providers and managers - on the current state and future visions of CBS. While there was wide support for new approaches to CBS, there are a number of challenges to achieving this. Although largely government funded, the community based delivery platform remains marginal to the formal public primary health care (PHC) and district health systems. CHW roles evolved from a system of home based care and are limited in scope. There is a high turnover of cadres, and support systems (supervision, monitoring, financing, training), coordination between CHWs, NGOs and PHC facilities, and sub-district capacity for planning and management of CBS are all poorly developed. Reorienting community based services that have their origins in care responses to HIV and TB presents an inter-related set of resource mobilisation, system design and governance challenges. These include not only formalising community based teams themselves, but also the forging of new roles, relationships and mind-sets within the primary health care system, and creating greater capacity for contracting and engaging a plural set of actors - government, NGO and community - at district and sub-district level.

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

ERIC Educational Resources Information Center

Brion-Meisels, Gretchen

2016-01-01

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

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

PubMed

Amundson, B

1993-01-01

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

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

PubMed

Friedman, Carli

2017-10-01

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

Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

PubMed

Dyess, Susan MacLeod

2015-01-01

It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

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

ERIC Educational Resources Information Center

O'Banion, Terry; Gillett-Karam, Rosemary

1996-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

PubMed

Chen, Ya-Mei; Berkowitz, Bobbie

2012-08-10

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

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

PubMed Central

2012-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-07-01

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

Student Management and Human Intelligence Skills Enhanced through Community Service

ERIC Educational Resources Information Center

Wilson, Stefanie Denise

2012-01-01

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

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

ERIC Educational Resources Information Center

Lear, Julia Graham; And Others

1985-01-01

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

Community action research track: Community-based participatory research and service-learning experiences for medical students.

PubMed

Gimpel, Nora; Kindratt, Tiffany; Dawson, Alvin; Pagels, Patti

2018-04-01

Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences. This article provides an overview of CART and reports the program impact based on students' participation, preliminary evaluations and accomplishments. CART is an optional 4‑year service-learning experience for medical students interested in community health. The curriculum includes a coordinated longitudinal program of electives, community service-learning and lecture-based instruction. From 2009-2015, 146 CART students participated. Interests in public health (93%), community service (73%), primary care (73%), CBPR (60%) and community medicine (60%) were the top reasons for enrolment. Significant improvements in mean knowledge were found when measuring the principles of CBPR, levels of prevention, determining health literacy and patient communication strategies (all p's < 0.05). Most students (73%) were satisfied with CART. Projects were disseminated by at least 65 posters and four oral presentations at local, national and international professional meetings. Six manuscripts were published in peer-reviewed journals. CART is an innovative curriculum for training future physicians to be community-responsive physicians. CART can be replicated by other medical schools interested in offering a longitudinal CBPR and service-learning track in an urban metropolitan setting.

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

PubMed

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

2016-03-01

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

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

PubMed

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

2017-05-01

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

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

ERIC Educational Resources Information Center

Walker, Pam

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

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

PubMed

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

2018-02-02

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

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

PubMed

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

2006-01-01

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

The DLESE Community Services Center

NASA Astrophysics Data System (ADS)

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

2003-12-01

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

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

PubMed

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

2015-02-01

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

Leveraging Globus to Support Access and Delivery of Scientific Data

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

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

PubMed

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

2015-09-28

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

Links between social environment and health care utilization and costs.

PubMed

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

2018-01-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2017-04-01

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

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

PubMed

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

2017-05-29

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

A call for differentiated approaches to delivering HIV services to key populations.

PubMed

Macdonald, Virginia; Verster, Annette; Baggaley, Rachel

2017-07-21

Key populations (KPs) are disproportionally affected by HIV and have low rates of access to HIV testing and treatment services compared to the broader population. WHO promotes the use of differentiated approaches for reaching and recruiting KP into the HIV services continuum. These approaches may help increase access to KPs who are often criminalized or stigmatized. By catering to the specific needs of each KP individual, differentiated approaches may increase service acceptability, quality and coverage, reduce costs and support KP members in leading the HIV response among their communities. WHO recommends the implementation of community-based and lay provider administered HIV testing services. Together, these approaches reduce barriers and costs associated with other testing strategies, allow greater ownership in HIV programmes for KP members and reach more people than do facility-based services. Despite this evidence availability and support for them is limited. Peer-driven interventions have been shown to be effective in engaging, recruiting and supporting clients. Some programmes employ HIV-positive or non-PLHIV "peer navigators" and other staff to provide case management, enrolment and/or re-enrolment in care and treatment services. However, a better understanding of the impact, cost effectiveness and potential burden on peer volunteers is required. Task shifting and non-facility-based service locations for antiretroviral therapy (ART) initiation and maintenance and antiretroviral (ARV) distribution are recommended in both the consolidated HIV treatment and KP guidelines of WHO. These approaches are accepted in generalized epidemics and for the general population where successful models exist; however, few organizations provide or initiate ART at KP community-based services. The application of a differentiated service approach for KP could increase the number of people who know their status and receive effective and sustained prevention and treatment for HIV. However, while community-based and lay provider testing are effective and affordable, they are not implemented to scale. Furthermore regulatory barriers to legitimizing lay and peer providers as part of healthcare delivery systems need to be overcome in many settings. WHO recommendations on task shifting and decentralization of ART treatment and care are often not applied to KP settings.

Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

PubMed

Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

2017-06-01

As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer patients regard psycho-oncology services as a highly reasonable and beneficial addition to medical care. In light of insufficient local coverage with services, difficulties with seamless referrals constitute a major challenge for physicians. Apart from emphasizing the effectiveness of psycho-oncology services and proactive attitudes toward the assessment of unmet needs, future policies should focus on the integration of medical and psychosocial follow-up of cancer survivors, especially in rural areas. © AlphaMed Press 2017.

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

42 CFR 441.510 - Eligibility.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

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

PubMed

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

2015-10-01

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

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa.

PubMed

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors-such as age, health status and coping styles-our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family's changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level.

A Service Delivery Model for Children with DCD Based on Principles of Best Practice.

PubMed

Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl

2015-01-01

In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

PubMed

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

2018-01-01

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

Community Mental Health as a Population-based Mental Health Approach.

PubMed

Yuxuan Cai, Stefanie; Shuen Sheng Fung, Daniel

2016-01-01

Mental health services for youths in Singapore were challenged by accessibility and resource constraints. A community-based mental health program working with schools and other partners was developed to address the population needs. To describe the formation of a community-based mental health program and evaluate the program in terms of its outcome and the satisfaction of the users of this program. Based on needs analyses, a community multidisciplinary team was set up in 15 schools to pilot a new model of care for youths. Implemented progressively over five years, networks of teams were divided into four geographic zones. Each zone had clusters of 10 to 15 schools. These teams worked closely with school counselors. Teams were supported by a psychiatrist and a resident. Interventions were focused on empowering school-based personnel to work with students and families, with the support of the teams. 4,184 students were served of whom 10% were seen by the school counselors and supported by the community team. Only 0.15% required referral to tertiary services. Outcome measured by counselor and teacher ratings showed improvements in the Clinical Global Impression scale and Strengths and Difficulties Questionnaire. These included reductions in conduct problems, emotional problems, hyperactive behaviors and peer problems. Furthermore, prosocial behavior also significantly improved. Preliminary cost effectiveness analyses suggest that community treatments are superior to clinic interventions.

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

PubMed

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

2018-06-04

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

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

PubMed

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

2015-11-01

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

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

45 CFR 1357.10 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

Community-based child health nurses: an exploration of current practice.

PubMed

Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

2011-12-01

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-03-01

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

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

ERIC Educational Resources Information Center

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

2005-01-01

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

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

PubMed

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

2014-01-01

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

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

PubMed

Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

2017-11-01

A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Beyond Academics: Challenging Issues Facing Community College Non-Academic Support Services

ERIC Educational Resources Information Center

Mitchell, Judith Lynn

2012-01-01

This research focused on identifying and exploring the significant current and emerging community college non-academic support service issues. These auxiliary services, not unlike academic or student affairs, support the community college mission and vision as well as students' academic success. Since December 2007, Americans have been…

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

ERIC Educational Resources Information Center

Naidoo, B.; Devnarain, B.

2009-01-01

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

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

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

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

NASA Astrophysics Data System (ADS)

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

2010-12-01

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

Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?

PubMed

Paul, Christine L; Boyes, Allison W; O'Brien, Lorna; Baker, Amanda L; Henskens, Frans A; Roos, Ian; Clinton-McHarg, Tara; Bellamy, Douglas; Colburn, Glenda; Rose, Shiho; Cox, Martine E; Fradgley, Elizabeth A; Baird, Hannah; Barker, Daniel

2016-10-26

Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support. A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed. It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support. If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.

Battered Agency Syndrome: The Challenge to Agencies Serving Low-Income Communities.

ERIC Educational Resources Information Center

Reed, Diane; Lally, J. Ronald; Quiett, Douglas

Community-based social service agencies working in low-income communities increasingly function with inadequate support and encounter numerous oppressive external and internal conditions that compromise organizational and staff well-being. Working with many such agencies, WestEd identified stressors that included funding problems, unrealistic…

Assistive Technology in Medicaid Home- and Community-Based Waiver Programs

ERIC Educational Resources Information Center

Kitchener, Martin; Ng, Terence; Lee, Hyang Yuol; Harrington, Charlene

2008-01-01

Purpose: As consensus emerges concerning the need to extend publicly funded home- and community-based services that support the independence of seniors, studies have reported the efficacy and cost effectiveness of assistive technology (AT). This article presents the latest available national AT expenditure and participation trends (1999-2002) for…

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

PubMed Central

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

2014-01-01

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

Job Designs: A Community Based Program for Students with Emotional and Behavioral Disorders.

ERIC Educational Resources Information Center

Lehman, Constance

1992-01-01

The Job Designs Project, a 3-year federally funded project, provides students (ages 16-22) at an Oregon residential treatment center for youth with emotional and behavioral disorders with supported paid employment in the community. The project has provided job supported employment services to 36 students working in such positions as restaurant bus…

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

PubMed

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

2011-12-01

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

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

PubMed Central

2012-01-01

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

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

PubMed

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

2012-07-09

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

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

PubMed Central

2012-01-01

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

Estimating the value of volunteer-assisted community-based aging services: a case example.

PubMed

Scharlach, Andrew E

2015-01-01

This study demonstrates the use of a social return on investment (SROI) approach in estimating the financial and social value created by volunteer-assisted community-based aging services. An expanded value added statement (EVAS) analysis found that the total value of outputs produced by the Concierge Club of San Diego substantially exceeded the cost of the program, after considering likely secondary and tertiary benefits for a range of affected stakeholders-including elderly service recipients, family members, volunteers, and societal institutions. Additional research is needed regarding the direct and indirect costs and benefits of volunteer support services for vulnerable older adults and their families.

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

PubMed

Hersberger, Kurt E; Messerli, Markus

2016-03-01

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

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

PubMed

Chalk, Annabel; Page, Sean

2016-03-01

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

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

PubMed

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

2017-01-01

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

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services.

PubMed

Ewen, Heidi H; Washington, Tiffany R; Emerson, Kerstin G; Carswell, Andrew T; Smith, Matthew Lee

2017-03-22

Background: The majority of older adults prefer to remain in their homes, or to "age-in-place." To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results : When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions : Findings suggest that older adults' residential environment is associated with their health status and HCBS utilization. Building upon the Person-Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

PubMed Central

Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

2017-01-01

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place. PMID:28327507

The Expanding Role of Community-Based Organizations: Implications for Vocational Education. Occasional Paper No. 90.

ERIC Educational Resources Information Center

Poulard, Othello W.

Community-based organizations (CBOs) are neighborhood-based groups committed to providing human services to poor and minority individuals. The charge that government ineptness generates a need for CBOs is supported by examination of the federal government's operation of the general revenue sharing program. A project set up by CBOs collected data…

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa

PubMed Central

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors—such as age, health status and coping styles—our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family’s changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level. PMID:27741239

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

PubMed

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

2012-01-01

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

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

PubMed

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

2018-05-01

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

Lessons from community-based payment for ecosystem service schemes: from forests to rangelands.

PubMed

Dougill, Andrew J; Stringer, Lindsay C; Leventon, Julia; Riddell, Mike; Rueff, Henri; Spracklen, Dominick V; Butt, Edward

2012-11-19

Climate finance investments and international policy are driving new community-based projects incorporating payments for ecosystem services (PES) to simultaneously store carbon and generate livelihood benefits. Most community-based PES (CB-PES) research focuses on forest areas. Rangelands, which store globally significant quantities of carbon and support many of the world's poor, have seen little CB-PES research attention, despite benefitting from several decades of community-based natural resource management (CBNRM) projects. Lessons from CBNRM suggest institutional considerations are vital in underpinning the design and implementation of successful community projects. This study uses documentary analysis to explore the institutional characteristics of three African community-based forest projects that seek to deliver carbon-storage and poverty-reduction benefits. Strong existing local institutions, clear land tenure, community control over land management decision-making and up-front, flexible payment schemes are found to be vital. Additionally, we undertake a global review of rangeland CBNRM literature and identify that alongside the lessons learned from forest projects, rangeland CB-PES project design requires specific consideration of project boundaries, benefit distribution, capacity building for community monitoring of carbon storage together with awareness-raising using decision-support tools to display the benefits of carbon-friendly land management. We highlight that institutional analyses must be undertaken alongside improved scientific studies of the carbon cycle to enable links to payment schemes, and for them to contribute to poverty alleviation in rangelands.

Lessons from community-based payment for ecosystem service schemes: from forests to rangelands

PubMed Central

Dougill, Andrew J.; Stringer, Lindsay C.; Leventon, Julia; Riddell, Mike; Rueff, Henri; Spracklen, Dominick V.; Butt, Edward

2012-01-01

Climate finance investments and international policy are driving new community-based projects incorporating payments for ecosystem services (PES) to simultaneously store carbon and generate livelihood benefits. Most community-based PES (CB-PES) research focuses on forest areas. Rangelands, which store globally significant quantities of carbon and support many of the world's poor, have seen little CB-PES research attention, despite benefitting from several decades of community-based natural resource management (CBNRM) projects. Lessons from CBNRM suggest institutional considerations are vital in underpinning the design and implementation of successful community projects. This study uses documentary analysis to explore the institutional characteristics of three African community-based forest projects that seek to deliver carbon-storage and poverty-reduction benefits. Strong existing local institutions, clear land tenure, community control over land management decision-making and up-front, flexible payment schemes are found to be vital. Additionally, we undertake a global review of rangeland CBNRM literature and identify that alongside the lessons learned from forest projects, rangeland CB-PES project design requires specific consideration of project boundaries, benefit distribution, capacity building for community monitoring of carbon storage together with awareness-raising using decision-support tools to display the benefits of carbon-friendly land management. We highlight that institutional analyses must be undertaken alongside improved scientific studies of the carbon cycle to enable links to payment schemes, and for them to contribute to poverty alleviation in rangelands. PMID:23045714

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2011-09-01

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

Educating for Community Change: Higher Education's Proposed Role in Community Transformation through the Federal Promise Neighborhood Policy

ERIC Educational Resources Information Center

Hudson, Elizabeth

2013-01-01

This study investigated a federal comprehensive community initiative, the Promise Neighborhood initiative, in order to understand higher education community engagement in an embedded context. Promise Neighborhood programs aim to create a place-based system of family and education services that can support youth from early childhood through college…

Decentralizing provision of mental health care in Sri Lanka.

PubMed

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

2017-04-01

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

Using peer support groups to enhance community integration of veterans in transition.

PubMed

Drebing, Charles E; Reilly, Erin; Henze, Kevin T; Kelly, Megan; Russo, Anthony; Smolinsky, John; Gorman, Jay; Penk, Walter E

2018-05-01

Peer support groups, also known as "self-help groups," provide a unique tool for helping veterans working through the military-to-civilian transition to achieve higher levels of social support and community integration. The number and variety of community-based peer support groups has grown to the point that there are now more visits to these groups each year than to mental health professionals. The focus of these groups on the provision of social support, the number and variety of groups, the lack of cost, and their availability in the community make them a natural transition tool for building community-based social support. A growing literature suggests that these groups are associated with measurable improvements in social support, clinical symptoms, self-efficacy and coping. For clinical populations, the combination of peer support groups and clinical care results in better outcomes than either alone. Given this evidence, we suggest clinical services use active referral strategies to help veterans engage in peer support groups as a means of improving community reintegration and clinical outcomes. Finally, suggestions for identifying appropriate peer support groups and assisting with active referrals are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychological Community Integration of Individuals With Serious Mental Illness.

PubMed

Pahwa, Rohini; Kriegel, Liat

2018-06-01

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

Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.

PubMed

Formica, Scott W; Apsler, Robert; Wilkins, Lindsay; Ruiz, Sarah; Reilly, Brittni; Walley, Alexander Y

2018-04-01

Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function. We sent an online screening questionnaire to police and fire departments in all 351 communities in Massachusetts to find instances in which they collaborated with a community-based public health agency to implement a post-overdose outreach and support program. We conducted telephone interviews with communities that implemented this type of program and categorized programs based on their structure, outreach approach, and other key characteristics. Police and fire personnel from 110 of the 351 communities in Massachusetts (31% response rate) completed the screening survey. Among respondents, 21% (23/110) had implemented a collaborative, community-based, post-overdose program with a well-defined process to connect overdose survivors and their personal networks with support services or addiction treatment services. Using data from the interviews, we identified four types of programs: (1) Multi-Disciplinary Team Visit, (2) Police Visit with Referrals, (3) Clinician Outreach, and (4) Location-Based Outreach. This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose. Copyright © 2018 Elsevier B.V. All rights reserved.

Developing a community based service model for disability: Listening to the needs of all beneficiaries and providers.

PubMed

Collins, Katrina

2017-12-11

To inform the strategic and operational development of a community based service model at the Crann Centre, Cork, Ireland for SB children, adults, their families and providers. A needs assessment was conducted by gathering the views of multiple stakeholder perspectives within the SB community in the geographical region the Centre will serve. The intention is to create project deliverables that are responsive to the needs highlighted through this research. The study used a multi method design with a participatory research approach to explore the needs of SB individuals, families and providers. This involved in depth interviews, focus groups and online surveys. One hundred and fifty-nine respondents contributed to this qualitative needs assessment. The research established a range of psychosocial, clinical, vocational and educational issues causing ongoing difficulties for SB individuals and families. Providers highlighted supports that would benefit the social and clinical wellbeing of persons with SB. Collectively participants in the study reported that there was an absence of coordinated, continuous and comprehensive service delivery for the SB community in the region. This was amplified by geographical location of services and access to relevant supports. Consensus across stakeholders in this research pointed to the necessity for an innovative model of community based provision at the Crann Centre. This was described as offering a service with family at the core of an assets based model of practice. A key finding was the lack of importance placed on the social and emotional development of SB individuals. Traditionally participants described a singular focus on physical health through clinically defined treatment models. The desire for a social model of disability that informed health and wellbeing of SB individuals and families emerged as a prominent recommendation from the research.

Connecting Vulnerable Children and Families to Community-Based Programs Strengthens Parents' Perceptions of Protective Factors

ERIC Educational Resources Information Center

Hughes, Marcia; Joslyn, Allison; Wojton, Morella; O'Reilly, Mairead; Dworkin, Paul H.

2016-01-01

We employed principles from a nationally recognized prevention model on family support to investigate whether connecting vulnerable children to community-based programs and services through a statewide intervention system, the "Help Me Grow" program, strengthens parents' perceptions of protective factors. We used a parent survey modeled…

Community perspectives on post-Katrina mental health recovery in New Orleans.

PubMed

Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

2011-01-01

Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

End-of-Life Care and Dying: Issues Raised by Staff Supporting Older People with Intellectual Disability in Community Living Services

ERIC Educational Resources Information Center

Wiese, Michele; Stancliffe, Roger J.; Balandin, Susan; Howarth, Glennys; Dew, Angela

2012-01-01

Background: The aim of this study was to explore the current status of end-of-life care and dying of people with intellectual disability based on the experiences of staff in community living services. Materials and Methods: Focus groups and individual interviews were conducted, guided by grounded theory methodology. Results: The current status of…

Capacity and readiness for quality improvement among home and community-based service providers.

PubMed

Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

2016-01-01

The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

OA17 Compassionate communities: engaging with communities to support patients at end of life: a birmingham st. mary's hospice lived experience.

PubMed

Murungu, Diana; Woolf, Tina Swani Sarah

2015-04-01

Researchers carrying out a rebranding exercise for us in 2006 found that people from Black Asian and other Minority Ethnic (BAME) communities did not respond to their survey. This appeared to support anecdotal evidence from staff suggesting that the number of BAME patients accessing our services did not reflect the real need. To increase access to Hospice Care services for people from BAME communities. From April to July 2007 we used qualitative methods to carry out an exploratory study, to identify barriers to hospice care for patients from BAME communities. Currently we use community development methods to raise awareness of hospice services among BAME communities in Birmingham and Sandwell; while offering training and cultural/spiritual broker services to clinicians increasing their understanding of patients and families from these communities. There was no information about Hospice care services among people from BAME communities. Many people from BAME communities belong to cultural or spiritual groups whose members support each other during times of celebration, illness, death and bereavement. They refer to this support as 'our way of life'. Death, dying, and cancer are taboo subjects. In 2009 we set up the Compassionate Communities Project (CCP) within our Reaching People Programme (RPP) to increase access to our services for people from BAME communities. CCP enables community groups and service providers to work together in end of life. Representatives from BAME communities help train clinicians on supporting people from their communities in end of life. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Community Health Worker-Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013.

PubMed

Rahmawati, Riana; Bajorek, Beata

2015-10-15

Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system.

Using Photovoice, Latina Transgender Women Identify Priorities in a New Immigrant-Destination State

PubMed Central

Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Simán, Florence; Garcia, Manuel; Abraham, Claire; Sun, Christina J.

2016-01-01

Little is known about the immigrant Latino/a transgender community in the southeastern United States. This study used photovoice, a methodology aligned with community-based participatory research, to explore needs, assets, and priorities of Latina transgender women in North Carolina. Nine immigrant Latina male-to-female transgender women documented their daily experiences through photography, engaged in empowerment-based photo-discussions, and organized a bilingual community forum to move knowledge to action. From the participants’ photographs and words, 11 themes emerged in three domains: daily challenges (e.g., health risks, uncertainty about the future, discrimination, and anxiety about family reactions); needs and priorities (e.g., health and social services, emotional support, and collective action); and community strengths and assets (e.g., supportive individuals and institutions, wisdom through lived experiences, and personal and professional goals). At the community forum, 60 influential advocates, including Latina transgender women, representatives from community-based organizations, health and social service providers, and law enforcement, reviewed findings and identified ten recommended actions. Overall, photovoice served to obtain rich qualitative insight into the lived experiences of Latina transgender women that was then shared with local leaders and agencies to help address priorities. PMID:27110226

Organizing uninsured safety-net access to specialist physician services.

PubMed

Hall, Mark A

2013-05-01

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

Preparing the workforce for healthy aging programs: the Skills for Healthy Aging Resources and Programs (SHARP) model.

PubMed

Frank, Janet C; Altpeter, Mary; Damron-Rodriguez, JoAnn; Driggers, Joann; Lachenmayr, Susan; Manning, Colleen; Martinez, Dana M; Price, Rachel M; Robinson, Patricia

2014-10-01

Current public health and aging service agency personnel have little training in gerontology, and virtually no training in evidence-based health promotion and disease management programs for older adults. These programs are rapidly becoming the future of our community-based long-term care support system. The purpose of this project was to develop and test a model community college career technical education program, Skills for Healthy Aging Resources and Programs (SHARP), for undergraduate college students, current personnel in aging service and community organizations, and others interested in retraining. A multidisciplinary cross-sector team from disciplines of public health, sociology, gerontology and nursing developed four competency-based courses that focus on healthy aging, behavior change strategies, program management, an internship, and an option for leader training in the Chronic Disease Self-Management Program. To enhance implementation and fidelity, intensive faculty development training was provided to all instructors and community agency partners. Baseline and postprogram evaluation of competencies for faculty and students was conducted. Process evaluation for both groups focused on satisfaction with the curricula and suggestions for program improvement. SHARP has been piloted five times at two community colleges. Trainees (n = 113) were primarily community college students (n = 108) and current aging service personnel (n = 5). Statistically significant improvements in all competencies were found for both faculty and students. Process evaluation outcomes identified the needed logical and component adaptations to enhance the feasibility of program implementation, dissemination, and student satisfaction. The SHARP program provides a well-tested, evidence-based effective model for addressing workforce preparation in support of healthy aging service program expansion and delivery. © 2014 Society for Public Health Education.

EnviroAtlas - Metrics for Austin, TX

EPA Pesticide Factsheets

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

Adapting to psychiatric disability and needs for home- and community-based care.

PubMed

Green, Carla A; Vuckovic, Nancy H; Firemark, Alison J

2002-03-01

The objective of the study was to describe adaptation strategies and use of formal and informal support by individuals with psychiatric disabilities, to delineate remaining needs, and to determine how home- and community-based services might address those needs. Using in-depth interviews and structured questionnaires, we examined functional status, adaptation, and needs for home- and community-based care among 33 severely mentally ill members of a large health maintenance organization. Despite success in community living, participants had significant functional deficits (physical and emotional), relied heavily on only one or two key informal caregivers, and often needed significant support from mental health professionals. Limited numbers of caregivers and social isolation placed participants at risk of negative outcomes if informal support resources were to be lost. Home- and community-based care interventions that attempt to increase informal support networks and provide instrumental help (cooking, cleaning, transport) on short notice during flare-ups could augment existing (but limited) informal caregiving, help severely mentally ill individuals remain independent, and reduce the likelihood that loss of an informal caregiver would result in unwanted outcomes.

ERMHAN: A Context-Aware Service Platform to Support Continuous Care Networks for Home-Based Assistance

PubMed Central

Paganelli, Federica; Spinicci, Emilio; Giuli, Dino

2008-01-01

Continuous care models for chronic diseases pose several technology-oriented challenges for home-based continuous care, where assistance services rely on a close collaboration among different stakeholders such as health operators, patient relatives, and social community members. Here we describe Emilia Romagna Mobile Health Assistance Network (ERMHAN) a multichannel context-aware service platform designed to support care networks in cooperating and sharing information with the goal of improving patient quality of life. In order to meet extensibility and flexibility requirements, this platform has been developed through ontology-based context-aware computing and a service oriented approach. We also provide some preliminary results of performance analysis and user survey activity. PMID:18695739

Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea.

PubMed

Kim, Sook-Nam; Choi, Soon-Ock; Shin, Seong Hoon; Ryu, Ji-Sun; Baik, Jeong-Won

2017-07-01

A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

Assessing support for supervised injection services among community stakeholders in London, Canada.

PubMed

Bardwell, Geoff; Scheim, Ayden; Mitra, Sanjana; Kerr, Thomas

2017-10-01

Few qualitative studies have examined support for supervised injection services (SIS), and these have been restricted to large cities. This study aimed to assess support for SIS among a diverse representation of community stakeholders in London, a mid-sized city in southwestern Ontario, Canada. This qualitative study was undertaken as part of the Ontario Integrated Supervised Injection Services Feasibility Study. We used purposive sampling methods to recruit a diversity of key informants (n=20) from five sectors: healthcare; social services; government and municipal services; police and emergency services; and the business and community sector. Interview data, collected via one-to-one semi structured interviews, were coded and analyzed using thematic analyses through NVivo 10 software. Interview participants unanimously supported the implementation of SIS in London. However, participant support for SIS was met with some implementation-related preferences and/or conditions. These included centralization or decentralization of SIS; accessibility of SIS for people who inject drugs; proximity of SIS to interview participants; and other services and strategies offered alongside SIS. The results of this study challenge the assumptions that smaller cities like London may be unlikely to support SIS. Community stakeholders were supportive of the implementation of SIS with some preferences or conditions. Interview participants had differing perspectives, but ultimately supported similar end goals of accessibility and reducing community harms associated with injection drug use. Future research and SIS programming should consider these factors when determining optimal service delivery in ways that increase support from a diversity of community stakeholders. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessing the vulnerability of human and biological communities to changing ecosystem services using a GIS-based multi-criteria decision support tool

USGS Publications Warehouse

Villarreal, Miguel; Norman, Laura M.; Labiosa, William B.

2012-01-01

In this paper we describe an application of a GIS-based multi-criteria decision support web tool that models and evaluates relative changes in ecosystem services to policy and land management decisions. The Santa Cruz Watershed Ecosystem Portfolio (SCWEPM) was designed to provide credible forecasts of responses to ecosystem drivers and stressors and to illustrate the role of land use decisions on spatial and temporal distributions of ecosystem services within a binational (U.S. and Mexico) watershed. We present two SCWEPM sub-models that when analyzed together address bidirectional relationships between social and ecological vulnerability and ecosystem services. The first model employs the Modified Socio-Environmental Vulnerability Index (M-SEVI), which assesses community vulnerability using information from U.S. and Mexico censuses on education, access to resources, migratory status, housing situation, and number of dependents. The second, relating land cover change to biodiversity (provisioning services), models changes in the distribution of terrestrial vertebrate habitat based on multitemporal vegetation and land cover maps, wildlife habitat relationships, and changes in land use/land cover patterns. When assessed concurrently, the models exposed some unexpected relationships between vulnerable communities and ecosystem services provisioning. For instance, the most species-rich habitat type in the watershed, Desert Riparian Forest, increased over time in areas occupied by the most vulnerable populations and declined in areas with less vulnerable populations. This type of information can be used to identify ecological conservation and restoration targets that enhance the livelihoods of people in vulnerable communities and promote biodiversity and ecosystem health.

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

PubMed

Mancini, Michael A

2018-02-01

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

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

PubMed Central

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

2016-01-01

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

Our Community, Our Schools: A Case Study of Program Design for School-Based Mental Health Services

ERIC Educational Resources Information Center

Capp, Gordon

2015-01-01

Schools face increasing demands to support the mental health needs of students and families; some estimate that 80 percent of students receive mental health services at school. Thus, schools face two daunting challenges: (1) to provide effective mental health support to students and (2) to address how mental health needs affect other students,…

Reckoning HIV/AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland.

PubMed

Root, Robin; Van Wyngaard, Arnau; Whiteside, Alan

2015-01-01

The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.

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

PubMed

Kesterton, Amy J; Cabral de Mello, Meena

2010-09-24

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

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

PubMed Central

2010-01-01

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

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

PubMed

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

A hybrid supported employment program for persons with schizophrenia in Japan.

PubMed

Fuller, T R; Oka, M; Otsuka, K; Yokoyama, N; Liberman, R P; Niwa, S I

2000-07-01

INTRODUCTION BY THE COLUMN EDITORS: Because the mental health system in Japan has emphasized hospital-based treatment (1), patients with schizophrenia often remain institutionalized for long periods, even after their symptoms have stabilized. In addition, the introduction of modern community-based methods of treatment and rehabilitation was delayed by an antipsychiatry movement in the 1970s and the ascendance of a reductionistic biological approach to services (2). Lack of adequate outpatient services and community residential care in Japan has been a serious obstacle to destigmatization of mental disorders and has contributed to the heavy burden and stress experienced by families of mentally ill persons (3). More than 80 percent of patients discharged from mental hospitals return to live with their families, who are ill prepared to provide the supportive services required for community tenure. Involvement in work activities can facilitate community reentry for people with serious and persistent mental illness because employment displaces symptoms, provides structure and meaning in daily life, offers socialization with peers, and permits workers to earn income for shelter and food. In this issue's Rehab Rounds column, the authors describe an innovative vocational rehabilitation program for patients with schizophrenia that was designed to overcome obstacles to discharge and community adjustment. The program at Yabuki Prefecture Psychiatric Hospital, in the northern prefecture of Fukushima, Japan, has been successful in training patients for competitive work while capitalizing on the importance of work in Japanese culture and its traditionally supportive employer-employee relationships. The program is termed "hybrid" because it combines elements of transitional employment with supported employment (4).

Geospatial information technology: an adjunct to service-based outreach and education.

PubMed

Faruque, Fazlay; Hewlett, Peggy O; Wyatt, Sharon; Wilson, Kaye; Lofton, Susan; Frate, Dennis; Gunn, Jennie

2004-02-01

This exemplar highlights how geospatial information technology was effective in supporting academic practice, faculty outreach, and education initiatives at the University of Mississippi School of Nursing. Using this cutting-edge technology created a community-based prototype for fully integrating point-of-service research, practice, and academics into a cohesive strategy to influence change within the health care delivery system. This exemplar discusses ways this knowledge benefits practice and curriculum development; informs critical decision making affecting the people we serve; underscores the vital role nurses play in linking this technology to practice; and develops community residents as partners in their own health and that of the community.

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

PubMed

Lillemoen, Lillian; Pedersen, Reidar

2015-04-17

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

An ontology-based system for context-aware and configurable services to support home-based continuous care.

PubMed

Paganelli, Federica; Giuli, Dino

2011-03-01

Continuous care models for chronic diseases pose several technology-oriented challenges for home-based care, where assistance services rely on a close collaboration among different stakeholders, such as health operators, patient relatives, and social community members. This paper describes an ontology-based context model and a related context management system providing a configurable and extensible service-oriented framework to ease the development of applications for monitoring and handling patient chronic conditions. The system has been developed in a prototypal version, and integrated with a service platform for supporting operators of home-based care networks in cooperating and sharing patient-related information and coordinating mutual interventions for handling critical and alarm situations. Finally, we discuss experimentation results and possible further research directions.

The role of a community coalition in the development of health services for the poor and uninsured.

PubMed

Bibeau, D L; Howell, K A; Rife, J C; Taylor, M L

1996-01-01

Access to primary health care for indigent citizens presents a dilemma for many communities in the United States. In response, communities have developed a variety of strategies to effectively deal with the problem. This article describes the evolution of a small free clinic into a comprehensive primary care clinic developed through the actions of a community-based coalition. The clinic originated within an umbrella organization for indigent residents as free medical service provided at a night shelter by a local physician once a week. Through a coalition of business, religious, medical, hospital, foundation, lay volunteer, county health department, and chamber of commerce representatives, the service was enlarged into a formal clinic operation with a small staff and volunteers providing services for about 3,500 patient visits each year. As the demand for services increased beyond resources, an expanded coalition created HealthServe Medical Center, a comprehensive primary care clinic operating 40 hours per week. The HealthServe Board is currently active in supporting service delivery at the clinic, with plans to serve 24,000 medical and dental visits annually by mid-1995. The evolution process was based upon the characteristics of effective community coalitions and the commitment of individuals from diverse community sectors.

Evolving Definitions of Autism and Impact on Eligibility for Developmental Disability Services: California Case Example

ERIC Educational Resources Information Center

Williams, Marian E.; Wheeler, Barbara Y.; Linder, Lisa; Jacobs, Robert A.

2017-01-01

When establishing eligibility for developmental disability (DD) services, definitions of specific diagnostic conditions, such as autism, impact policy. Under the Medicaid home and community-based waiver program, states have discretion in determining specific program or service eligibility criteria, the nature of supports to be provided, and the…

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

PubMed Central

Goeman, Dianne; King, Jordan; Koch, Susan

2016-01-01

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

Factors affecting success of an integrated community-based telehealth system.

PubMed

Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

2015-01-01

The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

The Digital Library for Earth System Education: A Progress Report from the DLESE Program Center

NASA Astrophysics Data System (ADS)

Marlino, M. R.; Sumner, T. R.; Kelly, K. K.; Wright, M.

2002-12-01

DLESE is a community-owned and governed digital library offering easy access to high quality electronic resources about the Earth system at all educational levels. Currently in its third year of development and operation, DLESE resources are designed to support systemic educational reform, and include web-based teaching resources, tools, and services for the inclusion of data in classroom activities, as well as a "virtual community center" that supports community goals and growth. "Community-owned" and "community-governed" embody the singularity of DLESE through its unique participatory approach to both library building and governance. DLESE is guided by policy development vested in the DLESE Steering Committee, and informed by Standing Committees centered on Collections, Services, Technology, and Users, and community working groups covering a wide variety of interest areas. This presentation highlights both current and projected status of the library and opportunities for community engagement. It is specifically structured to engage community members in the design of the next version of the library release. The current Version 1.0 of the library consists of a web-accessible graphical user interface connected to a database of catalogued educational resources (approximately 3000); a metadata framework enabling resource characterization; a cataloging tool allowing community cataloging and indexing of materials; a search and discovery system allowing browsing based on topic, grade level, and resource type, and permitting keyword and controlled vocabulary-based searches; and a portal website supporting library use, community action, and DLESE partnerships. Future stages of library development will focus on enhanced community collaborative support; development of controlled vocabularies; collections building and community review systems; resource discovery integrating the National Science Education Standards and geography standards; Earth system science vocabulary; georeferenced discovery; and ultimately, AAAS Benchmarks. DLESE is being designed from the outset to support resource discovery across a diverse, federated network of holdings and collections, including the Alexandria Digital Library Earth Prototype (ADL/ADEPT), NASA education collections, the DLESE reviewed collection, and other community-held resources that have been cataloged and indexed as part of the overall DLESE collections.

Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

PubMed

Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

2014-01-01

This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Michel, Franck; Montagnat, Johan; Glatard, Tristan

2012-01-01

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

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

PubMed

Sethi, Bharati

2013-10-01

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

Post-Project Assessment of Community-Supported Emergency Transport Systems for Health Care Services in Tanzania

ERIC Educational Resources Information Center

Ahluwalia, Indu B.; Robinson, Dorcas; Vallely, Lisa; Myeya, Juliana; Ngitoria, Lukumay; Kitambi, Victor; Kabakama, Alfreda

2012-01-01

We examined the continuation of community-organized and financed emergency transport systems implemented by the Community-Based Reproductive Health Project (CBRHP) from 1998 to 2000 in two rural districts in Tanzania. The CBRHP was a multipronged program, one component of which focused on affordable transport to health facilities from the…

Dublin Institute of Technology's Programme for Students Learning with Communities: A Critical Account of Practice

ERIC Educational Resources Information Center

Gamble, Elena; Bates, Catherine

2011-01-01

Purpose: This paper aims to focus on the process of critically evaluating Dublin Institute of Technology's Programme for Students Learning With Communities after its first year of operation. The programme supports and promotes community-based learning/service-learning across DIT. Design/methodology/approach: The paper is presented in the form of a…

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

PubMed

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

2017-07-11

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

Project FIND: a profile of a community-based senior services agency.

PubMed

Lockwood, Andrée

2007-01-01

Project FIND has been providing innovative supportive housing, nutrition, and social support to homeless and low- and moderate-income seniors on New York City's West Side since 1967. This article profiles this nonprofit, community-based agency, which was established to meet the needs of the frail and isolated elderly, and has continued to grow and evolve in response to changing demographics, neighborhood gentrification, and needs of both the homeless as well as the active "younger old." The article describes creative programming that has distinguished Project FIND's response to seniors' needs beyond basic housing and nutrition. It also explores what it takes to successfully provide senior services using limited resources and examines challenges for the future both nationally and for the agency.

The Evidence Information Service as a New Platform for Supporting Evidence-Based Policy: A Consultation of UK Parliamentarians

ERIC Educational Resources Information Center

Lawrence, Natalia S.; Chambers, Jemma C.; Morrison, Sinead M.; Bestmann, Sven; O'Grady, Gerard; Chambers, Christopher D.; Kythreotis, Andrew

2017-01-01

The value of evidence-based policy is well established, yet major hurdles remain in connecting policymakers with the wider research community. Here we assess whether a UK Evidence Information Service (EIS) could facilitate interaction between parliamentarians and research professionals. Fifty-six UK parliamentarians were interviewed to gauge the…

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru

PubMed Central

Perez-Brumer, Amaya G.; Reisner, Sari L.; McLean, Sarah A.; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H.; Sanchez, Jorge; Clark, Jesse L.; Mimiaga, Matthew J.; Lama, Javier R.

2017-01-01

Abstract Introduction: In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Methods: Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18–44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Results: Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). Conclusion: This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts. PMID:28362064

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru.

PubMed

Perez-Brumer, Amaya G; Reisner, Sari L; McLean, Sarah A; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Lama, Javier R

2017-02-28

In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts.

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

PubMed Central

2012-01-01

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings. PMID:22769593

Finding Funding: A Guide to Federal Sources for Out-of-School TIme and Community School Initiatives. Revised and Updated.

ERIC Educational Resources Information Center

Padgette, Heather Clapp

Noting the growing nation-wide demand for affordable, high-quality, out-of-school time and community school programs, this guide is intended to assist program developers, policy makers, and community leaders identify federal funding sources to support out-of-school time or broader-based community school services. The guide provides an overview of…

Community health workers, recipients' experiences and constraints to care in South Africa - a pathway to trust.

PubMed

Nxumalo, Nonhlanhla; Goudge, Jane; Manderson, Lenore

2016-01-01

Community health workers (CHWs) affiliated with community-based organisations are central to the implementation of primary health care in district health services in South Africa. Here, we explore factors that affect the provision of and access to care in two provinces - Gauteng and Eastern Cape. Drawing on narratives of care recipients and the CHWs who support them, we illustrate the complex issues surrounding health maintenance and primary care outreach in poor communities, and describe how the intimate interactions between providers and recipients work to build trust. In the study we report here, householders in Gauteng Province had poor access to health care and other services, complicating the impoverished circumstances of their everyday lives. The limited resources available to CHWs hindered their ability to meet householders' needs and for householders to benefit from existing services. CHWs in the Eastern Cape were better able to address the needs of poor householders because of the organisational support available to them. Based on an ethos of integrated and holistic care, this enabled the CHWs to address the recipients' context-related needs, and health and medical needs, while building greater levels of trust with their clients.

Service-Based Learning for Residents: A Success for Communities and Medical Education.

PubMed

Gefter, Liana; Merrell, Sylvia Bereknyei; Rosas, Lisa G; Morioka-Douglas, Nancy; Rodriguez, Eunice

2015-01-01

Community-based service-learning opportunities could support residents' acquisition of Accreditation Council for Graduate Medical Education (ACGME) competencies, but this concept has not been tested, and such programs are difficult to find. The objective of this work was to assess the value and the ACGME competency relevance of a service-learning program for residents that could be easily replicated nationally. Forty-one family medicine residents from three training programs participated in the Stanford Youth Diabetes Coaches Program at six high schools in California and Georgia serving minority students of low socioeconomic status. Residents completed online surveys to provide qualitative feedback and assess the program's impact on their acquisition of residency program competencies and self-management support proficiencies, including prior use and planned use of action plans-a key self-management support strategy. Ninety-five percent of residents indicated that the program was a valuable experience that contributed to acquisition of residency program competencies, including interpersonal and communication skills and communication with teens. Compared with baseline, significantly more residents reported intention to use action plans with patients following participation. Themes from qualitative feedback included: valuing the overall experience, increasing opportunities to practice teaching, enhancing their ability to communicate with adolescents, contributing to the health of the community, recognizing the potential of action plans, and increasing intent to use action plans. This pilot demonstrated that a brief service-learning program can enhance standard residency curriculum by encouraging acquisition of ACGME competencies and promoting utilization of self-management support in clinical practice.

HIV and Sexually Transmitted Infection Testing Among High-Risk Youths: Supporting Positive Opportunities With Teens (SPOT) Youth Center

PubMed Central

Garbutt, Jane; Kaushik, Gaurav N.

2015-01-01

Objectives. We investigated the development of and service utilization at Supporting Positive Opportunities with Teens (SPOT)—a community-based health and social service facility in St. Louis, Missouri, for youths that focuses on increasing HIV and sexually transmitted infection (STI) testing. Methods. We identified the US-based, co-located youth health and social service models that guided the establishment of the SPOT. We analyzed the first 5 years (2008–2013) of service delivery and utilization data. Results. During the study period, the SPOT provided services for 8233 youths in 37 480 visits. The 5 most utilized services included HIV and STI screening, food, transportation, contraception, and case management. A total of 9812 gonorrhea and chlamydia screenings revealed 1379 (14.1%) cases of chlamydia and 437 (4.5%) cases of gonorrhea, and 5703 HIV tests revealed 59 HIV infections (1.0%); 93.0% of patients found to have an STI were treated within a 5-day window. Conclusions. Co-locating health and social services in informal community settings attracts high-risk youths to utilize services and can prove instrumental in reducing STI burden in this population. PMID:25973833

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

PubMed

Goeman, Dianne; King, Jordan; Koch, Susan

2016-12-07

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

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

PubMed

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

2016-01-01

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

A Community Health Worker–Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013

PubMed Central

Bajorek, Beata

2015-01-01

Introduction Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. Methods A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. Results CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. Conclusion CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system. PMID:26469948

How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda.

PubMed

Ware, Norma C; Wyatt, Monique A; Asiimwe, Stephen; Turyamureeba, Bosco; Tumwesigye, Elioda; van Rooyen, Heidi; Barnabas, Ruanne V; Celum, Connie L

2016-01-01

The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. We conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building "social bridges," interpersonal connections established and developed through repeated face-to-face contact between counsellors and prospective users of HIV treatment and male circumcision services. Social bridges link communities to the service system, inspiring individuals to overcome obstacles and access care.

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

PubMed

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

2015-11-01

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

Current status of psychiatric rehabilitation in Portugal: A national survey.

PubMed

Teixeira, Carina; Santos, Eduardo; Abreu, Manuel Viegas; Rogers, E Sally

2015-09-01

This article reports on the current state of psychiatric rehabilitation in Portugal. A paper-and-pencil survey was sent to 70 institutions to inquire about the provision of psychiatric rehabilitation services and programs. With a response rate of 40%, 14% of institutions indicated that supported education was provided, 36% offered nonmainstream vocational training, and 29% provided supported employment; none provided evidence-based Individual Placement and Support. Permanent group homes in the community (29%) followed by transitional group homes on institutional grounds (18%) were the most common residential services, with supported housing services (14%) offered less frequently. Finally, 93% of institutions offered occupational activities, 61% provided multifamily psychoeducation, and 36% provided single-family psychoeducation. Despite recent national initiatives promoting effective psychiatric rehabilitation services, supported employment, supported education, and supported housing are not widely implemented in Portugal. To achieve better outcomes for clients, it is critical that evidence-based and promising practices be extensively disseminated. (c) 2015 APA, all rights reserved).

Examining the Relationship Between Intimate Partner Violence and Concern for Animal Care and Safekeeping.

PubMed

Wuerch, Melissa A; Giesbrecht, Crystal J; Price, Jill A B; Knutson, Tracy; Wach, Frances

2017-03-01

The current study examined the knowledge and experience of animal welfare and human service providers in urban and rural communities of Saskatchewan, Canada. Nine exploratory qualitative interviews were conducted to gather a more in-depth understanding of whether the concern for animal care and safekeeping impacts the decision to leave situations of intimate partner violence. The interviews were semistructured and guided by four questions, which were designed, reviewed, and revised based on feedback from a community-based research team. Thematic analysis highlighted important findings, allowing for the generation of suggestions for improvement of current supports and services offered. The current study findings suggest that concern for animal care and safekeeping creates significant barriers regarding the decision to leave situations of intimate partner violence and abuse, warranting further research to inform support services and resources within a Canadian context.

Pumps, feed and sets: is procurement limiting outcomes?

PubMed

Ojo, Omorogieva

This article aims to review the unique ways in which enteral feed, ancillary items and pumps are procured in the UK and to evaluate whether these are inhibiting innovation and reducing the choices of patients. There are a number of models that have been developed across the UK for the procurement of enteral feed, feeding accessories and pump. The two most common are the hospital-based nutrition support team, which may have an overarching role in the community, and the home enteral nutrition (HEN) team, a multidisciplinary community-based team with skilled health professionals dedicated to the delivery of the enteral nutrition service. While the HEN service has its advantages over other models in the community, it is primarily driven by its clinical role. The lack of significant opportunity for clinical audits and research within the service limits the prospects for service improvement, innovation and patients' choices.

Mental/Behavioral Health Services: Medicaid Home and Community-Based Services 1915(c) Waiver Allocation for People With Intellectual and Developmental Disabilities.

PubMed

Friedman, Carli; Lulinski, Amie; Rizzolo, Mary C

2015-08-01

Research has indicated that people who have intellectual and developmental disabilities (IDD) appear to be more vulnerable to having a co-existing psychiatric diagnosis. This study examined Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver applications for people with IDD to determine the mental/behavioral health services proposed. We found that a large variance exists across states in projected spending for services, spending per participant, annual hours of service per participant, and hourly reimbursement rates. Moreover, compared to overall funding we found a general lack of state commitment to mental/behavioral services. States must shore up the capacity of their HCBS 1915 (c) waivers to support people with behavioral challenges in addition to IDD in order to assure that services continue to be delivered in the least restrictive environment appropriate.

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

PubMed

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

2007-05-21

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

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

PubMed

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

2014-09-01

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

Community resources for frail older patients.

PubMed Central

Borgenicht, K; Carty, E; Feigenbaum, L Z

1997-01-01

The goal of community-based services for frail older patients is to help them achieve the greatest degree of functional ability and independence. The services available include case management, geriatric assessment, adult day health care, home health services, and the Program for All-inclusive Care for the Elderly (PACE). Definitive criteria for referral have not been established, but without some targeting, the efficacy of these services remains uncertain. Targeting criteria identified include dependency in 2 or more activities of daily living, no family support, dementia, many long-term illnesses, and many hospital stays. Although efficacy and cost-effectiveness remain uncertain, patients, families, and physicians generally report these services to be helpful. PMID:9348762

ERIC Review: The Impact of Financial Crisis on Access and Support Services in Community Colleges.

ERIC Educational Resources Information Center

Sheldon, Caroline Q.

2003-01-01

Discusses the impact of fiscal contraction on community colleges. Explores how reduced state appropriations have adversely affected community college instruction and student support systems. Research shows that because instruction and student support services suffer when budget is reduced, fiscal contraction can hamper the ability of colleges to…

The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden.

PubMed

Cheng, Jui-Fen; Huang, Xuan-Yi; Lin, Mei-Jue; Wang, Ya-Hui; Yeh, Tzu-Pei

2018-02-01

To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. A longitudinal quasi-experimental quantitative design. The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance. © 2017 John Wiley & Sons Ltd.

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

PubMed

Chiu, Frank P.F.

2000-01-01

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

Medicaid program; home and community-based services. Health Care Financing Administration (HCFA), HHS. Final rule with comment period.

PubMed

2000-10-10

This final rule with comment period expands State flexibility in providing prevocational, educational, and supported employment services under the Medicaid home and community-based services waiver provisions currently found in section 1915(c) of the Social Security Act (the Act); and incorporates the self-implementing provisions of section 4743 of the Balanced Budget Act of 1997 that amends section 1915(c)(5) of the Act to delete the requirements that an individual have prior institutionalization in a nursing facility or intermediate care facility for the mentally retarded before becoming eligible for the expanded habilitation services. In addition, we are making a number of technical changes to update or correct the regulations.

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

NASA Astrophysics Data System (ADS)

Manduca, C. A.

2017-12-01

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

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

PubMed

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

2014-09-01

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

Program planning for a community pharmacy residency support service using the nominal group technique.

PubMed

Rupp, Michael T

2002-01-01

To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

"Working with COW": Social Work Supporting Older Women Living in the Community.

PubMed

Rawsthorne, Margot; Ellis, Kayleigh; de Pree, Alison

2017-01-01

Australia, like all developed Western countries, is experiencing a demographic shift resulting in an increasing proportion of the population being over the age of 65 years. Contrary to stereotypes, the vast majority of older people live independently in communities. This article explores the potential of social work practice informed by community development principles to enable socially disadvantaged older women to live in vibrant and supportive communities, in which they feel safe and are able to access the support services they need. It argues that participation in social action not only builds older women's well-being but also enables them to become (or continue to be) agents for social change in local communities. Adopting a community-based research methodology, this article draws on a decade of community development practice with the Concerned Older Women's (COW) Group. This data suggests that community development practice based on participation, empowerment, and social action founded on respectful relationships may accrue significant benefits to individuals and the broader community. This social work practice creates the social conditions to facilitate older women's capacity to work collectively to achieve social change, challenging ageist stereotypes.

42 CFR 441.580 - Data collection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Data collection. 441.580 Section 441.580 Public... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.580 Data... year. (c) The number of individuals served broken down by type of disability, age, gender, education...

Improving Interpersonal Communication through Community Service

ERIC Educational Resources Information Center

Hoffman, August John; Wallach, Julie; Sanchez, Eduardo; Afkhami, Hasti

2009-01-01

The current study sought to determine if community based gardening projects would reduce perceptions of the need to use communication devices--cell phones or text messaging--and increase the likelihood of participating in future volunteer projects. Results strongly support the predictions in that the experimental group post-test mean score of the…

Learning Communities in Teacher Education Programs: Four Success Stories.

ERIC Educational Resources Information Center

Cox, Barbara, Ed.

This report describes a program implemented by the Tomas Rivera Center (Claremont, California) to increase the number of well-prepared Latino teachers. Based on the concept of learning communities, the program aims to reduce the isolation experienced by minority students, offer support services that help nontraditional students satisfy academic…

Effectiveness of Student Support Services Programs at California Community Colleges

ERIC Educational Resources Information Center

Sanchez, Mark Christopher

2010-01-01

Historically, first-generation, low-income, and students with disabilities have had very high attrition rates at California Community Colleges and institutions of higher education in general. Based on figures compiled by the National Center for Educational Statistics in 2004, 4.5 million low-income, first-generation college students comprise…

Partnering to run a community-based program for deaf-blind young adults.

PubMed

Riester, A E

1992-12-01

Community-based programs that assist deaf-blind young adults with living skills can be a cost effective alternative to institutional care. Their unique medical, psychosocial training, and daily living needs require services and support from a variety of agencies and providers. The elements and concepts necessary to conduct a program 24 hours a day for young adults who are deaf and blind includes sound management, realistic staff expectations for clients, developmentally appropriate activities, family participation in planning accessible medical and psychological services, and close collaboration with universities and community organizations. Management must also be sensitive to the emotional concerns of the staff and provide ongoing opportunities for supervision and training.

Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe.

PubMed

Patel, Diana; Matyanga, Priscilla; Nyamundaya, Tichaona; Chimedza, Delia; Webb, Karen; Engelsmann, Barbara

2012-07-11

Early diagnosis of children living with HIV is a prerequisite for accessing timely paediatric HIV care and treatment services and for optimizing treatment outcomes. Testing of HIV-exposed infants at 6 weeks and later is part of the national prevention of mother to child transmission (PMTCT) of HIV programme in Zimbabwe, but many opportunities to test infants and children are being missed. Early childhood development (ECD) playcentres can act as an entry point providing multiple health and social services for orphans and vulnerable children (OVC) under 5 years, including facilitating access to HIV treatment and care. Sixteen rural community-based, community-run ECD playcentres were established to provide health, nutritional and psychosocial support for OVC aged 5 years and younger exposed to or living with HIV, coupled with family support groups (FSGs) for their families/caregivers. These centres were located in close proximity to health centres giving access to nurse-led monitoring of 697 OVC and their caregivers. Community mobilisers identified OVC within the community, supported their registration process and followed up defaulters. Records profiling each child's attendance, development and health status (including illness episodes), vaccinations and HIV status were compiled at the playcentres and regularly reviewed, updated and acted upon by nurse supervisors. Through FSGs, community cadres and a range of officers from local services established linkages and built the capacity of parents/caregivers and communities to provide protection, aid psychosocial development and facilitate referral for treatment and support. Available data as of September 2011 for 16 rural centres indicate that 58.8% (n=410) of the 697 children attending the centres were tested for HIV; 18% (n=74) tested positive and were initiated on antibiotic prophylaxis. All those deemed eligible for antiretroviral therapy were commenced on treatment and adherence was monitored. This community-based playcentre model strengthens comprehensive care (improving emotional, cognitive and physical development) for OVC younger than 5 years and provides opportunities for caregivers to access testing, care and treatment for children exposed to, affected by and infected with HIV in a secure and supportive environment. More research is required to evaluate barriers to counselling and testing of young children and the long-term impact of playcentres upon specific health and developmental outcomes.

The Self-Concept of Students in Remediation in a Rural Community College in Mississippi

ERIC Educational Resources Information Center

Wicks, Corky Fitzgerald

2017-01-01

Identifying students who may require additional assistance and coaching based on their self-concept score will also allow community colleges to provide additional support services for those students. If there is a difference in self-concept among students in a Mississippi community college, leaders might be able to use self-concept as a way of…

A study of human resource competencies required to implement community rehabilitation in less resourced settings.

PubMed

Gilmore, Brynne; MacLachlan, Malcolm; McVeigh, Joanne; McClean, Chiedza; Carr, Stuart; Duttine, Antony; Mannan, Hasheem; McAuliffe, Eilish; Mji, Gubela; Eide, Arne H; Hem, Karl-Gerhard; Gupta, Neeru

2017-09-22

It is estimated that over one billion persons worldwide have some form of disability. However, there is lack of knowledge and prioritisation of how to serve the needs and provide opportunities for people with disabilities. The community-based rehabilitation (CBR) guidelines, with sufficient and sustained support, can assist in providing access to rehabilitation services, especially in less resourced settings with low resources for rehabilitation. In line with strengthening the implementation of the health-related CBR guidelines, this study aimed to determine what workforce characteristics at the community level enable quality rehabilitation services, with a focus primarily on less resourced settings. This was a two-phase review study using (1) a relevant literature review informed by realist synthesis methodology and (2) Delphi survey of the opinions of relevant stakeholders regarding the findings of the review. It focused on individuals (health professionals, lay health workers, community rehabilitation workers) providing services for persons with disabilities in less resourced settings. Thirty-three articles were included in this review. Three Delphi iterations with 19 participants were completed. Taken together, these produced 33 recommendations for developing health-related rehabilitation services. Several general principles for configuring the community rehabilitation workforce emerged: community-based initiatives can allow services to reach more vulnerable populations; the need for supportive and structured supervision at the facility level; core skills likely include case management, social protection, monitoring and record keeping, counselling skills and mechanisms for referral; community ownership; training in CBR matrix and advocacy; a tiered/teamwork system of service delivery; and training should take a rights-based approach, include practical components, and involve persons with disabilities in the delivery and planning. This research can contribute to implementing the WHO guidelines on the interaction between the health sector and CBR, particularly in the context of the Framework for Action for Strengthening Health Systems, in which human resources is one of six components. Realist syntheses can provide policy makers with detailed and practical information regarding complex health interventions, which may be valuable when planning and implementing programmes.

Rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems in the presence of trees.

PubMed

Scholz, Miklas; Uzomah, Vincent C

2013-08-01

The retrofitting of sustainable drainage systems (SuDS) such as permeable pavements is currently undertaken ad hoc using expert experience supported by minimal guidance based predominantly on hard engineering variables. There is a lack of practical decision support tools useful for a rapid assessment of the potential of ecosystem services when retrofitting permeable pavements in urban areas that either feature existing trees or should be planted with trees in the near future. Thus the aim of this paper is to develop an innovative rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems close to trees. This unique tool proposes the retrofitting of permeable pavements that obtained the highest ecosystem service score for a specific urban site enhanced by the presence of trees. This approach is based on a novel ecosystem service philosophy adapted to permeable pavements rather than on traditional engineering judgement associated with variables based on quick community and environment assessments. For an example case study area such as Greater Manchester, which was dominated by Sycamore and Common Lime, a comparison with the traditional approach of determining community and environment variables indicates that permeable pavements are generally a preferred SuDS option. Permeable pavements combined with urban trees received relatively high scores, because of their great potential impact in terms of water and air quality improvement, and flood control, respectively. The outcomes of this paper are likely to lead to more combined permeable pavement and tree systems in the urban landscape, which are beneficial for humans and the environment. Copyright © 2013 Elsevier B.V. All rights reserved.

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

PubMed Central

2015-01-01

Abstract As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro‐providers – very small community‐based organizations, which can work directly with individuals. These micro‐providers are assumed to be able to cater for the ‘seldom heard’ groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer‐reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small‐scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self‐organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community‐based micro‐providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization. PMID:27840462

Investigating the impact of a community home-based care on mental health and anti-retroviral therapy adherence in people living with HIV in Nepal: a community intervention study.

PubMed

Pokhrel, Khem N; Sharma, Vidya D; Pokhrel, Kalpana G; Neupane, Sanjeev R; Mlunde, Linda B; Poudel, Krishna C; Jimba, Masamine

2018-06-07

HIV-positive people often experience mental health disorders and engage in substance use when the disease progresses. In resource limited settings, mental health services are not integrated into HIV services. In Nepal, HIV-positive people do receive psychosocial support and other basic health care services from a community home-based care intervention; however, the effects of the intervention on health outcomes is not yet known. Therefore, we examined the impact of the intervention on mental health and antiretroviral therapy (ART) adherence. We conducted an intervention study to identify the effects of a community home-based care intervention on mental health disorders, substance use, and non-adherence to ART among HIV-positive people in Nepal from March to August 2015. In total, 344 participated in the intervention and another 338 were in the control group. The intervention was comprised of home-based psychosocial support and peer counseling, adherence support, basic health care, and referral services. We measured the participants' depression, anxiety, stress, substance use, and non-adherence to ART. We applied a generalized estimating equation to examine the effects of intervention on health outcomes. The intervention had positive effects in reducing depressive symptoms [Adjusted Odds Ratio (AOR) = 0.44, p < 0.001)], anxiety (AOR = 0.54, p = 0.014), stress (β = - 3.98, p < 0.001), substance use (AOR = 0.51, p = 0.005), and non-adherence to ART (AOR = 0.62, p = 0.025) among its participants at six-month follow-up. The intervention was effective in reducing mental health disorders, substance use, and non-adherence to ART among HIV-positive people. Community home-based care intervention can be applied in resource limited setting to improve the mental health of the HIV-positive people. Such intervention should be targeted to include more HIV-positive people in order to improve their ART adherence. ClinicalTrials.gov ID: NCT03505866 , Released Date: April 20, 2018.

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

NASA Technical Reports Server (NTRS)

Noll, Carey; Michael, Patrick

2016-01-01

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

Collecting data along the continuum of prevention and care: a Continuous Quality Improvement approach.

PubMed

Indyk, Leonard; Indyk, Debbie

2006-01-01

For the past 14 years, a team of applied social scientists and system analysts has worked with a wide variety of Community- Based Organizations (CBO's), other grassroots agencies and networks, and Medical Center departments to support resource, program, staff and data development and evaluation for hospital- and community-based programs and agencies serving HIV at-risk and affected populations. A by-product of this work has been the development, elaboration and refinement of an approach to Continuous Quality Improvement (CQI) which is appropriate for diverse community-based providers and agencies. A key component of our CQI system involves the installation of a sophisticated relational database management and reporting system (DBMS) which is used to collect, analyze, and report data in an iterative process to provide feedback among the evaluators, agency administration and staff. The database system is designed for two purposes: (1) to support the agency's administrative internal and external reporting requirements; (2) to support the development of practice driven health services and early intervention research. The body of work has fostered a unique opportunity for the development of exploratory service-driven research which serves both administrative and research needs.

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.

[The regional cooperation of medical services and a nutritional support team].

PubMed

Maruyama, Michio

2006-12-01

"Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.

Linkage strategies for successful and sustainable partnerships: a practical framework for community engagement by palliative care services.

PubMed

Rosenberg, John

2018-01-01

Partnerships are central to the success of linkages between palliative care services and the communities they support. The goal of partnership is to achieve more than individuals and groups can achieve on their own, yet the concept is often poorly understood. A clearly articulated understanding of partnership is a powerful step in transforming an organization's engagement with the community. The aim of this workshop is to enable participants to gain a clear understanding of partnership, understand the recognized evidence-based principles of establishing and maintaining partnerships, and identify practical approaches to partnering to take back to their organizations and communities.

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

PubMed Central

Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-01-01

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

Social inclusion and mental health.

PubMed

Cobigo, Virginie; Stuart, Heather

2010-09-01

Recent research on approaches to improving social inclusion for people with mental disabilities is reviewed. We describe four approaches (or tools) that can be used to improve social inclusion for people with mental disabilities: legislation, community-based supports and services, antistigma/antidiscrimination initiatives, and system monitoring and evaluation. While legislative solutions are the most prevalent, and provide an important framework to support social inclusion, research shows that their full implementation remains problematic. Community-based supports and services that are person-centered and recovery-oriented hold considerable promise, but they are not widely available nor have they been widely evaluated. Antistigma and antidiscrimination strategies are gaining in popularity and offer important avenues for eliminating social barriers and promoting adequate and equitable access to care. Finally, in the context of the current human rights and evidence-based health paradigms, systematic evidence will be needed to support efforts to promote social inclusion for people with mental disabilities, highlight social inequities, and develop best practice approaches. Tools that promote social inclusion of persons with mental disabilities are available, though not yet implemented in a way to fully realize the goals of current disability discourse.

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

PubMed

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

2018-03-01

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

An exploration of facilitators and challenges in the scale-up of a national, public sector community health worker cadre in Zambia: a qualitative study.

PubMed

Phiri, Sydney Chauwa; Prust, Margaret Lippitt; Chibawe, Caroline Phiri; Misapa, Ronald; van den Broek, Jan Willem; Wilmink, Nikhil

2017-06-24

In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system. Semi-structured, individual interviews were held across 5 districts with 16 CHAs and 6 CHA supervisors, and 10 focus group discussions were held with 93 community members. Audio recordings of interviews and focus group discussions were transcribed and thematically coded using Dedoose web-based software. The study showed that the CHAs play a critical role in providing a wide range of services at the community level, as described by supervisors and community members. Some challenges still remain, that may inhibit the CHAs ability to provide health services effectively. In particular, the respondents highlighted infrequent supervision, lack of medical and non-medical supplies for outreach services, and challenges with the mobile data reporting system. The study shows that in order to optimize the impact of CHAs or other community health workers, key health-system support structures need to be functioning effectively, such as supervision, community surveillance systems, supplies, and reporting. The Ministry of Health with support from partners are currently addressing these challenges through nationwide supervisor and community data trainings, as well as advocating for adding primary health care as a specific focus area in the new National Health Strategy Plan 2017-2021. This study contributes to the evidence base on the introduction of formalized community health worker cadres in developing countries.

CEMS: Building a Cloud-Based Infrastructure to Support Climate and Environmental Data Services

NASA Astrophysics Data System (ADS)

Kershaw, P. J.; Curtis, M.; Pechorro, E.

2012-04-01

CEMS, the facility for Climate and Environmental Monitoring from Space, is a new joint collaboration between academia and industry to bring together their collective expertise to support research into climate change and provide a catalyst for growth in related Earth Observation (EO) technologies and services in the commercial sector. A recent major investment by the UK Space Agency has made possible the development of a dedicated facility at ISIC, the International Space Innovation Centre at Harwell in the UK. CEMS has a number of key elements: the provision of access to large-volume EO and climate datasets co-located with high performance computing facilities; a flexible infrastructure to support the needs of research projects in the academic community and new business opportunities for commercial companies. Expertise and tools for scientific data quality and integrity are another essential component, giving users confidence and transparency in its data, services and products. Central to the development of this infrastructure is the utilisation of cloud-based technology: multi-tenancy and the dynamic provision of resources are key characteristics to exploit in order to support the range of organisations using the facilities and the varied use cases. The hosting of processing services and applications next to the data within the CEMS facility is another important capability. With the expected exponential increase in data volumes within the climate science and EO domains it is becoming increasingly impracticable for organisations to retrieve this data over networks and provide the necessary storage. Consider for example, the factor of o20 increase in data volumes expected for the ESA Sentinel missions over the equivalent Envisat instruments. We explore the options for the provision of a hybrid community/private cloud looking at offerings from the commercial sector and developments in the Open Source community. Building on this virtualisation layer, a further core services tier will support and serve applications as part of a service oriented architecture. We consider the constituent services in this layer to support access to the data, data processing and the orchestration of workflows.

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

PubMed

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

2015-04-30

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

An Innovative Role for Faith Community Nursing: Palliative Care Ministry.

PubMed

Lentz, Judy C

Although the specialty of palliative nursing and palliative care continues to grow in hospital and outpatient settings, a paucity of home-based palliative services remains. This article discusses a new paradigm of faith-based palliative care ministry using faith community nurses (FCNs). Under the leadership of a palliative care doula (a nurse expert in palliative care), nurses in the faith community can offer critical support to those with serious illness. Models such as this provide stimulating content for FCN practice and opportunity to broaden health ministry within faith communities.

76 FR 17139 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... programs to support the provision of oral health services for HIV-positive individuals. Institutions... programs use to apply for funding of non-reimbursed costs, incurred in providing oral health care to... their links and collaboration with community-based providers of oral health services. The primary...

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.

Occupational Therapy in Medicaid Home and Community-Based Services Waivers.

PubMed

Friedman, Carli; VanPuymbrouck, Laura

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. Comparisons across states strengthen the profession's ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Occupational Therapy in Medicaid Home and Community-Based Services Waivers

PubMed Central

VanPuymbrouck, Laura

2018-01-01

OBJECTIVE. Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. METHOD. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. RESULTS. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. CONCLUSION. Comparisons across states strengthen the profession’s ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. PMID:29426389

Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned.

PubMed

Livet, Melanie; Fixsen, Amanda

2018-01-01

With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation-provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.

Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

PubMed

Dunstan, Debra; Anderson, Donnah

2018-02-01

The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of client recovery, and taking a strengths-based rather than a deficit approach to the human and other resources that were available, the PHaMs service was established and is maintained by applying Strengths Model principles and being committed to teamwork and interagency respect. Caseworker ratings of participants who had completed an Individual Recovery Plan indicated significant gains in adaptive functioning, including improvements in physical health and wellbeing, management of symptoms, accommodation, vocational skills development and increased community involvement. Strengths-based recovery services offered by a rural PHaMs service can assist Australians with severe mental illness to achieve meaningful gains towards recovery. Furthermore, a Strengths Model approach to service development and operations – one that recognises individual abilities and prizes interpersonal relationships and teamwork – can maximise the potential of local human and other resources, and serve as a solution to resolving apparent service gaps and perceived deficits in rural and regional areas.

The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

PubMed

McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

2017-03-01

Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

ESIP Federation: A Case Study on Enabling Collaboration Infrastructure to Support Earth Science Informatics Communities

NASA Astrophysics Data System (ADS)

Robinson, E.; Meyer, C. B.; Benedict, K. K.

2013-12-01

A critical part of effective Earth science data and information system interoperability involves collaboration across geographically and temporally distributed communities. The Federation of Earth Science Information Partners (ESIP) is a broad-based, distributed community of science, data and information technology practitioners from across science domains, economic sectors and the data lifecycle. ESIP's open, participatory structure provides a melting pot for coordinating around common areas of interest, experimenting on innovative ideas and capturing and finding best practices and lessons learned from across the network. Since much of ESIP's work is distributed, the Foundation for Earth Science was established as a non-profit home for its supportive collaboration infrastructure. The infrastructure leverages the Internet and recent advances in collaboration web services. ESIP provides neutral space for self-governed groups to emerge around common Earth science data and information issues, ebbing and flowing as the need for them arises. As a group emerges, the Foundation quickly equips the virtual workgroup with a set of ';commodity services'. These services include: web meeting technology (Webex), a wiki and an email listserv. WebEx allows the group to work synchronously, dynamically viewing and discussing shared information in real time. The wiki is the group's primary workspace and over time creates organizational memory. The listserv provides an inclusive way to email the group and archive all messages for future reference. These three services lower the startup barrier for collaboration and enable automatic content preservation to allow for future work. While many of ESIP's consensus-building activities are discussion-based, the Foundation supports an ESIP testbed environment for exploring and evaluating prototype standards, services, protocols, and best practices. After community review of testbed proposals, the Foundation provides small seed funding and a toolbox of collaborative development resources including Amazon Web Services to quickly spin-up the testbed instance and a GitHub account for maintaining testbed project code enabling reuse. Recently, the Foundation supported development of the ESIP Commons (http://commons.esipfed.org), a Drupal-based knowledge repository for non-traditional publications to preserve community products and outcomes like white papers, posters and proceedings. The ESIP Commons adds additional structured metadata, provides attribution to contributors and allows those unfamiliar with ESIP a straightforward way to find information. The success of ESIP Federation activities is difficult to measure. The ESIP Commons is a step toward quantifying sponsor return on investment and is one dataset used in network map analysis of the ESIP community network, another success metric. Over the last 15 years, ESIP has continually grown and attracted experts in the Earth science data and informatics field becoming a primary locus of research and development on the application and evolution of Earth science data standards and conventions. As funding agencies push toward a more collaborative approach, the lessons learned from ESIP and the collaboration services themselves are a crucial component of supporting science research.

Activities of Intellectual Disability Clinical Nurse Specialists in Ireland.

PubMed

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems

PubMed Central

Jenkins, Melissa M.; Brookman-Frazee, Lauren

2010-01-01

The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family factors in children’s mental health services; however, stakeholders differed in reports of which factors were most salient. Specifically, clinicians endorsed most factors as being equally salient, while parents described a few salient factors, with parental stress and inadequate social support being the most frequently discussed. These qualitative data further elucidate the context of community services and have implications for evidence-based practice implementation and improving community care. PMID:21170419

42 CFR 440.180 - Home or community-based services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

42 CFR 440.180 - Home or community-based services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

42 CFR 440.180 - Home or community-based services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Home or community-based services. 440.180 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or community-based services. (a) Description and requirements for services. “Home or community-based services...

OCICATS (Online Community Input Classification to Advance Transportation Services) - a GIS-based decision-support tool.

DOT National Transportation Integrated Search

2016-09-02

Public transportation agencies can obtain large amounts of information regarding timeliness, efficiency, cleanliness, ridership, and other : performance measures. However, these metrics are based on the interests of these agencies and do not necessar...

An academic practice's transition to the business of medicine in the community. A case study.

PubMed

Griffin, S L; Schryver, D L

2000-01-01

This case study highlights the problems confronting a clinical practice corporation affiliated with a major medical school, and the business realizations it made in the acquisition of a community-based clinic. Launching a financially viable enterprise requires careful planning, determination of formal goals and expectations, an appropriate mix of physicians and services, a specific marketing campaign and community support.

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

Improving Community-Based Mental Health Care for Children: Translating Knowledge into Action

PubMed Central

Haine-Schlagel, Rachel; Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Trask, Emily; Fawley-King, Kya

2013-01-01

There is urgent need for improvement in community-based mental health care for children and families. Multiple studies have documented serious limitations in the effectiveness of “usual care.” Fortunately, many empirically-supported strategies to improve care have been developed, and thus there is now a great deal of knowledge available to address this significant public health problem. The goal of this selective review is to highlight and synthesize that empirically-supported knowledge to stimulate and facilitate the needed translation of knowledge into action. The review provides a sound foundation for constructing improved services by consolidating descriptive data on the status quo in children’s mental health care, as well as evidence for an array of promising strategies to improve (a) Service access and engagement; (b) Delivery of evidence-based practices; and (c) Outcome accountability. A multi-level framework is used to highlight recommended care improvement targets. PMID:23212902

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

PubMed

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

2017-08-30

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

Clinical skill development for community pharmacists.

PubMed

Barnette, D J; Murphy, C M; Carter, B L

1996-09-01

The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

ECHO Services: Foundational Middleware for a Science Cyberinfrastructure

NASA Technical Reports Server (NTRS)

Burnett, Michael

2005-01-01

This viewgraph presentation describes ECHO, an interoperability middleware solution. It uses open, XML-based APIs, and supports net-centric architectures and solutions. ECHO has a set of interoperable registries for both data (metadata) and services, and provides user accounts and a common infrastructure for the registries. It is built upon a layered architecture with extensible infrastructure for supporting community unique protocols. It has been operational since November, 2002 and it available as open source.

Reducing inequalities in access to health care: developing a toolkit through action research.

PubMed

Goyder, E C; Blank, L; Ellis, E; Furber, A; Peters, J; Sartain, K; Massey, C

2005-10-01

Healthcare organisations are expected both to monitor inequalities in access to health services and also to act to improve access and increase equity in service provision. Locally developed action research projects with an explicit objective of reducing inequalities in access. Eight different health care services in the Yorkshire and Humber region, including community based palliative care, general practice asthma care, hospital based cardiology clinics, and termination of pregnancy services. Changes in service provision, increasing attendance rates in targeted groups. Local teams identified the population concerned and appropriate interventions using both published and grey literature. Where change to service provision was achieved, local data were collected to monitor the impact of service change. A number of evidence based changes to service provision were proposed and implemented with variable success. Service uptake increased in some of the targeted populations. Interventions to improve access must be sensitive to local settings and need both practical and managerial support to succeed. It is particularly difficult to improve access effectively if services are already struggling to meet current demand. Key elements for successful interventions included effective local leadership, identification of an intervention which is both evidence based and locally practicable, and identification of additional resources to support increased activity. A "toolkit" has been developed to support the identification and implementation of appropriate changes.

Using Quality Schemes in Adult and Community Learning: A Guide for Managers.

ERIC Educational Resources Information Center

Ewens, David; Watters, Kate

This document examines adult and community learning (ACL) and quality programs across England. The difficulties faced by local education agencies' ACL services in delivering quality are noted, along with ways quality improvement has been supported. Quality programs--whether internal or external, based on awards, or used as diagnostic tools--are…

42 CFR 441.580 - Data collection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Data collection. 441.580 Section 441.580 Public... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.580 Data... under sections 1115, 1915(c) and (i) of the Act, or the personal care State plan option. (e) Data...

42 CFR 441.580 - Data collection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Data collection. 441.580 Section 441.580 Public... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.580 Data... under sections 1115, 1915(c) and (i) of the Act, or the personal care State plan option. (e) Data...

The Defence Medical Library Service and military medicine.

PubMed

Walker, S B

2005-01-01

The Defence Medical Library Service (DMLS) supports the clinical practice and career development of military health professionals across the world. Clinical governance and the need for medical knowledge to be evidence-based means the DMLS has a central role to play in support of defence medicine. The DMLS is important for enabling health professionals to make sense of the evidence-based pyramid and the hierarchy of medical knowledge. The Royal Centre for Defence Medicine (RCDM) in Birmingham is recognised as an international centre of excellence. The information, knowledge and research requirements of the RCDM will provide opportunities for the DMLS to support and engage with the academic community.

75 FR 6188 - Full-Service Community Schools

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-08

... community in the provision of comprehensive academic, social, and health services for students, students' family members, and community members. We intend the priorities to support the improvement of student... health services for students, students' family members, and community members that will result in...

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania.

PubMed

Chaki, Prosper P; Kannady, Khadija; Mtasiwa, Deo; Tanner, Marcel; Mshinda, Hassan; Kelly, Ann H; Killeen, Gerry F

2014-06-25

Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

PubMed Central

2014-01-01

Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790

Environmental Assessment for Integrated Natural Resources Management Plan Activities at Eglin Air Force Base, Florida

DTIC Science & Technology

2013-01-28

and coordination services by planning for and adapting to a rapidly changing military mission. 2. Restore the longleaf pine ecosystem and recover...success by supporting the Eglin AFB NRS adaptive management efforts through statistically sound, scientifically based monitoring of community...conservation targets, including sandhills, flatwoods, steepheads, seepage slopes, and stream habitats. Ecological monitoring supports adaptive

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

NASA Astrophysics Data System (ADS)

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

2012-12-01

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

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: Protocol for a randomized controlled trial

PubMed Central

Collins, Susan E.; Saxon, Andrew J.; Duncan, Mark H.; Smart, Brian F.; Merrill, Joseph O.; Malone, Daniel K.; Jackson, T. Ron; Clifasefi, Seema L.; Joesch, Jutta; Ries, Richard K.

2014-01-01

Background Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Aims Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. Methods This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4 weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. Discussion If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. PMID:24846619

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: protocol for a randomized controlled trial.

PubMed

Collins, Susan E; Saxon, Andrew J; Duncan, Mark H; Smart, Brian F; Merrill, Joseph O; Malone, Daniel K; Jackson, T Ron; Clifasefi, Seema L; Joesch, Jutta; Ries, Richard K

2014-07-01

Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. Copyright © 2014 Elsevier Inc. All rights reserved.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid Power System

NASA Technical Reports Server (NTRS)

Bubenheim, David; Meiners, Dennis

2016-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA. Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40% and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well being in remote communities today and tomorrow.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2017-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA.Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40 and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well-being in remote communities today and tomorrow.

Corporation for National and Community Service: Cost-Effective Solutions for Our Communities and Nation

ERIC Educational Resources Information Center

Corporation for National and Community Service, 2017

2017-01-01

The Corporation for National and Community Service (CNCS), a federal agency and the nation's largest grantmaker in support of service and volunteering, manages AmeriCorps, Senior Corps, and Volunteer Generation Fund. This brief report provides an overview of the Corporation for National and Community Service (CNCS).

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

PubMed Central

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

2012-01-01

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

Navigating the AIDS industry: being poor and positive in Tanzania.

PubMed

Boesten, Jelke

2011-01-01

This article shows how poor people living with HIV/AIDS in Tanzania navigate a myriad of actors, agencies and organizations to obtain the aid they need to survive. It focuses on community-based organizations which establish networks of care through which people obtain care, treatment and financial support. A case study of a roadside town in Tanzania illustrates that these community-based networks of care — essential to the survival of many — are partly the product of the AIDS industry, which encourages the establishment of community-based organizations and voluntary service delivery rather than more formalized systems of care. Community-based organizations, however, are so poorly supported that they often deploy self-destructive strategies. The need to strategically navigate the AIDS industry creates tension and even conflict among HIV-positive activists, the people they represent and the wider community, which undermines rather than strengthens community-based interventions. Whilst the AIDS industry promises inclusion of HIV-positive people in the response to HIV/AIDS, it succeeds only partially, with the result that it may potentially do more harm than good.

Family Supports for Children with Severe Disabilities and Chronic Illnesses in Maryland.

ERIC Educational Resources Information Center

Walker, Pam

This report focuses on positive practices in providing support services to families of children with severe disabilities and chronic illnesses, based on visits to three sites in Maryland: the Family Support Program at the Kennedy Institute in Baltimore, the Coordinating Center for Home and Community Care, and Sick Kids Need Involved People (SKIP).…

Results of the Collaborative Energy and Water Cycle Information Services (CEWIS) Workshop on Heterogeneous Dataset Analysis Preparation

NASA Technical Reports Server (NTRS)

Kempler, Steven; Teng, William; Acker, James; Belvedere, Deborah; Liu, Zhong; Leptoukh, Gregory

2010-01-01

In support of the NASA Energy and Water Cycle Study (NEWS), the Collaborative Energy and Water Cycle Information Services (CEWIS), sponsored by NEWS Program Manager Jared Entin, was initiated to develop an evolving set of community-based data and information services that would facilitate users to locate, access, and bring together multiple distributed heterogeneous energy and water cycle datasets. The CEWIS workshop, June 15-16, 2010, at NASA/GSFC, was the initial step of the process, starting with identifying and scoping the issues, as defined by the community.

Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services.

PubMed

Price, Sarah Kye; Coles, D Crystal; Wingold, Tracey

2017-11-01

Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs. © 2017 National Association of Social Workers.

Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

PubMed Central

Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

2015-01-01

Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school-based delivery, with vaccine offered at multiple venues, potentially through a campaign approach. PMID:26115523

Using conflict theory to explore the role of nursing home social workers in home- and community-based service utilization.

PubMed

Fogler, Sarah

2009-11-01

Nursing home social work (NHSW) practitioners are central to home- and community-based service (HCBS) utilization. They assist residents with long-term care (LTC) decision-making and coordinate community-based LTC supports and services for older adults transitioning back into the community after a rehabilitative nursing home (NH) stay. As members of multiple groups, they must simultaneously balance the needs of NH residents, the NH organization, and social policies related to LTC. To date, policy research on HCBS has been atheoretical in that it has not accounted for the possible inherent conflicts that adversely affect the discharge planning practices of NHSW practitioners. This article applies the Conflict Theory to (a) explore the competing interests of the NH industry and the nation's government, (b) examine the potential effect of these competing interests on the effectiveness of NHSW discharge planning practices, and (c) present a conceptual framework to further investigate the relationship between NHSW and both individual LTC outcomes and national policy initiatives aimed at increasing HCBS utilization.

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...

Facilitators and Barriers to Linkage to HIV Care among Female Sex Workers Receiving HIV Testing Services at a Community-Based Organization in Periurban Uganda: A Qualitative Study

PubMed Central

Kintu, Betty N.

2016-01-01

Introduction. While four in ten female sex workers (FSWs) in sub-Saharan Africa are infected with HIV, only a small proportion is enrolled in HIV care. We explored facilitators and barriers to linkage to HIV care among FSWs receiving HIV testing services at a community-based organization in periurban Uganda. Methods. The cross-sectional qualitative study was conducted among 28 HIV positive FSWs from May to July 2014. Key informant interviews were conducted with five project staff and eleven peer educators. Data were collected on facilitators for and barriers to linkage to HIV care and manually analyzed following a thematic framework approach. Results. Facilitators for linkage to HIV care included the perceived good quality of health services with same-day results and immediate initiation of treatment, community peer support systems, individual's need to remain healthy, and having alternative sources of income. Linkage barriers included perceived stigma, fear to be seen at outreach HIV clinics, fear and myths about antiretroviral therapy, lack of time to attend clinic, and financial constraints. Conclusion. Linkage to HIV care among FSWs is influenced by good quality friendly services and peer support. HIV service delivery programs for FSWs should focus on enhancing these and dealing with barriers stemming from stigma and misinformation. PMID:27493826

42 CFR 440.180 - Home or community-based services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Home or community-based services. 440.180 Section 440.180 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... community-based services. (a) Description and requirements for services. “Home or community-based services...

Pillars of Support: A Functional Asset-Based Framework for ABE Learners

ERIC Educational Resources Information Center

Reynolds, Sharon; Johnson, Jerry

2014-01-01

This paper reported results from a qualitative analysis of assets and supports disclosed in the narratives of adult basic education students. These students were identified as exemplary by their instructors for academic achievement, hours of program attendance, or community service. Themes were identified using the "Four Pillars"…

Predictors of disability-related attitudes: considering self-esteem, communication apprehension, contact, and geographic location

PubMed Central

Magsamen-Conrad, Kate; Tetteh, Dinah; Lee, Yen-I

2016-01-01

Individuals’ attitudes about persons with disability (PwD) strongly affect differently-abled persons’ quality of life and position in society. Some research offers support for the ability of systematic, supported, longitudinal contact between different groups of individuals to improve attitudes. College campuses, in particular, offer a potentially useful arena in which to facilitate this type of contact. This study explored contextual factors (eg, geographic region, biological sex) and predictors of disability-related attitudes among a college student population to determine strategies for course-based intervention design (eg, as community-engaged or service-learning initiatives). Surveying participants from universities in two regions of the United States, we found that self-esteem, audience-based communication apprehension, and contact with PwD explain more than 50% of the variance in disability-related attitudes. Further, we found that geographic location affects both self-esteem and audience-based communication apprehension (communicating/interacting with PwD). We discuss the implications for community engagement and/or service learning and highlight the importance of partnerships among relevant community stakeholders, including university faculty, students, and staff. PMID:27980439

Predictors of disability-related attitudes: considering self-esteem, communication apprehension, contact, and geographic location.

PubMed

Magsamen-Conrad, Kate; Tetteh, Dinah; Lee, Yen-I

2016-01-01

Individuals' attitudes about persons with disability (PwD) strongly affect differently-abled persons' quality of life and position in society. Some research offers support for the ability of systematic, supported, longitudinal contact between different groups of individuals to improve attitudes. College campuses, in particular, offer a potentially useful arena in which to facilitate this type of contact. This study explored contextual factors (eg, geographic region, biological sex) and predictors of disability-related attitudes among a college student population to determine strategies for course-based intervention design (eg, as community-engaged or service-learning initiatives). Surveying participants from universities in two regions of the United States, we found that self-esteem, audience-based communication apprehension, and contact with PwD explain more than 50% of the variance in disability-related attitudes. Further, we found that geographic location affects both self-esteem and audience-based communication apprehension (communicating/interacting with PwD). We discuss the implications for community engagement and/or service learning and highlight the importance of partnerships among relevant community stakeholders, including university faculty, students, and staff.

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

PubMed

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

2018-05-03

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

Extending Climate Analytics-As to the Earth System Grid Federation

NASA Astrophysics Data System (ADS)

Tamkin, G.; Schnase, J. L.; Duffy, D.; McInerney, M.; Nadeau, D.; Li, J.; Strong, S.; Thompson, J. H.

2015-12-01

We are building three extensions to prior-funded work on climate analytics-as-a-service that will benefit the Earth System Grid Federation (ESGF) as it addresses the Big Data challenges of future climate research: (1) We are creating a cloud-based, high-performance Virtual Real-Time Analytics Testbed supporting a select set of climate variables from six major reanalysis data sets. This near real-time capability will enable advanced technologies like the Cloudera Impala-based Structured Query Language (SQL) query capabilities and Hadoop-based MapReduce analytics over native NetCDF files while providing a platform for community experimentation with emerging analytic technologies. (2) We are building a full-featured Reanalysis Ensemble Service comprising monthly means data from six reanalysis data sets. The service will provide a basic set of commonly used operations over the reanalysis collections. The operations will be made accessible through NASA's climate data analytics Web services and our client-side Climate Data Services (CDS) API. (3) We are establishing an Open Geospatial Consortium (OGC) WPS-compliant Web service interface to our climate data analytics service that will enable greater interoperability with next-generation ESGF capabilities. The CDS API will be extended to accommodate the new WPS Web service endpoints as well as ESGF's Web service endpoints. These activities address some of the most important technical challenges for server-side analytics and support the research community's requirements for improved interoperability and improved access to reanalysis data.

Expanding roles in a library-based bioinformatics service program: a case study

PubMed Central

Li, Meng; Chen, Yi-Bu; Clintworth, William A

2013-01-01

Question: How can a library-based bioinformatics support program be implemented and expanded to continuously support the growing and changing needs of the research community? Setting: A program at a health sciences library serving a large academic medical center with a strong research focus is described. Methods: The bioinformatics service program was established at the Norris Medical Library in 2005. As part of program development, the library assessed users' bioinformatics needs, acquired additional funds, established and expanded service offerings, and explored additional roles in promoting on-campus collaboration. Results: Personnel and software have increased along with the number of registered software users and use of the provided services. Conclusion: With strategic efforts and persistent advocacy within the broader university environment, library-based bioinformatics service programs can become a key part of an institution's comprehensive solution to researchers' ever-increasing bioinformatics needs. PMID:24163602

Ten Year Plan for the Redevelopment of Intellectual Disability Services. Final Report.

ERIC Educational Resources Information Center

Neilson Associates Pty. Ltd., Melbourne (Australia).

This report recommends a 10-year plan for changes in services to people with intellectual disabilities in Victoria, Australia. Intended key outcomes of the plan include: increases in the numbers of clients receiving direct residential support in community-based accommodations; reductions in numbers of adult clients resident in large scale…

Community Pathways: Hospital-Based Services that Individualize Supports for Families and Children

ERIC Educational Resources Information Center

Boone, Harriet A.; Freund, Peggy J.; Barlow, Jane H.; Van Ark, Gwenn G.; Wilson, Thea K.

2004-01-01

Increasing numbers of infants and toddlers who were premature, had low birth weight, or experience chronic medical conditions are referred to early intervention services (Bernstein, Heimler, & Sasidharan, 1998). These young children often endure prolonged hospitalizations and are at risk for developmental disabilities by nature of their illnesses,…

Choice-Making among Medicaid HCBS and ICF/MR Recipients in Six States

ERIC Educational Resources Information Center

Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

2008-01-01

Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in nonfamily settings in six states. Everyday choice in daily life and in…

Domestic Violence Survivors' Access of Career Counseling Services: A Qualitative Investigation

ERIC Educational Resources Information Center

Chronister, Krista M.; Linville, Deanna; Kaag, Kristi Palmer

2008-01-01

The present study was a qualitative investigation of the impact of domestic violence on women's career development and the contextual barriers and supports that affect women's ability to access career counseling services. Our sample included 11 women who completed various stages of a community-based career counseling intervention program. The…

Cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.

PubMed

McPake, Barbara; Edoka, Ijeoma; Witter, Sophie; Kielmann, Karina; Taegtmeyer, Miriam; Dieleman, Marjolein; Vaughan, Kelsey; Gama, Elvis; Kok, Maryse; Datiko, Daniel; Otiso, Lillian; Ahmed, Rukhsana; Squires, Neil; Suraratdecha, Chutima; Cometto, Giorgio

2015-09-01

To assess the cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Incremental cost-effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value. The estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective. Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.

A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.

PubMed

Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I

2016-06-01

Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service planners and policymakers with a comprehensive list of evidence-based services that have the potential to be adapted to different settings from which they were originally implemented and evaluated in order to reduce the burden of CVD. Funding for this review was provided by the University of Technology Sydney Chancellor's Postdoctoral Fellowship awarded to Sabater-Hernández. No other potential conflict of interest was declared. Study concept and design were contributed by Sabater-Hernández, Fernandez-Llimos, Rotta, and Correr. Sabater-Galindo and Sabater-Hernández took the lead in data collection, along with Franco-Trigo and Rotta. Data interpretation was performed by Sabater-Hernández, Durks, and Lopes. The manuscript was written primarily by Sabater-Hernández, along with Hossain, and revised by Fernandez-Llimos, Rotta, and Benrimoj, with assistance from Durks, Sabater-Galindo, Franco-Trigo, and Correr.

Crossing Boundaries: A Qualitative Exploration of Relational Leadership in Three Full-Service Community Schools

ERIC Educational Resources Information Center

Sanders, Mavis G.

2018-01-01

Background/Context: Full-service community schools provide comprehensive and coordinated resources and supports to meet the complex needs of children and families in low-income communities. Given their intentional focus on expanded networks of school, family, and community stakeholders, full-service community schools are particularly useful…

Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

PubMed

Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

2018-02-01

Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services limits access, making fall prevention inaccessible, unaccommodating, unavailable, unaffordable, and unacceptable. Educating Providers, Working Together, and Changing Policies and Legislation offers promise to create more enabling contexts for community stakeholders, including those who do not initially see their work as preventing falls.

Identifying acceptable components for home-based health promotion services for older people with mild frailty: A qualitative study.

PubMed

Frost, Rachael; Kharicha, Kalpa; Jovicic, Ana; Liljas, Ann E M; Iliffe, Steve; Manthorpe, Jill; Gardner, Benjamin; Avgerinou, Christina; Goodman, Claire; Drennan, Vari M; Walters, Kate

2018-05-01

Mild frailty is common in later life, increasing the risk of hospitalisation, loss of independence and premature death. Targeted health promotion services may reduce adverse outcomes and increase quality of life; however, effective, well-developed theory-based interventions are lacking. We aimed to explore perceptions of health promotion behaviours undertaken by older people with mild frailty, barriers and facilitators to engagement, and identify potential components for new home-based health promotion services. We carried out 17 semi-structured qualitative interviews and six focus groups with 53 stakeholders, including 14 mildly frail older people, 12 family carers, 19 community health and social care professionals, and 8 homecare workers, in one urban and one semi-rural area of England. Transcripts were thematically analysed. Older people with mild frailty reported engaging in a variety of lifestyle behaviours to promote health and well-being. Key barriers or facilitators to engaging in these included transport, knowledge of local services, social support and acceptance of personal limitations. Older people, carers and professionals agreed that any new service should address social networks and mobility and tailor other content to each individual. Services should aim to increase motivation through focussing on independence and facilitate older people to continue carrying out behaviours that improve their well-being, as well as provide information, motivation, psychological support and practical support. Stakeholders agreed services should be delivered over a sustained period by trained non-specialist workers. New services including these components are likely to be acceptable to older people with mild frailty. © 2017 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Problems of Runaway Youth. Hearing before the Subcommittee on Juvenile Justice of the Committee on the Judiciary. United States Senate, Ninety-Seventh Congress, Second Session on Problems of and Services Provided for Runaway and Homeless Youth, Focusing on Support to State and Local Governments and Nonprofit Agencies for the Development of Community-Based Programs.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

These hearings, focusing on financial support for community-based programs dealing with problems of runaway and homeless youths, explore the scope of the problem, types of activities which are being undertaken, and paths for future action. Testimony and prepared statements are presented by several witnesses including a commissioner of the…

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

PubMed

Loewenthal, Kate Miriam; Rogers, Marian Brooke

2004-09-01

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

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

PubMed

Hewitt, Amy; Larson, Sheryl

2007-01-01

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

An Organizational Model for Instructional Support at a Community College.

ERIC Educational Resources Information Center

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

2003-01-01

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

The public vs private debate: separating facts from values.

PubMed

Narad, R A; Gillespie, W

1998-01-01

The choice between public and private emergency ambulance services is generally based on histological experience within the community. No empirical evidence exists that supports an argument that either public or private emergency ambulance services are better, per se. On a macro level, this debate is based on the question of the role of government and the role of the marketplace in the delivery of public services and medical care, and the comparative efficiencies of public and private organizations. On a micro or community level, these philosophical concerns are supplemented with issues relating to protection of individual jobs and investments, upholding of community tradition, and maintenance of existing relationships. Other specific values that are considered include the role of profit and equity--fairness of coverage. A rational choice would be based on consideration of efficiency and effectiveness. The effectiveness of an emergency medical services system is primarily based on its ability to provide patients with the level of care that they need within a clinically appropriate time. Efficiency is the ratio between inputs and outputs. One factor that can increase efficiency is the availability of excess production capacity that can be used to provide emergency ambulance service, with a low marginal cost of adding this to the other functions. A rational model is intended to change the level of the debate to one that is less based on values, but it is impossible for a community to select an ambulance provider in a value-free environment.

Latest Community Coordinated Modeling Center (CCMC) services and innovative tools supporting the space weather research and operational communities.

NASA Astrophysics Data System (ADS)

Mendoza, A. M. M.; Rastaetter, L.; Kuznetsova, M. M.; Mays, M. L.; Chulaki, A.; Shim, J. S.; MacNeice, P. J.; Taktakishvili, A.; Collado-Vega, Y. M.; Weigand, C.; Zheng, Y.; Mullinix, R.; Patel, K.; Pembroke, A. D.; Pulkkinen, A. A.; Boblitt, J. M.; Bakshi, S. S.; Tsui, T.

2017-12-01

The Community Coordinated Modeling Center (CCMC), with the fundamental goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research, has been serving as an integral hub for over 15 years, providing invaluable resources to both space weather scientific and operational communities. CCMC has developed and provided innovative web-based point of access tools varying from: Runs-On-Request System - providing unprecedented global access to the largest collection of state-of-the-art solar and space physics models, Integrated Space Weather Analysis (iSWA) - a powerful dissemination system for space weather information, Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and Mobile apps to view space weather data anywhere to the scientific community. In addition to supporting research and performing model evaluations, CCMC also supports space science education by hosting summer students through local universities. In this poster, we will showcase CCMC's latest innovative tools and services, and CCMC's tools that revolutionized the way we do research and improve our operational space weather capabilities. CCMC's free tools and resources are all publicly available online (http://ccmc.gsfc.nasa.gov).

Lay perspectives on lay health worker roles, boundaries and participation within three UK community-based health promotion projects.

PubMed

South, J; Kinsella, K; Meah, A

2012-08-01

This paper examines lay interpretations of lay health worker roles within three UK community-based health promotion projects. It argues that understanding lay health worker roles requires critical analysis of the complex interrelationships between professionals, lay workers and the communities receiving a programme. Findings are presented that are drawn from a qualitative study of lay engagement in public health programme delivery where a key objective was to examine the perspectives of community members with the experience of receiving services delivered by lay health workers. Interviews and focus groups were conducted with 46 programme recipients from three case study projects; a breastfeeding peer support service, a walking for health scheme and a neighbourhood health project. The results show how participants interpreted the function and responsibilities of lay health workers and how those roles provided personalized support and facilitated engagement in group activities. Further insights into community participation processes are provided revealing the potential for active engagement in both formal and informal roles. The paper concludes that social relationships are core to understanding lay health worker programmes and therefore analysis needs to take account of the capacity for community members to move within a spectrum of participation defined by increasing responsibility for others.

How can policy strengthen community support for children in military families?

PubMed

Boberiene, Liepa V; Hornback, Bradley J

2014-09-01

The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

Facility and market factors affecting transitions from nursing home to community.

PubMed

Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

2011-09-01

Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

Veterans Affairs Intensive Case Management for older veterans.

PubMed

Mohamed, Somaia; Neale, Michael S; Rosenheck, Robert

2009-08-01

There is a growing need for information on evidence-based practices that may potentially address needs of elderly people with severe mental illness (SMI), and more specifically on community-based services such as assertive community treatment (ACT). This study examines national evaluation data from fiscal year 2001-2005 from Veterans Affairs Mental Health Intensive Case Management (MHICM) program (N = 5,222), an ACT-based service model, to characterize the age distribution of participants and the distinctive needs, patterns of service delivery, and treatment outcomes for elderly veterans. Altogether, 24.8% of participants were 55-64 years; 7.4% 65-74 years; and 2.8% were older than 75. Veterans over 75 formed a distinct subgroup that had a later age of onset of primarily nonpsychotic illnesses without comorbid substance abuse and had experienced more limited lifetime hospital treatment than younger participants. Older veterans were less symptomatic and more satisfied with their social relationships than younger clients. They mostly live independently or in minimally restrictive housing, but they received less recovery-focused services and more crisis intervention and medical services. They thus do not appear to be young patients with SMI who have aged but rather constitute a distinct group with serious late-onset problems. It is possible that MHICM services keep them in the community and avoid costly nursing home placement while providing a respite service that reduces family burden. These data highlight the unique characteristics of older veterans receiving ACT-like services and the need to focus greater attention on recovery-oriented services as well as community support for this subgroup.

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

PubMed

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

2016-07-01

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

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

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

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

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

PubMed Central

2017-01-01

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

Research-Practice Linkages in Extension Leadership Development Programs: Focus on Community Leadership Development Programs. A Report.

ERIC Educational Resources Information Center

Vandenberg, Lela; And Others

The Research-Practice Linkages Project sought to identify the knowledge base supporting community leadership development (CLD) programs of the Cooperative Extension Service and to determine linkages between Extension programs and CLD research. A mail questionnaire was completed by 492 Extension staff involved in CLD programs in 18 states and 42…

Knowledge of Mental Capacity Issues in Community Teams for Adults with Learning Disabilities

ERIC Educational Resources Information Center

Willner, Paul; Jenkins, Rosemary; Rees, Paul; Griffiths, Vanessa J.; John, Elinor

2011-01-01

Background: The aim of this study was to evaluate the state of knowledge of mental capacity issues among health and social services professionals working in community teams supporting people with learning disabilities. Methods A structured interview was constructed around three scenarios, based on actual cases, concerning a financial/legal issue,…

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

ERIC Educational Resources Information Center

Hepburn, Kathy Seitzinger

2004-01-01

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

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

ERIC Educational Resources Information Center

Mier, Sharon; Boone, Matthew; Shropshire, Sonya

2009-01-01

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

Web-based Traffic Noise Control Support System for Sustainable Transportation

NASA Astrophysics Data System (ADS)

Fan, Lisa; Dai, Liming; Li, Anson

Traffic noise is considered as one of the major pollutions that will affect our communities in the future. This paper presents a framework of web-based traffic noise control support system (WTNCSS) for a sustainable transportation. WTNCSS is to provide the decision makers, engineers and publics a platform to efficiently access the information, and effectively making decisions related to traffic control. The system is based on a Service Oriented Architecture (SOA) which takes the advantages of the convenience of World Wide Web system with the data format of XML. The whole system is divided into different modules such as the prediction module, ontology-based expert module and dynamic online survey module. Each module of the system provides a distinct information service to the decision support center through the HTTP protocol.

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

PubMed

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

2016-09-01

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

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

PubMed

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

Synthesizing community wisdom: A model for sharing cancer-related resources through social networking and collaborative partnerships.

PubMed

Weiss, Jacob B; Lorenzi, Nancy M; Lorenzi, Nancy

2008-11-06

Despite the availability of community-based support services, cancer patients and survivors are not aware of many of these resources. Without access to community programs, cancer survivors are at risk for lower quality of care and lower quality of life. At the same time, non-profit community organizations lack access to advanced consumer informatics applications to effectively promote awareness of their services. In addition to the current models of print and online resource guides, new community-driven informatics approaches are needed to achieve the goal of comprehensive care for cancer survivors. We present the formulation of a novel model for synthesizing a local communitys collective wisdom of cancer-related resources through a combination of online social networking technologies and real-world collaborative partnerships. This approach can improve awareness of essential, but underutilized community resources.

Promising practices in vocational services for the community reintegration of returning veterans: The individual placement and support model and beyond.

PubMed

Wewiorski, Nancy J; Gorman, Jay A; Scoglio, Arielle A J; Fukuda, Seiya; Reilly, Erin; Mueller, Lisa; O'Connor, Maureen; Penk, Walter E; Drebing, Charles E

2018-05-01

Supporting returning veterans' job-seeking, hiring, and retention issues has become an essential goal for effective community reintegration. Given both the particular strengths and challenges associated with veterans transitioning from military to civilian life, multiple models for supported employment have become integrated into Veterans Affairs health care facilities across the nation. In this article, we review the state of vocational rehabilitation for veterans, with a particular focus on individual placement and support-supported employment (IPS-SE), the current vocational services model that is considered the gold standard of vocational rehabilitation. Various modifications to the IPS-SE model are presented, including additions such as cognitive rehabilitation, contingency management, motivational interviewing, supported self-employment, and transitional work. Finally, recommendations are made about future directions and strategies to expand access to IPS-SE-based programs and to effectively meet the needs of returning veterans for employment in jobs of their choice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Variation in Older Americans Act Caregiver Service Use, Unmet Hours of Care, and Independence Among Hispanics, African Americans, and Whites

PubMed Central

Herrera, Angelica P.; George, Rebecca; Angel, Jacqueline L.; Markides, Kyriakos; Torres-Gil, Fernando

2013-01-01

Home- and community-based services (HCBS) are underused by minority seniors and their caregivers, despite greater rates of disability. We examined racial/ethnic variation among 1,749 Hispanic, African American, and Whites receiving Older Americans Act Title III caregiver services in 2009. In addition, we identified the volume of services used by caregivers, their unmet hours of respite care, and the relationship between service use and seniors’ ability to live independently. Minority caregivers cared for seniors in urban areas who had higher rates of disability, poverty, and Medicaid coverage. Hispanics had the highest rate of unmet hours of care, while caregiver services were less likely to help African Americans remain at home. Minorities sought services through community agencies and were more educated than demographically similar national cohorts. Greater efforts to reach minority caregivers of less educated, disabled seniors in urban areas and through community agencies may reduce unmet needs and support independent living. PMID:23438508

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

PubMed

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

2015-05-01

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

The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Hecht, Debra B; Silovsky, Jane F; Chaffin, Mark J

2009-04-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children's services system. The study took place in the context of a statewide, regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. In the study 21 teams consisting of 153 home-based service providers were followed over a 29-month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families.

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children’s services system. The study took place in the context of a statewide regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. Twenty-one teams consisting of 153 home-based service providers were followed over a 29 month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families. PMID:19309186

Meeting stroke survivors' perceived needs: a qualitative study of a community-based exercise and education scheme.

PubMed

Reed, Mary; Harrington, Rachel; Duggan, Aine; Wood, Victorine A

2010-01-01

A qualitative study using a phenomenological approach, to explore stroke survivors' needs and their perceptions of whether a community stroke scheme met these needs. Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence and sense of purpose to 'create their social self', and external resources of 'responsive services' and an 'informal support network', to provide direction and encouragement. Participants felt the community stroke scheme met some of these needs through exercise, goal setting and peer group interaction, which included social support and knowledge acquisition. Stroke survivors need a variety of internal and external resources so that they can rebuild their lives positively post stroke. A stroke-specific community scheme, based on exercise, life-centred goal setting, peer support and knowledge acquisition, is an external resource that can help with meeting some of the stroke survivor's needs.

Using an academic-community partnership model and blended learning to advance community health nursing pedagogy.

PubMed

Ezeonwu, Mabel; Berkowitz, Bobbie; Vlasses, Frances R

2014-01-01

This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery. © 2013 Wiley Periodicals, Inc.

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

PubMed Central

Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

2012-01-01

Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

PubMed

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2014-08-01

Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

Feasibility and acceptability of point of care HIV testing in community outreach and GUM drop-in services in the North West of England: A programmatic evaluation

PubMed Central

2011-01-01

Background In Liverpool, injecting drug users (IDUs), men-who-have-sex-with-men (MSM) and UK Africans experience a disproportionate burden of HIV, yet services do not reach out to these groups and late presentations continue. We set out to: increase testing uptake in targeted marginalized groups through a community and genitourinary medicine (GUM)-based point of care testing (POCT) programme; and conduct a process evaluation to examine service provider inputs and document service user perceptions of the programme. Methods Mixed quantitative, qualitative and process evaluation methods were used. Service providers were trained to use fourth generation rapid antibody/antigen HIV tests. Existing outreach services incorporated POCT into routine practice. Clients completed a semi-structured questionnaire and focus group discussions (FGDs) were held with service providers. Results Between September 2009 and June 2010, 953 individuals underwent POCT (GUM: 556 [59%]; community-based sites: 397 [42%]). Participants in the community were more likely to be male (p = 0.028), older (p < 0.001), of UK African origin (p < 0.001) and IDUs (p < 0.001) than participants from the GUM clinic. Seventeen new HIV diagnoses were confirmed (prevalence = 1.8%), 16 of whom were in risk exposure categories (prevalence: 16/517, 3.1%). Questionnaires and FGDs showed that clients and service providers were supportive of POCT, highlighting benefits of reaching out to marginalised communities and incorporating HIV prevention messages. Conclusions Community and GUM clinic-based POCT for HIV was feasible and acceptable to clients and service providers in a low prevalence setting. It successfully reached target groups, many of whom would not have otherwise tested. We recommend POCT be considered among strategies to increase the uptake of HIV testing among groups who are currently underserved. PMID:21627851

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

ERIC Educational Resources Information Center

Marts, Jennifer Leigh

2016-01-01

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

Open access support groups for people experiencing personality disorders: do group members' experiences reflect the theoretical foundations of the SUN project?

PubMed

Gillard, Steve; White, Rachel; Miller, Steve; Turner, Kati

2015-03-01

The SUN Project is an innovative, open access support group, based in the community, for people experiencing personality disorders, developed in response to UK Department of Health policy advocating improvements in personality disorders services. The aim of this article is to critically explore where and how the theoretically informed model underpinning the SUN Project is reflected in the view and experiences of people attending the project. This article reports an in-depth, qualitative interview-based study employing a critical realist approach. As part of a larger study about self-care and mental health, in-depth qualitative interviews were held with 38 people new to the SUN Project, and again 9 months later. Data were extracted that were relevant to core components of the project model and were subjected to thematic analysis. The critical realist approach was used to move back and forth between empirical data and theory underpinning the SUN project, providing critical insight into the model. Participant accounts were broadly concordant with core components of the SUN Project's underlying model: Open access and self-referral; group therapeutic processes; community-based support; service users as staff. There were some tensions between interviewee accounts and theoretical aspects of the model, notably around the challenges that group processes presented for some individuals. The model underlying the SUN Project is useful in informing good practice in therapeutic, community-based peer support groups for people experiencing personality disorders. Careful consideration should be given to a limited multi-modal approach, providing focused one-to-one support for vulnerable individuals who find it hard to engage in group processes. Facilitated peer support groups based in the community may act as a powerful therapeutic resource for people experiencing personality disorders. Promoting open access and self-referral to support groups may increase feelings of empowerment and engagement for people experiencing personality disorders. Some individuals experiencing personality disorders who could potentially benefit from therapeutic groups may need focused one-to-one support to do so. © 2014 The British Psychological Society.

Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

PubMed Central

Layer, Erica H.; Kennedy, Caitlin E.; Beckham, Sarah W.; Mbwambo, Jessie K.; Likindikoki, Samuel; Davis, Wendy W.; Kerrigan, Deanna L.; Brahmbhatt, Heena

2014-01-01

Progression through the HIV continuum of care, from HIV testing to lifelong retention in antiretroviral therapy (ART) care and treatment programs, is critical to the success of HIV treatment and prevention efforts. However, significant losses occur at each stage of the continuum and little is known about contextual factors contributing to disengagement at these stages. This study sought to explore multi-level barriers and facilitators influencing entry into and engagement in the continuum of care in Iringa, Tanzania. We used a mixed-methods study design including facility-based assessments and interviews with providers and clients of HIV testing and treatment services; interviews, focus group discussions and observations with community-based providers and clients of HIV care and support services; and longitudinal interviews with men and women living with HIV to understand their trajectories in care. Data were analyzed using narrative analysis to identify key themes across levels and stages in the continuum of care. Participants identified multiple compounding barriers to progression through the continuum of care at the individual, facility, community and structural levels. Key barriers included the reluctance to engage in HIV services while healthy, rigid clinic policies, disrespectful treatment from service providers, stock-outs of supplies, stigma and discrimination, alternate healing systems, distance to health facilities and poverty. Social support from family, friends or support groups, home-based care providers, income generating opportunities and community mobilization activities facilitated engagement throughout the HIV continuum. Findings highlight the complex, multi-dimensional dynamics that individuals experience throughout the continuum of care and underscore the importance of a holistic and multi-level perspective to understand this process. Addressing barriers at each level is important to promoting increased engagement throughout the continuum. PMID:25119665

What core primary health care services should be available to Australians living in rural and remote communities?

PubMed

Thomas, Susan L; Wakerman, John; Humphreys, John S

2014-08-21

Australians living in rural and remote areas experience poorer access to primary health care (PHC) and poorer health outcomes compared to metropolitan populations. Current health reform in Australia aims to ensure all Australians, regardless of where they live, have access to essential PHC services. However, at a national level policy makers and health planners lack an evidence-based set of core PHC services to assist in implementing this goal. A Delphi method was used to reach consensus on an evidence-based list of core PHC services to which all Australians should have access and their necessary support functions. Experts in rural and remote and/or Indigenous PHC, including policy-makers, academics, clinicians and consumers, were invited to consider a list of core services derived from the literature. Thirty nine experts agreed to participate. After three survey rounds there was a strong consensus (≥80% agreement) on core PHC services namely; 'care of the sick and injured', 'mental health', 'maternal/child health', 'allied health', 'sexual/reproductive health', 'rehabilitation', 'oral/dental health' and 'public health/illness prevention'; and on the PHC support functions of; 'management/governance/leadership', 'coordination', 'health infrastructure', 'quality systems', 'data systems', 'professional development' and 'community participation'. Themes emerging from qualitative data included challenges in providing equitable PHC in rural and remote areas, the importance of service coordination and diverse strategies to overcome access barriers. This study identifies a basket of PHC services that consumers in rural and remote communities can expect to access. It provides rigorously derived evidence that will contribute to a more systematic approach to PHC service planning and availability and will assist policy makers in the allocation of scarce resources necessary to improve the health outcomes of residents of rural and remote areas.

Correlates of Caregiver Participation in a Brief, Community-Based Dementia Care Management Program.

PubMed

Mavandadi, Shahrzad; Patel, Samir; Benson, Amy; DiFilippo, Suzanne; Streim, Joel; Oslin, David

2017-11-10

The evidence base for dementia care management interventions for informal caregivers (CGs) is strong, yet enrollment and sustained engagement in academic and community-based research trials is low. This study sought to examine rates and correlates of participation in a community-based, telephone-delivered dementia care management program designed to address logistic and practical barriers to participation in CG trials and services. Participants included 290 CGs of older, community-dwelling, low-income care recipients (CRs) who met criteria for enrollment in a collaborative dementia care management program that provides assessment, psychosocial support and education, and connection to community resources via telephone. Cross-sectional analyses examined the association between CG-related (e.g., financial status, relationship to CR, caregiving burden) and CR-related (e.g., functional limitations, symptom severity) factors and CG enrollment and engagement. The majority of CGs were non-Hispanic White, female, financially stable, and adult children of the CRs. Over half of CGs lived with the CR and provided 20 or more hours of care per week. Roughly half of CGs refused care management services. Adjusted logistic regression models revealed that perceived caregiving burden and financial status were related to initial enrollment and engagement in services once enrolled, respectively. A significant proportion of CGs refuse free, convenient, evidence-based dementia care management services, underscoring the need for further examination of correlates of program acceptance. Nonetheless, community-based programs that address barriers may improve enrollment and engagement rates among CGs, including those who are especially vulnerable to negative CG and CR outcomes. Published by Oxford University Press on behalf of The Gerontological Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Scalable principles of community-based high-value care for seriously ill individuals: Diamonds in the rough.

PubMed

Parikh, Ravi B; Bowman, Brynn; Dahlin, Constance; Twohig, Jeanne S; Meier, Diane E

2017-03-01

Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

["I am nuts, but networking": the qualification process for peer support work with mental health users in the psychosocial care network of Rio de Janeiro].

PubMed

Magalhães Dahl, Catarina; de Araújo Carvalho, Maria C; Moscoso Teixeira de Mendonça, Joana; Mitkiewicz de Souza, Flávia; Wainstok Estivil Bustos, Mayra; Fernandes de Cintra Santos, Jacqueline; Marcos Lovisi, Giovani; Tavares Cavalcanti, Maria

2013-01-01

Peer support work has been increasingly incorporated by community services network in the context of mental health care paradigm shift; however, it is a relatively new device in Latin America. In this article, we will describe the qualification process of peer support workers for implementing a psychosocial intervention in the city of Rio de Janeiro. We use the following methodological strategies based on a narrative, participative and dialogical perspective: focus groups, knowledge transmission through a short course; visits to mental health services and field reports. We used a narrative analysis, building the following thematic categories: experience of the recovery process; what helps and what hinders in the recovery process; the role of the family; the role of community mental health services; prejudice among society and family members; the role of peer support work; challenges. From the users' perspective, recovery is tied to ups and downs and family can either help or disturb this process. Prejudice constitutes the main barrier for recovery. To have a social role and participating in training activities facilitate recovery. Users pointed out that it is necessary to have professional support for peer support work.

The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: a systematic literature review.

PubMed

Henderson, Saras; Kendall, Elizabeth; See, Laurenne

2011-05-01

Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities. © 2011 Blackwell Publishing Ltd.

Assessment without action; a randomised evaluation of the interRAI home care compared to a national assessment tool on identification of needs and service provision for older people in New Zealand.

PubMed

Parsons, Matthew; Senior, Hugh; Mei-Hu Chen, Xenia; Jacobs, Stephen; Parsons, John; Sheridan, Nicolette; Kenealy, Timothy

2013-09-01

Comprehensive geriatric assessment (CGA) is considered the cornerstone of good practice, as it identifies need across multiple domains such as social, physical and psychological. The interRAI home care (interRAI-HC), probably the most well-researched and supported community-based CGA has been implemented globally, often at considerable expense. Policy-makers, managers and clinicians anticipate significant gains in health outcomes following such investment; however, the implementation of CGA is often undertaken in the absence of community service development. This study sought to compare the interRAI-HC with an existing CGA [the Support Needs Assessment (SNA)] in community-dwelling older people. A randomised controlled trial was undertaken from January 2006 to January 2007 comparing the interRAI-HC and the SNA in 316 people (65+) referred for assessment of needs with follow-up at 1 and 4 months. Outcomes included health-related quality of life, physical function, social support, cognitive status, mood and health service usage as well as identified need. The study found that significantly more support needs were identified using the interRAI-HC compared to the SNA. More social and carer support were recommended by SNA and more rehabilitation and preventive health screens were recommended by interRAI-HC. Despite these differences, the mean healthcare use was similar at 4 months, although interRAI-HC participants had more Emergency Department presentations and hospital admissions. No statistically significant differences between groups were reported in terms of outcomes. In conclusion, the interRAI-HC was found to identify more unmet support needs than the SNA though resulted in no favourable outcomes for the older person or their carer. The study highlights the need to invest attention around the service context to maximise outcomes based on identified needs. © 2013 John Wiley & Sons Ltd.

Pregnancy and Parenting Support for Incarcerated Women: Lessons Learned

PubMed Central

Shlafer, Rebecca J.; Gerrity, Erica; Duwe, Grant

2017-01-01

Background There are more than 200,000 incarcerated women in U.S. prisons and jails, and it is estimated that 6% to 10% are pregnant. Pregnant incarcerated women experience complex risks that can compromise their health and the health of their offspring. Objectives Identify lessons learned from a community–university pilot study of a prison-based pregnancy and parenting support program. Methods A community–university–corrections partnership was formed to provide education and support to pregnant incarcerated women through a prison-based pilot program. Evaluation data assessed women’s physical and mental health concerns and satisfaction with the program. Between October 2011 and December 2012, 48 women participated. Lessons Learned We learned that providing services for pregnant incarcerated women requires an effective partnership with the Department of Corrections, adaptations to traditional community-based participatory research (CBPR) approaches, and resources that support both direct service and ongoing evaluation. Conclusions Effective services for pregnant incarcerated women can be provided through a successful community– university–corrections partnership. PMID:26548788

The Impact of Software Culture on the Management of Community Data

NASA Astrophysics Data System (ADS)

Collins, J. A.; Pulsifer, P. L.; Sheffield, E.; Lewis, S.; Oldenburg, J.

2013-12-01

The Exchange for Local Observations and Knowledge of the Arctic (ELOKA), a program hosted at the National Snow and Ice Data Center (NSIDC), supports the collection, curation, and distribution of Local and Traditional Knowledge (LTK) data, as well as some quantitative data products. Investigations involving LTK data often involve community participation, and therefore require flexible and robust user interfaces to support a reliable process of data collection and management. Often, investigators focused on LTK and community-based monitoring choose to use ELOKA's data services based on our ability to provide rapid proof-of-concepts and economical delivery of a usable product. To satisfy these two overarching criteria, ELOKA is experimenting with modifications to its software development culture both in terms of how the software applications are developed as well as the kind of software applications (or components) being developed. Over the past several years, NSIDC has shifted its software development culture from one of assigning individual scientific programmers to support particular principal investigators or projects, to an Agile Software Methodology implementation using Scrum practices. ELOKA has participated in this process by working with other product owners to schedule and prioritize development work which is then implemented by a team of application developers. Scrum, along with practices such as Test Driven Development (TDD) and paired programming, improves the quality of the software product delivered to the user community. To meet the need for rapid prototyping and to maximize product development and support with limited developer input, our software development efforts are now focused on creating a platform of application modules that can be quickly customized to suit the needs of a variety of LTK projects. This approach is in contrast to the strategy of delivering custom applications for individual projects. To date, we have integrated components of the Nunaliit Atlas framework (a Java/JavaScript client-server web-based application) with an existing Ruby on Rails application. This approach requires transitioning individual applications to expose a service layer, thus allowing interapplication communication via RESTful services. In this presentation we will report on our experiences using Agile Scrum practices, our efforts to move from custom solutions to a platform of customizable modules, and the impact of each on our ability to support researchers and Arctic residents in the domain of community-based observations and knowledge.

Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

ERIC Educational Resources Information Center

Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

2010-01-01

Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

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

ERIC Educational Resources Information Center

Purnell, Rogeair; Blank, Susan

2004-01-01

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

Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol

PubMed Central

2012-01-01

Background Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD), and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs) provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs) are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI) to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. Discussion The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with ASD the best and most effective services in their own community. Moreover, the proposed study will positively impact the field of implementation science by providing an empirically supported and tested model of implementation to facilitate the identification, adoption, and use of EBPs. PMID:22963616

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

Community-Based Services and Depression from Person-Environment Fit Perspective: Focusing on Functional Impairments and Living Alone.

PubMed

Kim, BoRin; Park, Sojung; Bishop-Saucier, Jennifer; Amorim, Carrie

2017-01-01

Guided by the Person-Environment Fit perspective, we investigated the extent to which personal and environmental factors influence depression among community-dwelling adults. The data came from the special section about community-based service utilization in the 2012 Health and Retirement Study (N=1,710). Although community-based service was not significantly associated with depression after controlling for covariates, respondents with functional limitations and living alone were less likely to be depressed when using community-based services. This study demonstrates the different associations between community-based services and depression depending on personal needs. It discusses the importance of community-based services for aging-in-place policy, particularly among vulnerable populations.

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

NASA Astrophysics Data System (ADS)

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

2012-12-01

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

Music in the Early Childhood Curriculum: Qualitative Analysis of Pre-Service Teachers' Reflective Writing

ERIC Educational Resources Information Center

Barry, Nancy H.; Durham, Sean

2017-01-01

This qualitative study employed grounded theory to explore how a university-based summer practicum experience with community children (N = 55) revealed and shaped pre-service teachers' (N = 24) understanding of young children and their musical skills and dispositions; how early childhood music curriculum is designed; and supports and barriers to…

Developing a student-led health and wellbeing clinic in an underserved community: collaborative learning, health outcomes and cost savings.

PubMed

Stuhlmiller, Cynthia M; Tolchard, Barry

2015-01-01

The University of New England (UNE), Australia decided to develop innovative placement opportunities for its increasing numbers of nursing students. Extensive community and stakeholder consultation determined that a community centre in rural New South Wales was the welcomed site of the student-led clinic because it fit the goals of the project-to increase access to health care services in an underserved area while providing service learning for students. Supported by a grant from Health Workforce Australia and in partnership with several community organisations, UNE established a student-led clinic in a disadvantaged community using an engaged scholarship approach which joins academic service learning with community based action research. The clinic was managed and run by the students, who were supervised by university staff and worked in collaboration with residents and local health and community services. Local families, many of whom were Indigenous Australians, received increased access to culturally appropriate health services. In the first year, the clinic increased from a one day per week to a three day per week service and offered over 1000 occasions of care and involved 1500 additional community members in health promotion activities. This has led to improved health outcomes for the community and cost savings to the health service estimated to be $430,000. The students learned from members of the community and community members learned from the students, in a collaborative process. Community members benefited from access to drop in help that was self-determined. The model of developing student-led community health and wellbeing clinics in underserved communities not only fulfils the local, State Government, Federal Government and international health reform agenda but it also represents good value for money. It offers free health services in a disadvantaged community, thereby improving overall health and wellbeing. The student-led clinic is an invaluable and sustainable link between students, health care professionals, community based organisations, the university, and the community. The community benefits from the clinic by learning to self-manage health and wellbeing issues. The benefits for students are that they gain practical experience in an interdisciplinary setting and through exposure to a community with unique and severe needs.

Contracting and Procurement for Evidence-Based Interventions in Public-Sector Human Services: A Case Study.

PubMed

Willging, Cathleen E; Aarons, Gregory A; Trott, Elise M; Green, Amy E; Finn, Natalie; Ehrhart, Mark G; Hecht, Debra B

2016-09-01

Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives.

Advancing Long Tail Data Capture and Access Through Trusted, Community-Driven Data Services at the IEDA Data Facility

NASA Astrophysics Data System (ADS)

Lehnert, K. A.; Carbotte, S. M.; Ferrini, V.; Hsu, L.; Arko, R. A.; Walker, J. D.; O'hara, S. H.

2012-12-01

Substantial volumes of data in the Earth Sciences are collected in small- to medium-size projects by individual investigators or small research teams, known as the 'Long Tail' of science. Traditionally, these data have largely stayed 'in the dark', i.e. they have not been properly archived, and have therefore been inaccessible and underutilized. The primary reason has been the lack of appropriate infrastructure, from adequate repositories to resources and support for investigators to properly manage their data, to community standards and best practices. Lack of credit for data management and for the data themselves has contributed to the reluctance of investigators to share their data. IEDA (Integrated Earth Data Applications), a NSF-funded data facility for solid earth geoscience data, has developed a comprehensive suite of data services that are designed to address the concerns and needs of investigators. IEDA's data publication service registers datasets with DOI and ensures their proper citation and attribution. IEDA is working with publishers on advanced linkages between datasets in the IEDA repository and scientific online articles to facilitate access to the data, enhance their visibility, and augment their use and citation. IEDA's investigator support ranges from individual support for data management to tools, tutorials, and virtual or face-to-face workshops that guide and assist investigators with data management planning, data submission, and data documentation. A critical aspect of IEDA's concept has been the disciplinary expertise within the team and its strong liaison with the science community, as well as a community-based governance. These have been fundamental to gain the trust and support of the community that have lead to significantly improved data preservation and access in the communities served by IEDA.

European grid services for global earth science

NASA Astrophysics Data System (ADS)

Brewer, S.; Sipos, G.

2012-04-01

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

The European ALMA Regional Centre: a model of user support

NASA Astrophysics Data System (ADS)

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

2014-08-01

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

A community-based partnership to promote information infrastructure for bleeding disorders.

PubMed

Aschman, Diane J; Abshire, Thomas C; Shapiro, Amy D; Lusher, Jeanne M; Forsberg, Ann D; Kulkarni, Roshni

2011-12-01

Specialists in rare disorders often face challenges in collecting surveillance and research data. As movement toward more fully realizing the potential of electronic health information gains momentum, practitioners who treat individuals with rare disorders are in need of public-private support to tap into the advantages offered by the developing electronic information technologies and the interoperability standards promulgated by the USDHHS. The not-for-profit American Thrombosis and Hemostasis Network (ATHN) was created in 2006 to provide stewardship of a secure, national, web-based database to support federally funded hemophilia treatment centers (HTCs) across the country. In pursuit of its mission to support clinical outcomes analysis, research, advocacy, and public health reporting in the hemostasis and thrombosis community, ATHN has established a spectrum of community-based partnerships. This paper describes the process and public health benefits of creating formal relationships with 127 of the 134 HTCs from 12 regional networks across the U.S., government agencies such as the CDC, Health Resources and Services Administration, and NIH; consumer-based organizations; and industry leaders. This community-based partnership model can be applied to other rare disorders communities with high economic and public health impact. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

ERIC Educational Resources Information Center

Emmanuel-Frenel, Rouseline

2017-01-01

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

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

ERIC Educational Resources Information Center

Stanlick, Sarah; Sell, Marla

2016-01-01

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

The process of developing a community-based research agenda with lesbian, gay, bisexual, transgender and queer youth in the Northwest Territories, Canada.

PubMed

Logie, Carmen H; Lys, Candice

2015-01-01

Youth in Canada's Northwest Territories (NWT) experience sexual and mental health disparities. Higher rates of sexual and mental health concerns among lesbian, gay, bisexual, transgender and queer (LGBTQ) youth in comparison with heterosexual and cisgender peers have been associated with stigma and discrimination. Although LGBTQ youth in the NWT are situated at the nexus of Northern and LGBTQ health disparities, there is little known about their health, well-being and experiences of stigma. This short communication discusses the process of developing a LGBTQ youth community-based research programme in the NWT. We developed an interdisciplinary research team of LGBTQ and allied young adults, including indigenous and non-indigenous researchers, community organisers and service providers in the NWT. We conducted meetings in Yellowknife with LGBTQ youth (n=12) and key stakeholders (n=15), including faculty, students, community groups and health and social service providers. Both meetings included LGBTQ and allied participants who were LGBTQ, indigenous, youth and persons at the intersection of these identities. LGBTQ youth participants discussed community norms that devalued same sex identities and stigma surrounding LGBTQ-specific services and agencies. Stigma among LGBT youth was exacerbated for youth in secondary schools, gender non-conforming and transgender youth and young gay men. In the stakeholder meeting, service providers discussed the importance of integrating LGBTQ issues in youth programmes, and LGBTQ community groups expressed the need for flexibility in service delivery to LGBTQ youth. Stakeholders identified the need to better understand the needs of indigenous LGBTQ youth in the NWT. Community-based LGBTQ groups, researchers and health and social service providers are interested in addressing LGBTQ youth issues in the NWT. The emergence of LGBTQ community building, support groups and activism in Northern Canada suggests that this is an opportune time to explore LGBTQ youth health.

Boomer Matters: Responding to Emotional Health Needs in an Aging Society.

PubMed

O'Connor, Deborah; Kelson, Elizabeth

2018-01-01

This study explores baby boomer-aged adults' experiences accessing an emotional health program (EHP) in a community-based seniors' center, examining differences between it and an older cohort of users. Data generation includes client-based surveys (n=118), in-depth qualitative interviews (n=20) with client users and professionally-trained counselors (n=2), and a focus group with peer support service worker (n=14). Key findings suggest EHPs as a preventative strategy to address familial abuse, the need for education and support on sexual health and dating, and the need to combat ageism to improve access. Community-based seniors' centers as a cost-effective approach to health promotion is also highlighted.

How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand

PubMed Central

Miller, Fiona; Breton, Mylaine; Couturier, Yves; Morton-Chang, Frances; Ashton, Toni; Sheridan, Nicolette; Peckham, Alexandra; Williams, A Paul; Kenealy, Tim; Wodchis, Walter

2017-01-01

Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence. PMID:28970754

School-based service delivery for homeless students: relevant laws and overcoming access barriers.

PubMed

Sulkowski, Michael L; Joyce-Beaulieu, Diana K

2014-11-01

Schools in the United States are facing a record number of homeless students. These students are highly at-risk for experiencing negative life outcomes, and they face considerable academic and social-emotional functional impairments. To help address the complex needs of homeless students, this article reviews the intersection of laws and practices that impact homeless students, as well as contemporary school-based service delivery efforts to support the academic and social-emotional needs of these students. In addition, this article also reviews several barriers to school-based service delivery for homeless students and ways to overcome these barriers. These barriers include confusion regarding consent and record-sharing procedures, ineffectively utilizing homeless liaisons, and misapplying tenants of Multitiered Systems of Support (MTSS), which is a school-based service-delivery framework that has been adopted by and implemented in many U.S. schools. Ultimately, this article aims to provide members of school communities with practical information that they can use to support the homeless youth they encounter and serve. (c) 2014 APA, all rights reserved.

Person-centred services? Rhetoric versus reality.

PubMed

Joyce, Catherine

2017-04-01

National and jurisdictional governments are increasingly using commissioning in health and community services. This includes the devolution of functions such as service planning, resource allocation, and regionalised approaches to intake and service delivery, to non-government organisations. The aims of this paper are to reflect on the experiences of commissioning as a not-for-profit health provider, and to identify some important early lessons. This analysis highlights the importance of a rights-based approach in which consumers, carers and communities actively participate in the design, implementation and evaluation of service systems, not just individual service needs; and that pays special attention to the most disadvantaged and the most vulnerable. The mechanisms and approaches used by cohealth to implement these principles are described. Service users need to be supported to develop advocacy capacity individually and collectively, in order to make informed choices about their own service needs and about the system more broadly, to ensure accessible and appropriate services.

Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.

PubMed

Bull, Janet; Zafar, S Yousuf; Wheeler, Jane L; Harker, Matthew; Gblokpor, Agbessi; Hanson, Laura; Hulihan, Deirdre; Nugent, Rikki; Morris, John; Abernethy, Amy P

2010-08-01

Outpatient palliative care, an evolving delivery model, seeks to improve continuity of care across settings and to increase access to services in hospice and palliative medicine (HPM). It can provide a critical bridge between inpatient palliative care and hospice, filling the gap in community-based supportive care for patients with advanced life-limiting illness. Low capacities for data collection and quantitative research in HPM have impeded assessment of the impact of outpatient palliative care. In North Carolina, a regional database for community-based palliative care has been created through a unique partnership between a HPM organization and academic medical center. This database flexibly uses information technology to collect patient data, entered at the point of care (e.g., home, inpatient hospice, assisted living facility, nursing home). HPM physicians and nurse practitioners collect data; data are transferred to an academic site that assists with analyses and data management. Reports to community-based sites, based on data they provide, create a better understanding of local care quality. The data system was developed and implemented over a 2-year period, starting with one community-based HPM site and expanding to four. Data collection methods were collaboratively created and refined. The database continues to grow. Analyses presented herein examine data from one site and encompass 2572 visits from 970 new patients, characterizing the population, symptom profiles, and change in symptoms after intervention. A collaborative regional approach to HPM data can support evaluation and improvement of palliative care quality at the local, aggregated, and statewide levels.

Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review

PubMed Central

Mwai, Grace W; Mburu, Gitau; Torpey, Kwasi; Frost, Peter; Ford, Nathan; Seeley, Janet

2013-01-01

Introduction The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). Methodology A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa. Results In total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making. Conclusions CHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further research focusing on comparative costs of CHW interventions and successful models for mainstreaming CHWs into wider health systems is needed. PMID:24029015

The Role of Empowerment in a School-Based Community Service Program with Inner-City, Minority Youth

PubMed Central

Gullan, Rebecca L.; Power, Thomas J.; Leff, Stephen S.

2014-01-01

Despite considerable fiscal and structural support for youth service programs, research has not demonstrated consistent outcomes across participants or programs, suggesting the need to identify critical program processes. The present study addresses this need through preliminary examination of the role of program empowerment in promoting positive identity development in inner-city, African American youth participating in a pilot school-based service program. Results suggest that participants who experienced the program as empowering experienced increases in self-efficacy, sense of civic responsibility, and ethnic identity, over and above general engagement and enjoyment of the program. Preliminary exploration of differences based on participant gender suggests that some results may be stronger and more consistent for males than females. These findings provide preliminary support for the importance of theoretically grounded program processes in producing positive outcomes for youth service participants. PMID:25104875

Moving diabetes management from clinic to community: development of a prototype based on automated voice messaging.

PubMed

Piette, J D

1997-01-01

The purpose of this study is twofold. First, it provides a review of the literature supporting the development of a new service to help patients with diabetes and their providers manage their care. This service, automated voice messaging (AVM) with nurse follow-up, allows for systematic and intensive patient monitoring and diabetes education as well as a means of focusing clinical resources where they are most needed. Second, it provides a description of a prototype AVM-based diabetes management service that has been developed as part of two ongoing, randomized, controlled trials to test the efficacy of AVM care for patients with Type 2 diabetes. Preliminary findings from implementing this service in two large public healthcare systems suggest that AVM-supported care is feasible, desirable by clinicians and patients with diabetes, and may identify serious health problems that otherwise would go unnoted through standard means of clinic-based patient care.

Pacific CRYSTAL Teacher Professional Development Models: Lessons Learned

NASA Astrophysics Data System (ADS)

van der Flier-Keller, E.; Yore, L.

2010-12-01

From 2005 to 2010 Pacific CRYSTAL (Centre for Research in Youth Science Teaching and Learning) has been engaged in community-based research fostering teacher leadership in innovative science education through a variety of approaches to teacher professional development. Pacific CRYSTAL is a University of Victoria based, NSERC funded project founded on a collaborative research model involving scentists, science educators and community members including schools, teachers, community groups and government. Pacific CRYSTAL professional development approaches embrace both in-service teachers and pre-service teachers, and include Lighthouse schools, workshops (ongoing as well as one-time), community-based partnerships in Pacific CRYSTAL research projects, teachers as researchers, and university science courses and workshops for pre-education and education students. A number of common themes, identified through these approaches, should be considered in the development and implementation of future science professional development initiatives. They include; teacher turnover, expanding and adding schools and participating teachers, teacher apprehension, building leadership capacity, further engagement of 'tourist' teachers, continuing professional support for teachers, as well as on-going mentoring.

Building Fire Behavior Analyst (FBAN) capability and capacity: Lessons learned From Victoria, Australia's Bushfire Behavior Predictive Services Strategy

Treesearch

K. E. Gibos; A. Slijepcevic; T. Wells; L. Fogarty

2015-01-01

Wildland fire managers must frequently make meaning from chaos in order to protect communities and infrastructure from the negative impacts of fire. Fire management personnel are increasingly turning to science to support their experience-based decision-making processes and to provide clear, confident leadership for communities frequently exposed to risk from wildfire...

C.I.T.E. Community Integrated Training and Education: An Alternative to Facility-Based Services.

ERIC Educational Resources Information Center

Robinson, David L.

The Community Integrated Training and Education (C.I.T.E.) program, sponsored by the Hamilton County (Ohio) Board of Mental Retardation, is a support program for county families with mentally retarded children, aged 6 months to 22 years. The program is structured to provide education and training for families who have decided against residential…

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

PubMed

McVilly, K; Webber, L; Paris, M; Sharp, G

2013-08-01

Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence.

PubMed

Lyle, David; Saurman, Emily; Kirby, Sue; Jones, Debra; Humphreys, John; Wakerman, John

2017-01-01

A Centre of Research Excellence (CRE) in Rural and Remote Primary Healthcare was established in 2012 with the goal of providing evidence to inform policy development to increase equity of access to quality health care and the identification of services that should be available to the diverse communities characterising Australia. This article reports on the key findings from seven CRE service evaluations to better understand what made these primary health care (PHC) models work where they worked, and why. We conducted a narrative synthesis of 15 articles reporting on seven CRE service evaluations of different PHC models published between 2012 and 2015. Three different contexts for PHC reform were evaluated: community, regional and clinic based. Themes identified were factors that enabled changes to PHC delivery, processes that supported services to improve access to PHC and requirements for service adaptation to promote sustainability. In both Indigenous and mainstream community settings, the active engagement with local communities, and their participation in, or leadership of, shared decision-making was reported across the three themes. In addition, local governance processes, informed by service activity and impact data, enabled these service changes to be sustained over time. The considerations were different for the outreach, regional and clinic services that relied on internal processes to drive change because they did not require the cooperation of multiple organisations to succeed. The review highlighted that shared decision-making, negotiation and consultation with communities is important and should be used to promote feasible strategies that improve access to community-based PHC services. There is a growing need for service evaluations to report on the feasibility, acceptability and fit of successful service models within context, in addition to reach and effectiveness in order to provide evidence for local dissemination, adaption and implementation strategies.

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

ERIC Educational Resources Information Center

Bailey, Maria; Doody, Owen; Lyons, Rosemary

2016-01-01

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

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

PubMed

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

2018-05-06

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

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

PubMed

Flood, Jeanie L

2017-01-01

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

Adopting a Sustainable Community of Practice Model when Developing a Service to Support Patients with Epidermolysis Bullosa (EB): A Stakeholder-Centered Approach.

PubMed

Gowran, Rosemary Joan; Kennan, Avril; Marshall, Siobhán; Mulcahy, Irene; Ní Mhaille, Sile; Beasley, Sarah; Devlin, Mark

2015-02-01

Epidermolysis bullosa (EB) is a rare, genetic skin condition that is complicated, distressing, and painful and permeates every aspect of patients' lives. Support services are essential for meeting the primary needs of patients and families living with EB; however, provision is challenged by many complex issues. In collaboration with the patient organization DEBRA Ireland, this research conducted an in-depth analysis of Irish healthcare support services for EB, with a view to moving towards an improved and sustainable care pathway. A sustainable community of practice model (SCOP), as a core construct provided a simplified framework when studying this complex system. The research utilized mixed methods, comprising individual interviews, questionnaires, and a participatory action research workshop based on a soft systems approach. The study engaged patients, family members, service providers, and policy developers. Findings emphasized that the complexities of life with EB are more than 'skin deep'. The lived experience of stakeholders revealed many levels of emotion, both positive and heart-rending. Despite the positive efforts of specialists in this field, inadequacies to meet the primary needs of people with EB, such as bandages-fundamental for survival-were highlighted. Participants reported challenges relating to understanding patients' needs, access to consistent services within hospitals and the community, time constraints, and the strong emotions evoked by this severe and rare disease. The study identified several areas that can be targeted to bring about improvements in meeting primary needs. Education and research at public, policy, and practice levels need to be prioritized. It is imperative that citizens move beyond an awareness that EB exists and demonstrate a consciousness about the importance of advocating and enabling seamless and sustainable support services through collective action.

[Development of a nurse-led family counseling program for families of the elderly: the first cycle of a Community-Based Action Research Project (CBPR)].

PubMed

Mahrer-Imhof, Romy; Hediger, Hannele; Naef, Rahel; Bruylands, Michelle

2014-08-01

With the support of family members many elderly people can live an independent life at home. Accepting support respectively providing support might be a challenge for both elder and family member. Families often have little professional support to manage those challenges. Therefore, a nurse-led counseling program for families of the elders has been established. The counseling program was developed with community-based participatory research (CBPR) methodology using individual and focus group interviews, as well as a written survey and tested in a pilot study. Managing disease in everyday life, helpful means of support at home, changes in family relations, information about services as well as information how to navigate the healthcare system have been themes to discuss in the counseling sessions. Participants in the pilot study showed a statistically not significant increase in well-being, and preparedness for care and were highly satisfied with the counseling program. Families of the elderly could actively participate in developing and researching a nurse-led family counseling program. Several family members still engage as co-researcher in the program and participate to improve the new service.

Using Satellite-Based Earth Science Data in a Public Health Decision-Support System to Track and Forecast Pollen Events

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Budge, A.

2013-12-01

There is widespread recognition within the public health community that ongoing changes in climate are expected to increasingly pose threats to human health. Environmentally induced health risks to populations with respiratory illnesses are a growing concern globally. Of particular concern are dust and smoke events carrying PM2.5 and PM10 particle sizes, ozone, and pollen. There is considerable interest in documenting the precise linkages between changing patterns in the climate and how these shifts impact the prevalence of respiratory illnesses. The establishment of these linkages can drive the development of early warning and forecasting systems to alert health care professionals of impending air-quality events. As a component of a larger NASA-funded project on Integration of Airborne Dust Prediction Systems and Vegetation Phenology to Track Pollen for Asthma Alerts in Public Health Decision Support Systems, the Earth Data Analysis Center (EDAC) at the University of New Mexico, is developing web-based visualization and analysis services for forecasting pollen concentration data. This decision-support system, New Mexico's Environmental Public Health Tracking System (NMEPHTS), funded by the Centers for Disease Control (CDC) Environmental Public Health Tracking Network (EPHTN), aims to improve health awareness and services by linking health effects data with levels and frequency of environmental exposure. The forecast of atmospheric events with high pollen concentrations has employed a modified version of the DREAM (Dust Regional Atmospheric Model, a verified model for atmospheric dust transport modeling. In this application, PREAM (Pollen Regional Atmospheric Model) models pollen emission using a MODIS-derived phenology of Juniperus spp. communities. Model outputs are verified and validated with ground-based records of pollen release timing and quantities. Outputs of the PREAM model are post-processed and archived in EDAC's Geographic Storage, Transformation, and Retrieval Engine (GStore) database. The GStore geospatial services platform provides general purpose web services based upon the REST service model, and is capable of data discovery, access, and publication functions, metadata delivery functions, data transformation, and auto-generated OGC services for those data products that can support those services. These services are in turn ingested by New Mexico's EPHTN where end users in the public health community can then assess environmental-pubic health data associations. Advances in web mapping and related technologies open new doors for data providers and users that can deliver data and information in near-real time. In the public health community these technologies are being used to enhance disease and syndromic surveillance systems, visualize environmentally-related events such as pollen and dust events, and to provide focused mapping and analysis capabilities on the desktop. Here we present the current results of the project, and will focus on the challenges encountered in providing reliable and accurate forecast of pollen concentrations, as well as the experience of integrating output results and services into end user applications that can provide timely and meaningful alerts and forecasts.

Quality Indicators for Multidisciplinary Team Functioning in Community-Based Children’s Mental Health Services

PubMed Central

Kutash, Krista; Acri, Mary; Pollock, Michele; Armusewicz, Kelsey; Hoagwood, Kimberly Eaton

2014-01-01

The current study examined the organizational social context in 21 community-based programs serving youth at-risk for out-of-home care due to emotional or behavioral disorders and their families and program performance on five quality indicators of team functioning in teams that included a family support specialist. Results indicate that programs with higher performance on structures to facilitate teamwork, informal communication mechanisms among team members, and the ability to integrate family support specialists as equal members of the team showed more positive organizational functioning. Implications for the role of quality indicators in health care reform efforts are discussed. PMID:23873037

Tackling community integration in mental health home visit integration in Finland.

PubMed

Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

2016-09-01

Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge. © 2015 John Wiley & Sons Ltd.

Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

PubMed

Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

2015-02-01

Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

Socioecological Influences on Community Involvement in HIV Vaccine Research

PubMed Central

Frew, Paula M.; Archibald, Matthew; Hixson, Brooke; del Rio, Carlos

2011-01-01

Objective This study investigated socioecological factors influencing HIV vaccine research participation among communities living in geographic areas with high HIV prevalence and high poverty rates. Methods We surveyed a sample of 453 adults ≥ 18 years from areas of high poverty and high HIV prevalence in metro Atlanta and differentiated the effects of individual-, social/organizational-, and community-level characteristics on participation in HIV vaccine research via multilevel modeling techniques that incorporated questionnaire, program, and census data. Results Models that adjusted for both individual-level covariates (such as race, gender, attitudes, and beliefs concerning HIV research), social/organizational- and community-level factors such as local HIV prevalence rates, revealed that the extent of HIV prevention-related programs and services in census tracts contributed to individuals’ likelihood of participation in an HIV vaccine study. Additionally, neighborhood-based organizations offering HIV medical and treatment programs, support groups, and services (e.g., food, shelter, and clothing) encourage greater HIV vaccine research participation. Conclusions The findings support the hypothesis that community-level factors facilitate participation in HIV vaccine research independent of both individual- and social/organizational-level factors. PMID:21722689

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

DOT National Transportation Integrated Search

2007-04-25

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

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

ERIC Educational Resources Information Center

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

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

Self-efficacy, social support and service integration at medical cannabis facilities in the San Francisco Bay area of California.

PubMed

Reiman, Amanda E

2008-01-01

In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out on site. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups - all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a social model of cannabis care, including allowing patients to use medicine on site and offering social services. This approach has implications for the creation and maintenance of a continuum of care among bottom-up social and health services agencies.

A primary care-public health partnership addressing homelessness, serious mental illness, and health disparities.

PubMed

Weinstein, Lara Carson; Lanoue, Marianna D; Plumb, James D; King, Hannah; Stein, Brianna; Tsemberis, Sam

2013-01-01

People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the "10 Essential Public Health Services." Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system. The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the "grand challenges" of integrated community health services.

Direct telemarketing of smoking cessation interventions: will smokers take the call?

PubMed

Paul, C L; Wiggers, J; Daly, J B; Green, S; Walsh, R A; Knight, J; Girgis, A

2004-07-01

Few smokers currently make use of available and effective cessation strategies, despite their expressed desire to quit and reported interest in cessation support. This study aimed to explore the feasibility of a telephone-based direct-marketing approach to delivering cessation strategies. DESIGN, SETTING, MEASUREMENTS AND PARTICIPANTS: A community survey was conducted to explore the views of current adult smokers regarding the acceptability, likely uptake and barriers to uptake of smoking cessation services offered by direct telephone marketing. Three quarters (73.8%) of smokers contacted agreed to be surveyed. Of the 194 study participants, 75.3% reported that they would utilize vouchers for discount nicotine replacement therapy (NRT), 66.5% would use a mailed self-help booklet, 57.2% would take up the offer of regular mailings of personalized letters and self-help materials and 46.4% would utilize a 'we-call-you' telephone counselling service. The characteristics of those indicating likely uptake of these services were also explored. The two major barriers to uptake of services were preferring to quit without help and a belief that a particular service would not help the participant. The data suggest strong support for the direct marketing of smoking cessation strategies; they also highlight the need for further study of the cost-effectiveness of telephone-based direct marketing of smoking cessation strategies as a population-based strategy for reducing the prevalence of smoking in the community.

Community-based Provision for Young Deaf Children Aged from Birth to Five Years.

ERIC Educational Resources Information Center

Evans, Roy; Robinshaw, Helen

2000-01-01

Reports preliminary findings of the first national survey of services to identify and provide specialist support to profoundly deaf infants and young children in England and Wales. Notes that the resources available for early identification of deaf infants and the quality of professional support to promote habilitation is quite variable.…

The need and its influence factors for community-based rehabilitation services for disabled persons in one district in Beijing.

PubMed

Dai, Hong; Xue, Hui; Yin, Zong-Jie; Xiao, Zhong-Xin

2006-12-01

To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Of the interviewees, 57.4% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost (P < 0.05), knowledge about rehabilitation medicine (P < 0.05); and the belief in the therapeutic benefit of the community-based rehabilitation service (P < 0.05). A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

PubMed Central

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-01-01

Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394

Delivering Coordinated, Community-Based Services by Putting Networks into Action: New York City's Change Capital Fund. No. 3

ERIC Educational Resources Information Center

Aceves, Aurelia De La Rosa; Greenberg, David M.; Schell, Sarah

2016-01-01

This brief is the third in a series documenting the implementation of an economic mobility initiative supported by New York City's Change Capital Fund (CCF). CCF is a consortium of New York City donors formed to invest in local nonprofits that undertake data-driven antipoverty strategies integrating housing, education, and employment services. CCF…

Un/Paid Labor: Medicaid Home and Community Based Services Waivers That Pay Family as Personal Care Providers

ERIC Educational Resources Information Center

Friedman, Carli; Rizzolo, Mary C.

2016-01-01

The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how…

The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs.

PubMed

Shelby, Rebecca A; Taylor, Kathryn L; Kerner, Jon F; Coleman, Ellen; Blum, Diane

2002-01-01

We examined information from community-based and philanthropic organizations to document the cancer-related services that are currently available, establish which services are still needed, and determine who utilizes these formal support networks. In Phase I, 32 of 41 eligible organizations participated in a survey conducted from December 1999 to March 2000. The most common mission focus among participating organizations was information/referral-centered. The most common services provided were referrals to information resources and provision of cancer-related information. Only two of the organizations in Phase I provided client demographic information and both indicated that client populations were predominantly white, female, and over age 40. Phase II of the study involved analyzing patient data from Cancer Care, Inc., a national service organizations for cancer patients. Between 1983 and 1997, there were 2,714 prostate cancer patients and 9,451 breast cancer patients included in the Cancer Care database. Their most commonly reported problems were related to personal adjustment to illness, financial, home care, and transportation needs. There were significant differences in problems reported depending upon age and disease status. In addition, the results of this study support the idea that those at highest risk for developing and dying of cancer are the least likely to utilize formal support networks. Further, a gap in service provision for assistance with practical needs (e.g., transportation, home care, child care, psychosocial support) was identified. Due to the increasing use of outpatient care for cancer patients, a greater demand for practical assistance can be expected in the future. The availability of practical services will need to be increased in order to effectively meet cancer patient needs.

Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

PubMed Central

Moshabela, Mosa; Sips, Ilona; Barten, Francoise

2015-01-01

Background Community care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network. Design We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network available to the client, and preferences of the clients remain central to the process of negotiating care. PMID:26689459

Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa.

PubMed

Moshabela, Mosa; Sips, Ilona; Barten, Francoise

2015-01-01

Community care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network. We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter - 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants' references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients' care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network available to the client, and preferences of the clients remain central to the process of negotiating care.

[Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

PubMed

Boidin, B

2015-02-01

This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

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

DOT National Transportation Integrated Search

2009-07-01

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

"It was the whole picture" a mixed methods study of successful components in an integrated wellness service in North East England.

PubMed

Cheetham, M; Van der Graaf, P; Khazaeli, B; Gibson, E; Wiseman, A; Rushmer, R

2018-03-22

A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of 'active ingredients' at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

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

ERIC Educational Resources Information Center

Kleinert, Harold L.; Sheppard-Jones, Kathy

2014-01-01

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

Enculturation and attitudes toward intimate partner violence and gender roles in an asian Indian population: implications for community-based prevention.

PubMed

Yoshihama, Mieko; Blazevski, Juliane; Bybee, Deborah

2014-06-01

This study examined the relationships among enculturation, attitudes supporting intimate partner violence (IPV-supporting attitudes), and gender role attitudes among one of the largest Asian Indian population groups in the US. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit. Using structural equation modeling, we modeled the effects of three components of enculturation (behavior, values, and community participation) on gender role attitudes and IPV-supporting attitudes among married respondents (N = 373). Analyses also accounted for the effects of respondent age, education, religious service attendance, perceived financial difficulty, and lengths of residence in the US. The second-order, overall construct of enculturation was the strongest predictor of IPV-supporting attitudes (standardized B = 0.61), but not gender role attitudes. Patriarchal gender role attitudes were positively associated with IPV-supporting attitudes (B = 0.49). In addition to the overall effect of the enculturation construct, two of the components of enculturation had specific effects. "Enculturation-values" had a specific positive indirect association with IPV-supporting attitudes, through its relationship with patriarchal gender role attitudes. However, "enculturation-community participation" was negatively associated with IPV-supporting attitudes, suggesting the importance of community-based prevention of IPV among this immigrant population group.

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of 'Living Life to the Full Interactive', 'Sleepio' and 'Breaking Free Online' at 'Self Help Services'.

PubMed

Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

2017-07-20

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. 1068 service users referred to the service for secondary care for their mental health difficulties. Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need. Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p<0.0001; anxiety CI 077 to 1.72, p<0.0001) and Sleepio (depression CI 1.19 to 4.52, p<0.0001; anxiety CI 2.16 to 5.23, p<0.0001) groups. Promising improvements in mental health scores were found within all three groups (all p<0.0001), as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties (p<0.0001). Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online. Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Supporting the scientific lifecycle through cloud services

NASA Astrophysics Data System (ADS)

Gensch, S.; Klump, J. F.; Bertelmann, R.; Braune, C.

2014-12-01

Cloud computing has made resources and applications available for numerous use cases ranging from business processes in the private sector to scientific applications. Developers have created tools for data management, collaborative writing, social networking, data access and visualization, project management and many more; either for free or as paid premium services with additional or extended features. Scientists have begun to incorporate tools that fit their needs into their daily work. To satisfy specialized needs, some cloud applications specifically address the needs of scientists for sharing research data, literature search, laboratory documentation, or data visualization. Cloud services may vary in extent, user coverage, and inter-service integration and are also at risk of being abandonend or changed by the service providers making changes to their business model, or leaving the field entirely.Within the project Academic Enterprise Cloud we examine cloud based services that support the research lifecycle, using feature models to describe key properties in the areas of infrastructure and service provision, compliance to legal regulations, and data curation. Emphasis is put on the term Enterprise as to establish an academic cloud service provider infrastructure that satisfies demands of the research community through continious provision across the whole cloud stack. This could enable the research community to be independent from service providers regarding changes to terms of service and ensuring full control of its extent and usage. This shift towards a self-empowered scientific cloud provider infrastructure and its community raises implications about feasability of provision and overall costs. Legal aspects and licensing issues have to be considered, when moving data into cloud services, especially when personal data is involved.Educating researchers about cloud based tools is important to help in the transition towards effective and safe use. Scientists can benefit from the provision of standard services, like weblog and website creation, virtual machine deployments, and groupware provision using cloud based app store-like portals. And, other than in an industrial environment, researchers will want to keep their existing user profile when moving from one institution to another.

Palliative care needs of terminally ill people living alone: a service provider perspective.

PubMed

Aoun, Samar M; Wall, David; Kristjanson, Linda J; Shahid, Shaouli

2013-01-01

Community-based palliative care services face challenges in meeting the needs of terminally ill clients who live alone without a primary caregiver. Yet, there is a dearth of literature on the perceptions of health service providers (HSPs) regarding the care needs and possible management options to assist this growing group to remain at home. This paper investigated the support needs of people living alone with a terminal illness from a service provider perspective. In depth semi-structured interviews were conducted with nine HSPs from community based services in three Australian states. Four main themes emerged: care challenges, differences in care provision, appropriate approaches to care and essentials for an effective service such as 24 h care, cost-free provision of personal alarm systems, supported and coordinated housekeeping services, funded respite care and financial care packages. HSPs expressed a respect for the autonomy and independence of the clients, yet felt pressured to ensure that safe and attentive care was possible. HSPs recognised the central importance of maintaining the independence and autonomy of palliative care clients living alone. This study is the first in-depth account of what HSPs perceive they need to effectively look after home alone dying clients. The study provided directions to inform service planning for this growing and challenging population group regarding adequate and timely services that will lead to more complying with the clients' wishes, more care being delivered at home, a reduction in hospitalisations, a better quality of life and a capacity to die at home.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Pharmacy students' attitudes towards physician-pharmacist collaboration: Intervention effect of integrating cooperative learning into an interprofessional team-based community service.

PubMed

Wang, Jun; Hu, Xiamin; Liu, Juan; Li, Lei

2016-09-01

The aim of this study was to evaluate the attitudes towards physician-pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students' attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP(2)C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP(2)C among 235 Chinese pharmacy students was 51.44. Cronbach's alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE.

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.

New Data Services for Polar Investigators from Integrated Earth Data Applications (IEDA)

NASA Astrophysics Data System (ADS)

Nitsche, F. O.; Ferrini, V.; Morton, J. J.; Arko, R. A.; McLain, K.; O'hara, S. H.; Carbotte, S. M.; Lehnert, K. A.; IEDA Team, I.

2013-12-01

Accessibility and preservation of data is needed to support multi-disciplinary research in the key environmentally sensitive Polar Regions. IEDA (Integrated Earth Data Applications) is a community-based data facility funded by the US National Science Foundation (NSF) to support, sustain, and advance the geosciences by providing data services for observational solid earth data from the Ocean, Earth, and Polar Sciences. IEDA tools and services relevant to the Polar Research Community include the Antarctic and Southern Ocean Data System (ASODS), the U.S. Antarctic Program Data Coordination Center (USAP-DCC), GeoMapApp, as well as a number of services for sample-based data (SESAR and EarthChem). In addition to existing tools, which assist Polar investigators in archiving their data, and creating DIF records for global searches in AMD, IEDA recently added several new tools and services that will provide further support for investigators with the data life cycle process. These include a data management plan (http://www.iedadata.org/compliance/plan) and data compliance reporting tool (http://www.iedadata.org/compliance/report) that will help investigators comply with the requirements of funding agencies such as the National Science Foundation (NSF). Data, especially from challenging Polar Regions, are likely to be used by other scientists for future studies. Therefore, data acknowledgment is an important concern of many investigators. To encourage data acknowledgments by data users, we link references of publications (when known) to datasets and cruises registered within the ASODS system as part of our data curation services (http://www.marine-geo.org/portals/antarctic/references.php). In addition, IEDA offers a data publication service to register scientific data with DOI's, making data sets citable as publications with attribution to investigators as authors. IEDA is a publication agent of the DataCite consortium. Offering such services provides additional incentives for making data available through data centers. Such tools and services are important building blocks of a coherent and comprehensive (cyber) data support structure for Polar investigators.

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...

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

PubMed

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

2012-06-01

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

Providing Health Sciences Services in a Joint-Use Distributed Learning Library System: An Organizational Case Study.

PubMed

Enslow, Electra; Fricke, Suzanne; Vela, Kathryn

2017-01-01

The purpose of this organizational case study is to describe the complexities librarians face when serving a multi-campus institution that supports both a joint-use library and expanding health sciences academic partnerships. In a system without a centralized health science library administration, liaison librarians are identifying dispersed programs and user groups and collaborating to define their unique service and outreach needs within a larger land-grant university. Using a team-based approach, health sciences librarians are communicating to integrate research and teaching support, systems differences across dispersed campuses, and future needs of a new community-based medical program.

Accelerating the translation of research into practice in long term services and supports: a critical need for federal infrastructure at the nexus of aging and disability.

PubMed

Washko, Michelle M; Campbell, Margaret; Tilly, Jane

2012-01-01

The nexus of aging and disability, characterized by the phenomenon of aging with a disability, will become more visible as the population ages and the number of people with disabilities surviving to midlife increases. This article addresses 3 interrelated issues critical to the fields of aging and disability: increasing demand for community-based long-term services and supports, a paucity of evidence-based programs demonstrating effectiveness in facilitating independence for those aging with a disability, and lack of a federal infrastructure to support coordinated investments in research-to-practice for this population. Suggestions for federal interagency collaborations are given, along with roles for key stakeholders.

The effects of state-level expenditures for home- and community-based services on the risk of becoming a long-stay nursing home resident after hip fracture.

PubMed

Blackburn, J; Locher, J L; Morrisey, M A; Becker, D J; Kilgore, M L

2016-03-01

This study measures the effect of spending policies for long-term care services on the risk of becoming a long-stay nursing home resident after a hip fracture. Relative spending on community-based services may reduce the risk of long-term nursing home residence. Policies favoring alternative sources of care may provide opportunities for older adults to remain community-bound. This study aims to understand how long-term care policies affect outcomes by investigating the effect of state-level spending for home- and community-based services (HCBSs) on the likelihood of an individual's nursing home placement following hip fracture. This study uses data from the 5% sample of Medicare beneficiaries from 2005 to 2010 to identify incident hip fractures among dual-eligibility, community-dwelling adults aged at least 65 years. A multilevel generalized estimating equation (GEE) model estimated the association between an individual's risk of nursing home residence within 1 year and the percent of states' Medicaid long-term support service (LTSS) budget allocated to HCBS. Other covariates included expenditures for Title III services and individual demographic and health status characteristics. States vary considerably in HCBS spending, ranging from 17.7 to 83.8% of the Medicaid LTSS budget in 2009. Hip fractures were observed from claims among 7778 beneficiaries; 34% were admitted to a nursing home and 25% died within 1 year. HCBS spending was associated with a decreased risk of nursing home residence by 0.17 percentage points (p 0.056). Consistent with other studies, our findings suggest that state policies favoring an emphasis on HCBS may reduce nursing home residence among low-income older adults with hip fracture who are at high risk for institutionalization.

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017.

PubMed

Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey

2012-10-01

To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were identified as priorities.

Community based promotion on VCT acceptance among rural migrants in Shanghai, China.

PubMed

Zhang, Tiejun; Tian, Xiuhong; Ma, Fuchang; Yang, Ying; Yu, Feng; Zhao, Yanping; Gao, Meiyang; Ding, Yingying; Jiang, Qingwu; He, Na

2013-01-01

Voluntary counseling and testing (VCT) plays an important integral role in response to the HIV/AIDS epidemic. However, VCT service has not been effectively utilized among rural migrants, a high risk group in China. In this study, we developed a community based intervention to examine if community mobilization with comprehensive VCT is more effective than current HIV preventions with routine VCT service in promoting VCT acceptability among rural migrants in Shanghai, China. A comprehensive intervention with community mobilization and comprehensive VCT services including community-based VCT and mobile VCT was implemented during 2007-2009. Three communities in Minhang District of Shanghai were randomly selected and were designed to receive community mobilization and comprehensive VCT, traditional VCT and none intervention, respectively. After 24 months intervention, effects were evaluated by comparing outcome indicators between the baseline (2,690 participants) and follow-up surveys (1,850 participants). A substantial increase in VCT acceptance was observed among community mobilization group (94.9% vs. 88.5%, P<0.001), whereas the reverse effect was seen in the traditional VCT group (86.1% vs. 94.6%, P<0.001) and control group (69.0% vs. 91.7%, P<0.001). Rural migrants from community mobilization group were more likely to accept VCT (OR = 2.91, 95% CI 1.69-4.97). Rural migrants from community mobilization group also showed significant increase in HIV/AIDS knowledge, positive attitude towards HIV positive individuals and condom use. Community mobilization with comprehensive VCT has significant impact on promotion of VCT acceptance and utilization among rural migrants in Shanghai. These findings provide evidence to support community mobilization as a suitable strategy for VCT promotion among rural migrants in Shanghai, China.

Services for children with developmental co-ordination disorder: an evaluation against best practice principles.

PubMed

Pentland, Jacqueline; Maciver, Donald; Owen, Christine; Forsyth, Kirsty; Irvine, Linda; Walsh, Mike; Crowe, Miriam

2016-01-01

The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation. There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

Community-based abstinence education project: program outcomes.

PubMed

Bailey, Denise Nagle; Wolf, Zane Robinson

2015-01-01

Middle school and adolescent populations demonstrate high rates of unintended pregnancies and sexually transmitted infections, with young people in inner cities in the United States especially vulnerable. Teen births remain high, and youth are affected physically, mentally, socially, and economically. The Sex After Marriage primary prevention program, a federally funded, community-based abstinence education (CBAE) initiative, was implemented for 3 years in Philadelphia neighborhoods with vulnerable youth 12 to 18 years of age, supporting adults, healthcare professionals, and the general public. The three-tiered program offered a middle school curriculum, Sex Can Wait, at 16 different sites. The CBAE program delivered by the university's nursing center attempted to support vulnerable youths' decisions to postpone sexual activity by matching the interests of young people through an established curriculum, by holding workshops for supporting adults, and by creating a multimedia approach to supplement abstinence education initiatives including public service announcements and a website. Youth and college ambassadors and community colleagues were trained in the curriculum with a focus on healthy lifestyles. Youth and parents in experimental and control groups completed self-report surveys before and after program implementation. The project achieved most of its objectives on program evaluation. Youth (n = 1,428) 12 to 18 years of age received services, with most completing ≥75% of the program. Parents (n = 338) and other participating adults (n = 486) also received education or services. The need for risk reduction programs persists for youth in light of pregnancy, birth, and sexually transmitted disease statistics. Bailey Wolf. © 2014 Wiley Periodicals, Inc.

"The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

PubMed

2017-06-01

Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Contracting and Procurement for Evidence-Based Interventions in Public-Sector Human Services: A Case Study

PubMed Central

Willging, Cathleen E.; Aarons, Gregory A.; Trott, Elise M.; Green, Amy E.; Finn, Natalie; Ehrhart, Mark G.; Hecht, Debra B.

2016-01-01

Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives. PMID:26386977

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

PubMed Central

2010-01-01

Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations. PMID:21138584

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand.

PubMed

Ameratunga, Shanthi; Abel, Sally; Tin Tin, Sandar; Asiasiga, Lanuola; Milne, Sharon; Crengle, Sue

2010-12-07

Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations.

Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health

PubMed Central

Levin, Bruce Lubotsky; Massey, Tom; Baldwin, Julie; Williamson, Heather

2016-01-01

An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program’s curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships. PMID:26746638

Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health.

PubMed

Burton, Donna L; Levin, Bruce Lubotsky; Massey, Tom; Baldwin, Julie; Williamson, Heather

2016-04-01

An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program's curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships.

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

PubMed

Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

2017-01-01

New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

The Family Value of Information, Community Support, and Experience Study: Rationale, Design, and Methods of a "Family-Centered" Research Study.

PubMed

Reeves, Gloria M; Wehring, Heidi J; Connors, Kathleen M; Bussell, Kristin; Schiffman, Jason; Medoff, Deborah R; Tsuji, Thomas; Walker, Jane; Brown, Alicia; Strobeck, Danielle; Clough, Tammy; Rush, Caitlin B; Riddle, Mark A; Love, Raymond C; Zachik, Albert; Hoagwood, Kimberly; Olin, S Serene; Stephan, Sharon; Okuzawa, Nana; Edwards, Sarah; Baquet, Claudia; dosReis, Susan

2015-12-01

The Patient Protection and Affordable Care Act focuses on improving consumer engagement and patient-centered care. This article describes the design and rationale of a study targeting family engagement in pediatric mental health services. The study is a 90-day randomized trial of a telephone-delivered Family Navigator services versus usual care for parents of Medicaid-insured youth younger than 13 years with serious mental illness. Youth are identified through a pediatric antipsychotic medication preauthorization program. Family Navigators offer peer support to empower and engage parents in their child's recovery. Outcomes include parent report of empowerment, social support, satisfaction with child mental health services, and child functioning as well as claims-based measures of psychotherapy service utilization and antipsychotic medication dosage. The focus on "family-centered" care in this study is strongly supported by the active role of consumers in study design and implementation.

The Evolution of an Innovative Community-Engaged Health Navigator Program to Address Social Determinants of Health.

PubMed

Page-Reeves, Janet; Moffett, Maurice L; Steimel, Leah; Smith, Daryl T

Health navigators and other types of community health workers (CHWs) have become recognized as essential components of quality care, and key for addressing health disparities owing to the complex health care services landscape presents almost insurmountable challenges for vulnerable individuals. Bernalillo County, New Mexico, has high rates of uninsurance, poverty, and food insecurity. The design of the Pathways to a Healthy Bernalillo County Program (BP) has evolved innovations that are unique in terms of program stability and security, expansive reach, and community capacity across six domains: sustainable public mechanism for program funding, involvement of community organizations in designing the program, expanded focus to address the broader social determinants of health with targeted outreach, an integrated, community-based implementation structure, an outcomes-based payment structure, and using an adaptive program design that actively incorporates navigators in the process. In 2008, the Pathways to a Healthy Bernalillo County Program (BP), located in the Albuquerque metropolitan area in central New Mexico, was established to provide navigation and support for the most vulnerable county residents. BP is funded through a 1% carve out of county mill levy funds. The pathways model is an outcome-based approach for health and social services coordination that uses culturally competent CHW as "navigators" trained to connect at-risk individuals to needed health and social services. One of the important innovations of the pathways approach is a shift in focus from merely providing discrete services to confirming healthy outcomes for the individual patient.

Antenatal peer support workers and initiation of breast feeding: cluster randomised controlled trial.

PubMed

MacArthur, Christine; Jolly, Kate; Ingram, Lucy; Freemantle, Nick; Dennis, Cindy-Lee; Hamburger, Ros; Brown, Julia; Chambers, Jackie; Khan, Khalid

2009-01-30

To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. Cluster randomised controlled trial. Community antenatal clinics in one primary care trust in a multiethnic, deprived population. 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 weeks' gestation within the antenatal clinic or at home. The trained peer support workers were of similar ethnic and sociodemographic backgrounds to their clinic population. Initiation of breast feeding obtained from computerised maternity records of the hospitals where women from the primary care trust delivered. The sample was multiethnic, with only 9.4% of women being white British, and 70% were in the lowest 10th for deprivation. Most of the contacts with peer support workers took place in the antenatal clinics. Data on initiation of breast feeding were obtained for 2398 of 2511 (95.5%) women (1083/1140 intervention and 1315/1371 controls). The groups did not differ for initiation of breast feeding: 69.0% (747/1083) in the intervention group and 68.1% (896/1315) in the control groups; cluster adjusted odds ratio 1.11 (95% confidence interval 0.87 to 1.43). Ethnicity, parity, and mode of delivery independently predicted initiation of breast feeding, but randomisation to the peer support worker service did not. A universal service for initiation of breast feeding using peer support workers provided within antenatal clinics serving a multiethnic, deprived population was ineffective in increasing initiation rates. Current Controlled Trials ISRCTN16126175.

Developing Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial.

PubMed

Watson, Dennis P; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P; Hill, James; Shue, Sarah

2017-01-01

There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.

HIV/AIDS prevention, faith, and spirituality among black/African American and Latino communities in the United States: strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities.

PubMed

Sutton, Madeline Y; Parks, Carolyn P

2013-06-01

Black/African American and Latino communities are disproportionately affected by the domestic HIV/AIDS epidemic. Blacks/African Americans and Latinos are also more likely to report a formal, religious, or faith affiliation when compared with non-Hispanic whites. As such, faith leaders and their institutions have been identified in the National HIV/AIDS Strategy as having a vital role to serve in reducing: (1) HIV-related health disparities and (2) the number of new HIV infections by promoting non-judgmental support for persons living with and at risk for HIV/AIDS and by serving as trusted information resources for their congregants and communities. We describe faith doctrines and faith-science partnerships that are increasing in support of faith-based HIV prevention and service delivery activities and discuss the vital role of these faith-based efforts in highly affected black/African American and Latino communities.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-12-01

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

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

PubMed Central

2013-01-01

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

Utilizing findings from a gender-based analysis to address chronic disease prevention and management among African-American women in a Michigan community.

PubMed

Lombard, Wendy; Burke, Jodi; Waddell, Sandra; Franke, Arthur

2015-08-01

This research note underscores the importance of including strategies to address gender-based disparities when planning and implementing community health improvement programs. Working in collaboration with the Inkster Partnership for a Healthier Community (IPHC), the National Kidney Foundation of Michigan conducted a gender-based analysis as part of its broader community health needs assessment efforts in Inkster, MI. The findings from these studies revealed significant challenges impacting women that were not being adequately addressed within the community. In response to these findings, the IPHC created a strategic action plan to respond to the highest priority needs by increasing community awareness of and linkages to resources that provide supportive services for low-income African-American women. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

PubMed

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

2012-04-01

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

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

PubMed Central

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

2017-01-01

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

Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.

PubMed

Rosenberg, David; Schön, Ulla-Karin; Nyholm, Maria; Grim, Katarina; Svedberg, Petra

2017-04-01

Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers. The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context. The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity. The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden. The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

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

ERIC Educational Resources Information Center

Miller, Michael T.; Tuttle, Courtney C.

2007-01-01

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

Lessons learnt from promising practices in community engagement for the elimination of new HIV infections in children by 2015 and keeping their mothers alive: summary of a desk review.

PubMed

Ackerman Gulaid, Laurie; Kiragu, Karusa

2012-07-11

Through the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping their Mothers Alive, leaders have called for broader action to strengthen the involvement of communities. The Global Plan aspires to reduce new HIV infections among children by 90 percent, and to reduce AIDS-related maternal mortality by half. This article summarizes the results of a review commissioned by UNAIDS to help inform stakeholders on promising practices in community engagement to accelerate progress towards these ambitious goals. This research involved extensive literature review and key informant interviews. Community engagement was defined to include participation, mobilization and empowerment while excluding activities that involve communities solely as service recipients. A promising practice was defined as one for which there is documented evidence of its effectiveness in achieving intended results and some indication of replicability, scale up and/or sustainability. Promising practices that increased the supply of preventing mother-to-child transmission (PMTCT) services included extending community cadres, strengthening linkages with community- and faith-based organizations and civic participation in programme monitoring. Practices to improve demand for PMTCT included community-led social and behaviour change communication, peer support and participative approaches to generate local solutions. Practices to create an enabling environment included community activism and government leadership for greater involvement of communities. Committed leadership at all levels, facility, community, district and national, is crucial to success. Genuine community engagement requires a rights-based, capacity-building approach and sustained financial and technical investment. Participative formative research is a first step in building community capacity and helps to ensure programme relevance. Building on existing structures, rather than working in parallel to them, improves programme efficiency, effectiveness and sustainability. Monitoring, innovation and information sharing are critical to scale up. Ten recommendations on community engagement are offered for ending vertical transmission and enhancing the health of mothers and families: (1) expand the frontline health workforce, (2) increase engagement with community- and faith-based organizations, (3) engage communities in programme monitoring and accountability, (4) promote community-driven social and behaviour change communication including grassroots campaigns and dialogues, (5) expand peer support, (6) empower communities to address programme barriers, (7) support community activism for political commitment, (8) share tools for community engagement, (9) develop better indicators for community involvement and (10) conduct cost analyses of various community engagement strategies. As programmes expand, care should be taken to support and not to undermine work that communities are already doing, but rather to actively identify and build on such efforts.

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

Any qualified provider: a qualitative case study of one community NHS Trust's response.

PubMed

Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara

2016-02-23

To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Intrinsic case study combining qualitative analysis of interviews and field notes. An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013-2014. NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Payao: a community platform for SBML pathway model curation

PubMed Central

Matsuoka, Yukiko; Ghosh, Samik; Kikuchi, Norihiro; Kitano, Hiroaki

2010-01-01

Summary: Payao is a community-based, collaborative web service platform for gene-regulatory and biochemical pathway model curation. The system combines Web 2.0 technologies and online model visualization functions to enable a collaborative community to annotate and curate biological models. Payao reads the models in Systems Biology Markup Language format, displays them with CellDesigner, a process diagram editor, which complies with the Systems Biology Graphical Notation, and provides an interface for model enrichment (adding tags and comments to the models) for the access-controlled community members. Availability and implementation: Freely available for model curation service at http://www.payaologue.org. Web site implemented in Seaser Framework 2.0 with S2Flex2, MySQL 5.0 and Tomcat 5.5, with all major browsers supported. Contact: kitano@sbi.jp PMID:20371497

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

ERIC Educational Resources Information Center

Griffith, James; Thomas, Todd

2014-01-01

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

Predictors of needs for families of children with cerebral palsy.

PubMed

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

2014-01-01

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

Rural school-based telehealth: how to make it happen.

PubMed

Burke, Bryan; Bynum, Ann; Hall-Barrow, Julie; Ott, Rachel; Albright, Margaret

2008-11-01

When organizing new health care interventions among a rural population, a careful planning process respecting community-specific considerations should be used. The project objective centered on the successful implementation of a school-based telehealth clinic serving a rural, health-disparate population. Using an American Academy of Pediatrics Community Access to Child Health planning grant, a needs assessment of the Delta community was conducted. In synthesizing the results of this planning project, consensually addressed issues led to establishing a pilot school-based telehealth clinic within the rural county schools. Seven essential steps emerged as a set of guidelines that entities might consider in introducing a telemedicine school-based service in a rural community. The steps included assessing local and regional needs, securing community support and establishing goals, evaluating resources, configuring logistics, training staff, informing parents, and launching the clinic. Proper planning is crucial to the establishment of a rural school-based telehealth clinic.

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

PubMed Central

2017-01-01

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

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

PubMed Central

Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

2016-01-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

Implementation and evolution of a regional chronic disease self-management program.

PubMed

Liddy, Clare; Johnston, Sharon; Nash, Kate; Irving, Hannah; Davidson, Rachel

2016-08-15

To establish a comprehensive, community-based program to improve and sustain self-management support for individuals with chronic diseases and complement office-based strategies to support behaviour change. Health service delivery organizations. The Champlain Local Health Integration Network (LHIN), a health district in Eastern Ontario. We created Living Healthy Champlain (LHC), a regional organization providing peer leader training and coordination for the group Stanford Chronic Disease Self-Management Program (CDSMP); skills training and mentorship in behaviour change approaches for health care providers; and support to organizations to integrate self-management support into routine practice. We used the RE-AIM framework to evaluate the overall program's impact by exploring its reach, effectiveness, adoption, implementation and maintenance. A total of 232 Stanford CDSMP sessions (63 during the pilot project and 169 post-pilot) have been held at 127 locations in 24 cities across the Champlain LHIN, reaching approximately 4,000 patients. The effectiveness of the service was established through ongoing evidence reviews, a focus group and a pre-post utilization study of the pilot. LHC trained over 300 peer volunteers to provide the Stanford CDSMP sessions, 98 of whom continue to activelyhost workshops. An additional 1,327 providers have been trained in other models of self-management support, such as Health Coaching and Motivational Interviewing. Over the study period, LHC grew from a small pilot project to a regional initiative with sustainable provincial funding and was adopted by the province as a model for similar service delivery across Ontario. A community-based self-management program working in partnership with primary care can be effectively and broadly implemented in support of patients living with chronic conditions.

VisPort: Web-Based Access to Community-Specific Visualization Functionality [Shedding New Light on Exploding Stars: Visualization for TeraScale Simulation of Neutrino-Driven Supernovae (Final Technical Report)

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

Baker, M Pauline

2007-06-30

The VisPort visualization portal is an experiment in providing Web-based access to visualization functionality from any place and at any time. VisPort adopts a service-oriented architecture to encapsulate visualization functionality and to support remote access. Users employ browser-based client applications to choose data and services, set parameters, and launch visualization jobs. Visualization products typically images or movies are viewed in the user's standard Web browser. VisPort emphasizes visualization solutions customized for specific application communities. Finally, VisPort relies heavily on XML, and introduces the notion of visualization informatics - the formalization and specialization of information related to the process and productsmore » of visualization.« less

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.

The Future of Service-Learning and Community Engagement: Asset-Based Approaches and Student Learning in First-Year Courses

ERIC Educational Resources Information Center

Bauer, Tamara; Kniffin, Lori E.; Priest, Kerry L.

2015-01-01

In the 20 years since Zlotkowski (1995) called for curricular integration of service-learning (SL) across the academy, the authors have observed an increasing adoption of and support for the pedagogy in students' first-year experience. In another article, Gardner (2002) suggests that SL in the first year is particularly important because it can…

Analysis of the Adaptation of the Responsive Teaching Paradigm to Serve Predominantly Native Hawaiian Communities: A Framework for Guiding Culturally Appropriate, Family-Centered, Relationship-Based Early Childhood Services

ERIC Educational Resources Information Center

Bettag, Dewayne

2016-01-01

Research shows early childhood is critical for establishing a foundation for overall development and future success (National Scientific Council on the Developing Child [NSCDC], 2012). Empirically supported early childhood services (ECS) are the most effective, efficient means of promoting lifelong success (Heckman, 2006). However, policies and…

Practice Leadership at the Front Line in Supporting People with Intellectual Disabilities and Challenging Behaviour: A Qualitative Study of Registered Managers of Community-Based, Staffed Group Homes

ERIC Educational Resources Information Center

Deveau, Roy; McGill, Peter

2016-01-01

Background: The front-line management role in services for people with intellectual disabilities remains rather under-researched. The aim of this study was to examine the experiences of registered managers in services for adults with intellectual disability who exhibit challenging behaviour. Method: Interviews, primarily focussed upon staff…

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

PubMed

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

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

The NHERI RAPID Facility: Enabling the Next-Generation of Natural Hazards Reconnaissance

NASA Astrophysics Data System (ADS)

Wartman, J.; Berman, J.; Olsen, M. J.; Irish, J. L.; Miles, S.; Gurley, K.; Lowes, L.; Bostrom, A.

2017-12-01

The NHERI post-disaster, rapid response research (or "RAPID") facility, headquartered at the University of Washington (UW), is a collaboration between UW, Oregon State University, Virginia Tech, and the University of Florida. The RAPID facility will enable natural hazard researchers to conduct next-generation quick response research through reliable acquisition and community sharing of high-quality, post-disaster data sets that will enable characterization of civil infrastructure performance under natural hazard loads, evaluation of the effectiveness of current and previous design methodologies, understanding of socio-economic dynamics, calibration of computational models used to predict civil infrastructure component and system response, and development of solutions for resilient communities. The facility will provide investigators with the hardware, software and support services needed to collect, process and assess perishable interdisciplinary data following extreme natural hazard events. Support to the natural hazards research community will be provided through training and educational activities, field deployment services, and by promoting public engagement with science and engineering. Specifically, the RAPID facility is undertaking the following strategic activities: (1) acquiring, maintaining, and operating state-of-the-art data collection equipment; (2) developing and supporting mobile applications to support interdisciplinary field reconnaissance; (3) providing advisory services and basic logistics support for research missions; (4) facilitating the systematic archiving, processing and visualization of acquired data in DesignSafe-CI; (5) training a broad user base through workshops and other activities; and (6) engaging the public through citizen science, as well as through community outreach and education. The facility commenced operations in September 2016 and will begin field deployments beginning in September 2018. This poster will provide an overview of the vision for the RAPID facility, the equipment that will be available for use, the facility's operations, and opportunities for user training and facility use.

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.

Coordination of palliative cancer care in the community: "unfinished business".

PubMed

Brazil, Kevin; Bainbridge, Daryl; Sussman, Jonathan; Whelan, Tim; O'Brien, Mary Ann; Pyette, Nancy

2009-07-01

This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care.

NASA's Global Imagery Browse Services - Technologies for Visualizing Earth Science Data

NASA Astrophysics Data System (ADS)

Cechini, M. F.; Boller, R. A.; Baynes, K.; Schmaltz, J. E.; Thompson, C. K.; Roberts, J. T.; Rodriguez, J.; Wong, M. M.; King, B. A.; King, J.; De Luca, A. P.; Pressley, N. N.

2017-12-01

For more than 20 years, the NASA Earth Observing System (EOS) has collected earth science data for thousands of scientific parameters now totaling nearly 15 Petabytes of data. In 2013, NASA's Global Imagery Browse Services (GIBS) formed its vision to "transform how end users interact and discover [EOS] data through visualizations." This vision included leveraging scientific and community best practices and standards to provide a scalable, compliant, and authoritative source for EOS earth science data visualizations. Since that time, GIBS has grown quickly and now services millions of daily requests for over 500 imagery layers representing hundreds of earth science parameters to a broad community of users. For many of these parameters, visualizations are available within hours of acquisition from the satellite. For others, visualizations are available for the entire mission of the satellite. The GIBS system is built upon the OnEarth and MRF open source software projects, which are provided by the GIBS team. This software facilitates standards-based access for compliance with existing GIS tools. The GIBS imagery layers are predominantly rasterized images represented in two-dimensional coordinate systems, though multiple projections are supported. The OnEarth software also supports the GIBS ingest pipeline to facilitate low latency updates to new or updated visualizations. This presentation will focus on the following topics: Overview of GIBS visualizations and user community Current benefits and limitations of the OnEarth and MRF software projects and related standards GIBS access methods and their in/compatibilities with existing GIS libraries and applications Considerations for visualization accuracy and understandability Future plans for more advanced visualization concepts including Vertical Profiles and Vector-Based Representations Future plans for Amazon Web Service support and deployments

Understanding consumers' initial expectations of community-based residential mental health rehabilitation in the context of past experiences of care: A mixed-methods pragmatic grounded theory analysis.

PubMed

Parker, Stephen; Meurk, Carla; Newman, Ellie; Fletcher, Clayton; Swinson, Isabella; Dark, Frances

2018-04-16

This study explores how consumers expect community-based residential mental health rehabilitation to compare with previous experiences of care. Understanding what consumers hope to receive from mental health services, and listening to their perspectives about what has and has not worked in previous care settings, may illuminate pathways to improved service engagement and outcomes. A mixed-methods research design taking a pragmatic approach to grounded theory guided the analysis of 24 semi-structured interviews with consumers on commencement at three Community Care Units (CCUs) in Australia. Two of these CCUs were trialling a staffing model integrating peer support work with clinical care. All interviews were conducted by an independent interviewer within the first 6 weeks of the consumer's stay. All participants expected the CCU to offer an improvement on previous experiences of care. Comparisons were made to acute and subacute inpatient settings, supported accommodation, and outpatient care. Consumers expected differences in the people (staff and co-residents), the focus of care, physical environ, and rules and regulations. Participants from the integrated staffing model sites articulated the expected value of a less clinical approach to care. Overall, consumers' expectations aligned with the principles articulated in policy frameworks for recovery-oriented practice. However, their reflections on past care suggest that these services continue to face significant challenges realizing these principles in practice. Paying attention to the kind of working relationship consumers want to have with mental health services, such as the provision of choice and maintaining a practical and therapeutic supportive focus, could improve their engagement and outcomes. © 2018 Australian College of Mental Health Nurses Inc.

Psychosocial treatments for schizophrenia.

PubMed

Mueser, Kim T; Deavers, Frances; Penn, David L; Cassisi, Jeffrey E

2013-01-01

The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model. Interventions targeting specific domains of functioning, age groups, stages of illness, and human service system gaps are classified as evidence-based practices or promising practices according to the extent to which their efficacy is currently supported by meta-analyses and individual randomized controlled trials (RCTs). Evidence-based practices include assertive community treatment (ACT), cognitive behavior therapy (CBT) for psychosis, cognitive remediation, family psychoeducation, illness self-management training, social skills training, and supported employment. Promising practices include cognitive adaptive therapy, CBT for posttraumatic stress disorder, first-episode psychosis intervention, healthy lifestyle interventions, integrated treatment for co-occurring disorders, interventions targeting older individuals, peer support services, physical disease management, prodromal stage intervention, social cognition training, supported education, and supported housing. Implications and future directions are discussed.

One-Stop Shop

ERIC Educational Resources Information Center

Protheroe, Nancy

2010-01-01

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

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

ERIC Educational Resources Information Center

Furco, Andrew; Moely, Barbara E.

2012-01-01

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

How to Trigger Emergence and Self-Organisation in Learning Networks

NASA Astrophysics Data System (ADS)

Brouns, Francis; Fetter, Sibren; van Rosmalen, Peter

The previous chapters of this section discussed why the social structure of Learning Networks is important and present guidelines on how to maintain and allow the emergence of communities in Learning Networks. Chapter 2 explains how Learning Networks rely on social interaction and active participations of the participants. Chapter 3 then continues by presenting guidelines and policies that should be incorporated into Learning Network Services in order to maintain existing communities by creating conditions that promote social interaction and knowledge sharing. Chapter 4 discusses the necessary conditions required for knowledge sharing to occur and to trigger communities to self-organise and emerge. As pointed out in Chap. 4, ad-hoc transient communities facilitate the emergence of social interaction in Learning Networks, self-organising them into communities, taking into account personal characteristics, community characteristics and general guidelines. As explained in Chap. 4 community members would benefit from a service that brings suitable people together for a specific purpose, because it will allow the participant to focus on the knowledge sharing process by reducing the effort or costs. In the current chapter, we describe an example of a peer support Learning Network Service based on the mechanism of peer tutoring in ad-hoc transient communities.

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’

PubMed Central

Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

2017-01-01

Objectives There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. Setting ‘Self Help Services’, an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. Participants 1068 service users referred to the service for secondary care for their mental health difficulties. Interventions Participants were triaged into one of three eTherapy programmes: ‘Living Life to the Full Interactive’ for low mood, stress and anxiety; ‘Sleepio’ for insomnia; and ‘Breaking Free Online’ for substance misuse, depending on clinical need. Primary outcomes measures Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Results Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p<0.0001; anxiety CI 077 to 1.72, p<0.0001) and Sleepio (depression CI 1.19 to 4.52, p<0.0001; anxiety CI 2.16 to 5.23, p<0.0001) groups. Promising improvements in mental health scores were found within all three groups (all p<0.0001), as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties (p<0.0001). Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online. Conclusion Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. PMID:28729322

Perceived Community Functions and Supportive Residential Environments.

ERIC Educational Resources Information Center

Blake, Brian F.

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

A New Framework and Practice Center for Adapting, Translating, and Scaling Evidence-Based Health/Wellness Programs for People With Disabilities.

PubMed

Rimmer, James H; Vanderbom, Kerri A; Graham, Ian D

2016-04-01

Supporting the transition of people with newly acquired and existing disability from rehabilitation into community-based health/wellness programs, services, and venues requires rehabilitation professionals to build evidence by capturing successful strategies at the local level, finding innovative ways to translate successful practices to other communities, and ultimately to upgrade and maintain their applicability and currency for future scale-up. This article describes a knowledge-to-practice framework housed in a national resource and practice center that will support therapists and other rehabilitation professionals in building and maintaining a database of successful health/wellness guidelines, recommendations, and adaptations to promote community health inclusion for people with disabilities. A framework was developed in the National Center on Health, Physical Activity and Disability (NCHPAD) to systematically build and advance the evidence base of health/wellness programs, practices, and services applicable to people with disabilities. N-KATS (NCHPAD Knowledge Adaptation, Translation, and Scale-up) has 4 sequencing strategies: strategy 1-new evidence- and practice-based knowledge is collected and adapted for the local context (ie, community); strategy 2-customized resources are effectively disseminated to key stakeholders including rehabilitation professionals with appropriate training tools; strategy 3-NCHPAD staff serve as facilitators assisting key stakeholders in implementing recommendations; strategy 4-successful elements of practice (eg, guideline, recommendation, adaptation) are archived and scaled to other rehabilitation providers. The N-KATS framework supports the role of rehabilitation professionals as knowledge brokers, facilitators, and users in a collaborative, dynamic structure that will grow and be sustained over time through the NCHPAD.Video abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A130).

78 FR 66939 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... Support Grants (Name changed to Child Abuse Prevention Program). OMB No.: 0970-0155. Description: The... Prevention of Child Abuse and Neglect (administratively known as the Community Based Child Abuse Prevention...

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

PubMed Central

Jenkins, Melissa M.; Haine-Schlagel, Rachel

2012-01-01

This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups, 3 parent focus groups, and 10 youth semi-structured interviews. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate support and lack of family involvement; however, parents and therapists, in particular, identified different contributing factors to these barriers. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research. PMID:24019737

Barriers to Male Involvement in Antenatal Care in Rural Mozambique

PubMed Central

Audet, Carolyn M.; Chire, Yazalde Manual; Vaz, Lara; Bechtel, Ruth; Carlson-Bremer, Daphne; Wester, C. William; Amico, K. Rivet; Calvo, Lázaro

2015-01-01

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. Additionally, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged; (1) gender inequality in decision making and responsibility for pregnancy and (2) community beliefs that uptake of ANC services, particularly if supported by a male partner, reflects a woman’s HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed. PMID:25854615

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-01-01

Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users’ control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Conclusions Regardless of providers’ portal use, service users’ control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users’ autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans). PMID:28465277

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

PubMed

Bates, Jason; Sharratt, Martin; King, John

2014-01-01

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

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

PubMed

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

2016-01-01

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

“Living With a Ball and Chain”: The Experience of Stroke for Individuals and Their Caregivers in Rural Appalachian Kentucky

PubMed Central

Danzl, Megan M.; Hunter, Elizabeth G.; Campbell, Sarah; Sylvia, Violet; Kuperstein, Janice; Maddy, Katherine; Harrison, Anne

2013-01-01

Purpose Individuals in rural Appalachian Kentucky face health disparities and are at increased risk for negative health outcomes and poor quality of life secondary to stroke. The purpose of this study is to describe the experience of stroke for survivors and their caregivers in this region. A description of their experiences is paramount to developing tailored interventions and ultimately improving health care and support. Methods An interprofessional research team used a qualitative descriptive study design and interviewed 13 individuals with stroke and 12 caregivers, representing 10 rural Appalachian Kentucky counties. The transcripts were analyzed using qualitative content analysis. Findings A descriptive summary of the participants’ experience of stroke is presented within the following structure: 1) Stroke onset, 2) Transition through the health care continuum (including acute care, inpatient rehabilitation, and community-based rehabilitation), and 3) Reintegration into life and rural communities. Conclusions The findings provide insight for rural health care providers and community leaders to begin to understand the experience of stroke in terms of stroke onset, transition through the health care continuum, return to home, and community reintegration. An understanding of these experiences may lead to discussions of how to improve service provision, facilitate reintegration, support positive health outcomes and improve quality of life for stroke survivors and their caregivers. The findings also indicate areas in need of future research including investigation of the effects of support groups, local health navigators to improve access to information and services, involvement of faith communities, proactive screening for management of mental health needs, and caregiver respite services. PMID:24088211

42 CFR 436.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver granted...

42 CFR 436.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver granted...

42 CFR 436.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver granted...

42 CFR 435.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver granted...

42 CFR 435.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals receiving home and community-based... receiving home and community-based services. The agency may provide Medicaid to any group or groups of... if institutionalized. (b) In the absence of home and community-based services under a waiver granted...