Program Intensity and Service Delivery Models in the Schools: SLP Survey Results

ERIC Educational Resources Information Center

Brandel, Jayne; Loeb, Diane Frome

2011-01-01

Purpose: School-based speech-language pathologists (SLPs) routinely work with team members to make recommendations regarding an intervention program's intensity and method of service delivery for children with speech and language impairments. In this study, student, SLP, and workplace characteristics that may influence SLPs' recommendations were…

Regional Cooperation To Meet Global Competition.

ERIC Educational Resources Information Center

Price, Thomas

In response to the recognition that significant changes were required in service delivery approaches to meet the changing needs for workforce training, Illinois' Joliet Junior College (JJC) implemented a series of innovative training programs. The guiding philosophy behind the programs was that service delivery must correspond to shifts in focus…

A Case Study: Service Delivery and Parents with Disabilities.

ERIC Educational Resources Information Center

Pomerantz, Phyllis; And Others

1990-01-01

Describes a home-based intervention program that provided time-intensive, supervised, paraprofessional services to a family in which parents and infant had serious disabilities. Programmatic needs and delivery of services to disabled parents and families are discussed. (NH)

National dissemination of supported housing in the VA: model adherence versus model modification.

PubMed

O'Connell, Maria; Kasprow, Wesley; Rosenheck, Robert A

2010-01-01

The continuing development and dissemination of emerging evidence-based practices may be facilitated by the availability of descriptive information on the actual delivery of the service, and its variability, across sites. This paper presents data on the participation of 2,925 homeless veterans in the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program at 36 sites across the country, for up to five years. While most conceptual models emphasize rapid placement, sustained intensive case management, rehabilitation services, and "permanent" housing, no program has yet presented empirical data on the actual delivery of such services over an extended period of time. Using extensive longitudinal data from the VA's national homeless outreach program, the Health Care for Homeless Veterans (HCHV) program, a quantitative portrait presents what happens in supported housing in a large real-world dissemination effort. Program entry to HUD-VASH was generally slow with 108 days (sd = 92 days) on average passing between program entry and housing placement. Total program participation lasted 2.6 years on average (sd = 1.6 years)-just half of the possible 5 years. Service delivery became substantially less intensive over time by several measures, and three-fourths of the veterans terminated within five years, although the vast majority (82%) were housed at the time. Few veterans received rehabilitation services (6%) or employment assistance (17%) and most service delivery focused on obtaining housing. These data suggest that real-world supported housing programs may not adhere to the prevalent model descriptions either because of implementation failure or because veteran needs and preferences differ from those suggested by that model.

Staff survey of organizational structure and process for a Public Health Department.

PubMed

Dwyer, J J

1995-01-01

A survey of 227 North York Public Health Department (NYPHD) staff provided their perspective on the organizational structure. They perceived that (a) the departmental and divisional organizational structures are effective for program delivery, (b) the Central Resources structure and divisional and departmental reporting structures are moderately effective for program delivery, (c) the decentralized office structure is an advantage for service delivery but less so for administration and intra-division and inter-division communication, (d) the mandatory program structure involves low to moderate interdisciplinary teamwork and moderately impacts service delivery, (e) intra-division and management-staff communication are fair but inter-division and office communication are between poor and fair, (f) education, research, and service are moderately integrated, and (g) the divisional and departmental work atmospheres are a little positive. Management perceived greater participation in program planning, more frequent communication with other divisions, a number of education and research opportunities from various divisions/units, and more management recognition than front line staff did.

Evaluation of a cross-sector community initiative partnership: delivering a local sport program.

PubMed

Kihl, Lisa A; Tainsky, Scott; Babiak, Kathy; Bang, Hyejin

2014-06-01

Corporate community initiatives (CCI) are often established via cross-sector partnerships with nonprofit agencies to address critical social problems. While there is a growing body of literature exploring the effectiveness and social impact of these partnerships, there is a limited evaluative research on the implementation and execution processes of CCIs. In this paper, we examined the implementation and operational processes in the delivery of a professional sport organization's CCI initiative using program theory evaluation. The findings showed discrepancies between the associate organization and the implementers regarding understanding and fulfilling responsibilities with performing certain aspects (maintaining accurate records and program marketing) of the service delivery protocol. Despite program stakeholders being satisfied overall with the program delivery, contradictions between program stakeholders' satisfaction in the quality of program delivery was found in critical components (marketing and communications) of the service delivery. We conclude that ongoing evaluations are necessary to pinpoint the catalyst of the discrepancies along with all partners valuing process evaluation in addition to outcome evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bridging the Silos of Service Delivery for High-Need, High-Cost Individuals.

PubMed

Sherry, Melissa; Wolff, Jennifer L; Ballreich, Jeromie; DuGoff, Eva; Davis, Karen; Anderson, Gerard

2016-12-01

Health care reform efforts that emphasize value have increased awareness of the importance of nonmedical factors in achieving better care, better health, and lower costs in the care of high-need, high-cost individuals. Programs that care for socioeconomically disadvantaged, high-need, high-cost individuals have achieved promising results in part by bridging traditional service delivery silos. This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration: flexible financing, shared leadership, shared data, and a strong shared vision of commitment toward delivery of person-centered care.

Development, Implementation, and Evaluation of the Apollo Model of Pediatric Rehabilitation Service Delivery

ERIC Educational Resources Information Center

Camden, Chantal; Swaine, Bonnie; Tetreault, Sylvie; Bergeron, Sophie; Lambert, Carole

2013-01-01

This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical…

Implementation of Age-Specific Services for Transition-Age Youths in California.

PubMed

Ojeda, Victoria D; Hiller, Sarah P; Hurst, Samantha; Jones, Nev; McMenamin, Sara; Burgdorf, James; Gilmer, Todd P

2016-09-01

This study examined the implementation of age-specific services for transition-age youths in California under the Mental Health Services Act (MHSA). This study employed a sequential, exploratory mixed-methods design. Qualitative interviews with 39 mental health service area administrators in California were analyzed to develop an understanding of how the MHSA has facilitated the development of youth-specific programs or services. A quantitative survey of 180 youth-focused programs was also used to describe the range of services that were implemented, the use of evidence-based and promising practices, and the role of youths in the design, planning, delivery, and evaluation of services. Administrators described the MHSA as providing a programmatic focus and financial support for youth-specific services, outlining a stakeholder process to create buy-in and develop a vision for services, and emphasizing the role of youths in service delivery and planning. Youth-specific programs implemented a diverse array of services, including general medical care; employment and education support; housing placement and support; and family, mentoring, and social support. Programs described implementing evidence-based and promising practices and involving youths in service planning, implementation, or quality improvement activities. The MHSA has had a substantial impact on the landscape of youth-specific services in California by expanding both the number of programs and the diversity in types of services and by promoting the engagement of youths in the planning and delivery of services. Additional efforts are necessary to determine the extent to which youth-specific services yield greater improvements in youths' outcomes compared with services designed for adults.

Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services.

PubMed

Cason, Jana; Behl, Diane; Ringwalt, Sharon

2012-01-01

Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states' IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1-2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming. Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.

Overview of States’ Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services

PubMed Central

Cason, Jana; Behl, Diane; Ringwalt, Sharon

2012-01-01

Background: Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. Method: A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Results: Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1–2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming. Conclusions: Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country. PMID:25945202

Health Care Delivery.

ERIC Educational Resources Information Center

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

7 CFR 1940.959 - Area plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) GENERAL System for Delivery of Certain Rural Development Programs § 1940.959 Area plan...

Mental health services for Nunavut children and youth: evaluating a telepsychiatry pilot project.

PubMed

Volpe, T; Boydell, K M; Pignatiello, A

2014-01-01

This study examines the delivery of psychiatric consultation services using videoconferencing technology to health and mental health workers in the Nunavut territory of Canada. The research provides insights into the TeleLink Mental Health Program and the delivery of professional-to-professional program consultations and continuing education seminars. Participant observation of 12 program consultations and four continuing education sessions was conducted. Individual interviews were conducted with the consulting psychiatrist and the lead program coordinator in Nunavut. As well, a focus group was held with Nunavut workers who participated in the televideo sessions. The study found a number of factors that facilitated or hindered the process and content of a consultation-based telepsychiatry program and its effect on building capacity among frontline staff. Four main themes emerged related to the delivery of psychiatric services via televideo: gaining access, ensuring culturally appropriate services, providing relevant continuing education, and offering stable and confidential technology. Live interactive videoconferencing technology is an innovative and effective way of delivering specialized mental health services to professionals working in remote areas of Nunavut. Study results provide important strategies for expanding this approach to other jurisdictions in Nunavut and other Inuit regions.

Developing case managers for chronically ill children: Florida's registered nurse specialist program.

PubMed

Urbano, M T; vonWindeguth, B; Siderits, P; Parker, J; Studenic-Lewis, C

1991-01-01

This article describes the Florida Health and Rehabilitative Services/Children's Medical Services Nurse Specialist Program. This program is a statewide training and service delivery system designed to prepare selected nurses to provide comprehensive, family-centered case management services to children with special health care needs, within the home and community settings.

The World Report on Disability in relation to the development of speech-language pathology in Viet Nam.

PubMed

Atherton, Marie; Dung, Nguyễn Thị Ngọc; Nhân, Võ Hoàng

2013-02-01

Wylie, McAllister, Davidson, and Marshall (2013) argue that recommendations made within the World Report on Disability provide an opportunity for speech-language pathologists to consider new ways of developing services for people with communication and swallowing disorders. They propose that current approaches to the delivery of speech-language pathology services are largely embedded within the medical model of impairment, thereby limiting the ability of services to meet the needs of people in a holistic manner. In this paper, the criticality of selecting an appropriate service delivery model is discussed within the context of a recently established post-graduate speech therapy education programme in Viet Nam. Driving forces for the implementation of the program will be explored, as will the factors that determined the choice of service delivery. Opportunities and challenges to the long-term viability of the program and the program's potential to meet the needs of persons with communication and swallowing disorders in Viet Nam will be considered.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved.

PubMed

Inrig, Stephen J; Tiro, Jasmin A; Melhado, Trisha V; Argenbright, Keith E; Craddock Lee, Simon J

2014-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. To better understand how to implement a decentralized regional delivery "hub & spoke" model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow's RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow's RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved

PubMed Central

Inrig, Stephen J.; Tiro, Jasmin A.; Melhado, Trisha V.; Argenbright, Keith E.; Craddock Lee, Simon J.

2017-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. Objectives To better understand how to implement a decentralized regional delivery “hub & spoke” model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow’s RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Methods and Design The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow’s RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. Discussion This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting. PMID:28713882

Research Fellowships Program of the National Center for Health Services Research and Development. Policies and Guidelines for Applicants.

ERIC Educational Resources Information Center

Health Services and Mental Health Administration (DHEW), Bethesda, MD.

The National Center for Health Services Research and Development supports individual research training in an institutional setting for the development of competence in research techniques relevant to the organization, delivery, quality, financing, utilization, and evaluation of health delivery systems. The evolution of health services science…

A Survey of Educational Services Provided to JTPA Clients in Florida's Service Delivery Areas. July 1, 1991 - June 30, 1992.

ERIC Educational Resources Information Center

Florida State Council on Vocational Education, Tallahassee.

Evaluation of the coordination of vocational education and programs provided under the Job Training Partnership Act (JTPA) included a survey of Florida's 24 service delivery areas (SDAs). The assessment was designed to provide a "snapshot" of the services provided to JTPA clients through educational institutions and on-the-job training…

Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

PubMed

Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

2017-07-01

The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

SKI*HI Home-Based Programming for Children with Hearing Impairments: Demographics, Child Identification, and Program Effectiveness, 1979-1991.

ERIC Educational Resources Information Center

Strong, Carol J.; And Others

SKI*HI is a program designed to identify children with hearing impairments as early as possible and to provide them and their families with complete home programming that will facilitate development. The delivery model includes identification/screening services, home visit services, support services, and program management. A parent advisor makes…

Sobriety Treatment and Recovery Teams: Implementation Fidelity and Related Outcomes.

PubMed

Huebner, Ruth A; Posze, Lynn; Willauer, Tina M; Hall, Martin T

2015-01-01

Although integrated programs between child welfare and substance abuse treatment are recommended for families with co-occurring child maltreatment and substance use disorders, implementing integrated service delivery strategies with fidelity is a challenging process. This study of the first five years of the Sobriety Treatment and Recovery Team (START) program examines implementation fidelity using a model proposed by Carroll et al. (2007). The study describes the process of strengthening moderators of implementation fidelity, trends in adherence to START service delivery standards, and trends in parent and child outcomes. Qualitative and quantitative measures were used to prospectively study three START sites serving 341 families with 550 parents and 717 children. To achieve implementation fidelity to service delivery standards required a pre-service year and two full years of operation, persistent leadership, and facilitative actions that challenged the existing paradigm. Over four years of service delivery, the time from the child protective services report to completion of five drug treatment sessions was reduced by an average of 75 days. This trend was associated with an increase in parent retention, parental sobriety, and parent retention of child custody. Conclusions/Importance: Understanding the implementation processes necessary to establish complex integrated programs may support realistic allocation of resources. Although implementation fidelity is a moderator of program outcome, complex inter-agency interventions may benefit from innovative measures of fidelity that promote improvement without extensive cost and data collection burden. The implementation framework applied in this study was useful in examining implementation processes, fidelity, and related outcomes.

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

PubMed

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

20 CFR 662.230 - What are the responsibilities of the required One-Stop partners?

Code of Federal Regulations, 2010 CFR

2010-04-01

... delivery system the core services that are applicable to the partner's programs; (WIA sec. 121(b)(1)(A... delivery system; and (2) Provide core services; (WIA sec. 134(d)(1)(B).) (c) Enter into a memorandum of...

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

Multiple Stakeholder Perspectives on Teletherapy Delivery of Speech Pathology Services in Rural Schools: A Preliminary, Qualitative Investigation

PubMed Central

LINCOLN, MICHELLE; HINES, MONIQUE; FAIRWEATHER, CRAIG; RAMSDEN, ROBYN; MARTINOVICH, JULIA

2015-01-01

The objective of this study was to investigate stakeholders’ views on the feasibility and acceptability of a pilot speech pathology teletherapy program for children attending schools in rural New South Wales, Australia. Nine children received speech pathology sessions delivered via Adobe Connect® web-conferencing software. During semi-structured interviews, school principals (n = 3), therapy facilitators (n = 7), and parents (n = 6) described factors that promoted or threatened the program’s feasibility and acceptability. Themes were categorized according to whether they related to (a) the use of technology; (b) the school-based nature of the program; or (c) the combination of using technology with a school-based program. Despite frequent reports of difficulties with technology, teletherapy delivery of speech pathology services in schools was highly acceptable to stakeholders. However, the use of technology within a school environment increased the complexities of service delivery. Service providers should pay careful attention to planning processes and lines of communication in order to promote efficiency and acceptability of teletherapy programs. PMID:25945230

Models of Service Delivery for the Elderly Mentally Ill.

ERIC Educational Resources Information Center

VandeCreek, Leon

This paper is concerned with the problem that elderly persons do not seek or receive mental health services as frequently as their numbers or the incidence of mental health problems would indicate is appropriate. The report focuses on the identification of innovative mental health service delivery programs which have been designed to reach and to…

Frail elderly patients. New model for integrated service delivery.

PubMed Central

Hébert, Rejean; Durand, Pierre J.; Dubuc, Nicole; Tourigny, André

2003-01-01

PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions. PMID:12943358

The Medicaid School Program: An Effective Public School and Private Sector Partnership

ERIC Educational Resources Information Center

Mallett, Christopher A.

2013-01-01

Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…

An Evaluation of Parent Aide Programs.

ERIC Educational Resources Information Center

Andrews, Mary P.; Swanson, Jane F.

A descriptive-comparative study was designed to document the service delivery functions and impacts of three different parent-aide programs ongoing in Michigan. The study took place over the period of summer 1978 to summer 1979. The programs involved in the study were the Genesee County Department of Social Services' Volunteer Services Parent-Aide…

Income Tax Preparation Assistance Service Learning Program: A Multidimensional Assessment

ERIC Educational Resources Information Center

Aldridge, Richard; Callahan, Richard A.; Chen, Yining; Wade, Stacy R.

2015-01-01

The authors present a multidimensional assessment of the outcomes and benefits of an income tax preparation assistance (ITPA) service learning program. They measure the perceived proximate benefits at the delivery of the service program, the actual learning outcome benefits prior to graduation, and the perceived long-term benefits from a…

Managed Care, School Health Programs, and Adolescent Health Services: Opportunities for Health Promotion.

ERIC Educational Resources Information Center

Santelli, John; Vernon, Mary; Lowry, Richard; Osorio, Jenny; DuShaw, Martha; Lancaster, Mary Sue; Pham, Ngoc; Song, Elisa; Ginn, Elizabeth; Kolbe, Lloyd J.

1998-01-01

Managed care organizations (MCOs) and school health programs share some common goals and some competing, conflicting priorities. Partnerships between the two are important for the effective coordination and delivery of comprehensive adolescent health services. This paper discusses adolescent clinical preventive services, school health services,…

Treatment Service Patterns and Organizational Structures: An Analysis of Programs in DATOS-A.

ERIC Educational Resources Information Center

Delany, Peter J.; Broome, Kirk M.; Flynn, Patrick M.; Fletcher, Bennett W.

2001-01-01

Examined availability of various treatment services within a national sample of programs treating adolescent drug abuse patients. Created treatment service delivery profiles and examined them in context of organizational variables. Found that distinct profiles of services existed within residential and outpatient modalities and that these service…

Cost effectiveness and efficiency in assistive technology service delivery.

PubMed

Warren, C G

1993-01-01

In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in Northern Ghana

PubMed Central

2014-01-01

Background The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women. Methods We conducted a cross-sectional household survey with women who had ever given birth in the three years prior to the survey. We employed a two stage sampling techniques: In the first stage we proportionally selected enumeration areas, and the second stage involved random selection of households. In each household, where there is more than one woman with a child within the age limit, we interviewed the woman with the youngest child. We collected data on awareness of the program, use of the services and factors that are associated with skilled attendants at birth. Results A total of 407 households/women were interviewed. Eighty three percent of respondents knew that CHO-midwives provided delivery services in CHPS zones. Seventy nine percent of the deliveries were with skilled attendants; and over half of these skilled births (42% of total) were by CHO-midwives. Multivariate analyses showed that women of the Nankana ethnic group and those with uneducated husbands were less likely to access skilled attendants at birth in rural settings. Conclusions The implementation of the CHO-midwife program in UER appeared to have contributed to expanded skilled delivery care access and utilization for rural women. However, women of the Nankana ethnic group and uneducated men must be targeted with health education to improve women utilizing skilled delivery services in rural communities of the region. PMID:24721385

Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in northern Ghana.

PubMed

Sakeah, Evelyn; Doctor, Henry V; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel

2014-04-10

The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women. We conducted a cross-sectional household survey with women who had ever given birth in the three years prior to the survey. We employed a two stage sampling techniques: In the first stage we proportionally selected enumeration areas, and the second stage involved random selection of households. In each household, where there is more than one woman with a child within the age limit, we interviewed the woman with the youngest child. We collected data on awareness of the program, use of the services and factors that are associated with skilled attendants at birth. A total of 407 households/women were interviewed. Eighty three percent of respondents knew that CHO-midwives provided delivery services in CHPS zones. Seventy nine percent of the deliveries were with skilled attendants; and over half of these skilled births (42% of total) were by CHO-midwives. Multivariate analyses showed that women of the Nankana ethnic group and those with uneducated husbands were less likely to access skilled attendants at birth in rural settings. The implementation of the CHO-midwife program in UER appeared to have contributed to expanded skilled delivery care access and utilization for rural women. However, women of the Nankana ethnic group and uneducated men must be targeted with health education to improve women utilizing skilled delivery services in rural communities of the region.

An assessment of the safe delivery incentive program at a tertiary level hospital in Nepal.

PubMed

Baral, G

2012-05-01

Maternity incentive program of Nepal known as Safe Delivery Incentive Program (SDIP) was introduced nationwide in 2005 with the intention of increasing utilization of professional care at childbirth. The program provided both childbirth service as well as 'cash' to women giving birth in a health facility in addition to incentives to health provider for each delivery attended, either at home or the facility. Due to a lack of uniformity in its implementation and administrative delays, the program was reformed and even extended to many not-for-profit health institutions in early 2007, and implemented as a 'Safer Mother Program' popularly known as "Aama-Suraksha-Karyakram" since January 2009. This is a system research with observational and analytical components. Plausibility design is selected to evaluate the performance-based funding (PBF) as a system level intervention of maternity care using two instruments: Pay-For-Performance and Conditional-Cash-Transfer. It uses interrupted time-series to control for the natural trend. Research tools used are interviews, the focus group discussions and literature review. Numerical data are presented in simple graphs. While online random number generator was used partly, the purposive sampling was used for qualitative data. There is a gross discrepancy in non-targeted service delivery at the tertiary level health facility. Overflooding of maternity cases has hampered gynecological admission and surgical management delaying subspecialty care and junior physicians' training. With the same number and quality of physical facility and human resource, the additional program has put more strains to service providers and administrators. There should be adequate planning and preparation at all levels of health facilities; implementing a new program should not adversely affect another existing service delivery system. For the optional implementation, hospital organogram should be revised; and physical facilities and the low-risk birthing-centers with referral linkages should be expanded.

32 CFR 199.13 - TRICARE Dental Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...

32 CFR 199.13 - TRICARE Dental Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...

32 CFR 199.13 - TRICARE Dental Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...

78 FR 26033 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... precision requirements or power calculations that justify the proposed sample size, the expected response... Collection of Qualitative Feedback on Agency Service Delivery--NEW--Epidemiology and Analysis Program Office... Clearance for the Collection of Qualitative Feedback on Agency Service Delivery'' to OMB for approval under...

77 FR 70893 - Authorization for Non-VA Medical Services

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

... professions, Health records, Homeless, Mental health programs, Nursing homes, Reporting and recordkeeping... restrictive modes of healthcare delivery. Although VA has made great strides to expand the delivery of... expand VA's authority to provide non-VA medical services under the non- VA care authority. As amended...

Introduction strategies raise key questions.

PubMed

Finger, W R; Keller, S

1995-09-01

Key issues that must be considered before a new contraceptive is introduced center on the need for a trained provider to begin or terminate the method, its side effects, duration of use, method's ability to meet users' needs and preferences, and extra training or staff requirements. Logistics and economic issues to consider are identifying a dependable way of effectively supplying commodities, planning extra services needed for the method, and cost of providing the method. Each contraceptive method presents a different side effect pattern and burdens the service delivery setting differently. The strategy developed to introduce or expand the 3-month injectable Depo-Provera (DMPA) can be used for any method. It includes a needs assessment and addresses regulatory issues, service delivery policies and procedures, information and training, evaluation, and other concerns. Viet Nam's needs assessment showed that Norplant should not be introduced until the service delivery system becomes stronger. Any needs assessment for expansion of contraceptive services should cover sexually transmitted disease/HIV issues. A World Health Organization strategy helps officials identify the best method mix for local situations. Introductory strategies must aim to improve the quality of family planning programs and expand choices. Many begin by examining existing data and conducting interviews with policymakers, users, providers, and women's health advocates. Introductory programs for Norplant focus on provider training, adequate counseling and informed consent for users, and ready access to removal. They need a well-prepared service delivery infrastructure. The first phase of the DMPA introductory strategy for the Philippines comprised a social marketing campaign and DMPA introduction at public clinics in 10 pilot areas with strong service delivery. Successful AIDS prevention programs show that people tend to use barrier methods when they are available. USAID is currently studying whether or not women in developing countries will use the female condom.

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

PubMed Central

White, Julia N; Corker, Jamaica

2016-01-01

ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

PubMed

White, Julia N; Corker, Jamaica

2016-08-11

Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

Private vs. Public Care for Juvenile Offenders: A Qualitative Examination.

ERIC Educational Resources Information Center

Kronick, Robert F.

1993-01-01

Examined effectiveness of methods used by public and private institutions' handling of incarcerated delinquents. Concluded that organizational culture is key concept in delivery of services to incarcerated children and youth; that private sector provides alternative to public in delivery of services; that alcohol and drug treatment programs are…

34 CFR 361.4 - Applicable regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Stop Service Delivery System under Title I of the Workforce Investment Act of 1998). (d) 29 CFR part 37, to the extent programs and activities are being conducted as part of the One-Stop service delivery... (Nonprocurement) and Governmentwide Requirements for Drug-Free Workplace (Grants)). (9) 34 CFR part 86 (Drug and...

34 CFR 361.4 - Applicable regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Stop Service Delivery System under Title I of the Workforce Investment Act of 1998). (d) 29 CFR part 37, to the extent programs and activities are being conducted as part of the One-Stop service delivery... (Nonprocurement) and Governmentwide Requirements for Drug-Free Workplace (Grants)). (9) 34 CFR part 86 (Drug and...

34 CFR 361.4 - Applicable regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Stop Service Delivery System under Title I of the Workforce Investment Act of 1998). (d) 29 CFR part 37, to the extent programs and activities are being conducted as part of the One-Stop service delivery... (Nonprocurement) and Governmentwide Requirements for Drug-Free Workplace (Grants)). (9) 34 CFR part 86 (Drug and...

Funding gap for immunization across 94 low- and middle-income countries.

PubMed

Ozawa, Sachiko; Grewal, Simrun; Portnoy, Allison; Sinha, Anushua; Arilotta, Richard; Stack, Meghan L; Brenzel, Logan

2016-12-07

Novel vaccine development and production has given rise to a growing number of vaccines that can prevent disease and save lives. In order to realize these health benefits, it is essential to ensure adequate immunization financing to enable equitable access to vaccines for people in all communities. This analysis estimates the full immunization program costs, projected available financing, and resulting funding gap for 94 low- and middle-income countries over five years (2016-2020). Vaccine program financing by country governments, Gavi, and other development partners was forecasted for vaccine, supply chain, and service delivery, based on an analysis of comprehensive multi-year plans together with a series of scenario and sensitivity analyses. Findings indicate that delivery of full vaccination programs across 94 countries would result in a total funding gap of $7.6 billion (95% uncertainty range: $4.6-$11.8 billion) over 2016-2020, with the bulk (98%) of the resources required for routine immunization programs. More than half (65%) of the resources to meet this funding gap are required for service delivery at $5.0 billion ($2.7-$8.4 billion) with an additional $1.1 billion ($0.9-$2.7 billion) needed for vaccines and $1.5 billion ($1.1-$2.0 billion) for supply chain. When viewed as a percentage of total projected costs, the funding gap represents 66% of projected supply chain costs, 30% of service delivery costs, and 9% of vaccine costs. On average, this funding gap corresponds to 0.2% of general government expenditures and 2.3% of government health expenditures. These results suggest greater need for country and donor resource mobilization and funding allocation for immunizations. Both service delivery and supply chain are important areas for further resource mobilization. Further research on the impact of advances in service delivery technology and reductions in vaccine prices beyond this decade would be important for efficient investment decisions for immunization. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Service-Learning Model for At-Risk Adolescents

ERIC Educational Resources Information Center

Nelson, Judith A.; Eckstein, Daniel

2008-01-01

This article describes a service-learning case study and program description involving the development and the delivery of services in a Disciplinary Alternative Education Program for secondary students. Following an overview of the philosophy of constructivist theory applied to the concept of the dissemination of information concerning adolescent…

Save the Best Till Last: Retaining Enrollment through Exceptional Service.

ERIC Educational Resources Information Center

Wassom, Julie

1996-01-01

Discusses relationship marketing as a technique for successful enrollment building. Describes components of relationship marketing: (1) ethical delivery of the promised program and making delivery evident to parents; (2) flexibility in programming to meet parents' needs; (3) attention to parents to make them feel special; (4) effective…

Delivery of health services to migrant and seasonal farmworkers.

PubMed

Arcury, Thomas A; Quandt, Sara A

2007-01-01

Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

Employee assistance programs: an alternative resource for mental health service delivery.

PubMed

Santa-Barbara, J

1984-09-01

The purpose of this article is to provide a very brief introduction to employee assistance programs (EAPs) and their role in the mental health delivery system. In addition, some consideration will be given to the opportunity these programs offer for making a significant impact on both the mental health of Canadians and the productivity of Canadian business.

National Weatherization Assistance Program Impact Evaluation - Client Satisfaction Survey: WAP Service Delivery from the Client's Perspective

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

Miller, Carolyn; Carroll, David; Berger, Jacqueline

This report presents the results of a survey of recipients to measure satisfaction with services provided by local weatherization agencies being supported by funding from Department of Energy's Weatherization Assistance Program.

Roles of Social Movement Organizations for Securing Workers' Safety in Korea: A Case Study of Abolition of the 30-Minute Delivery Guarantee Program in Pizza Delivery Service.

PubMed

Park, Ji-Eun; Kim, Myoung-Hee

2016-07-01

Many restaurants in Korea maintain quick-delivery service programs to satisfy customers. This service allows delivery workers limited time to deliver, which frequently put them in danger. Most of the workers are young, work part-time, and are rarely organized into trade unions. In this article, through a case study of the social movement to abolish the 30-minute delivery guarantee program of pizza companies in Korea, we argue that social movements involving social movement organizations (SMOs) and individual citizens could serve as a means to rectify this problem. We show how the SMOs developed and expanded the movement using a framing perspective and how the general public became involved through social media. Data was collected via online searching. Interview scripts from key players of SMOs and unofficial documents they provided were also reviewed. Three SMOs primarily led the movement, successfully forming a frame that emphasized social responsibility. SMOs also utilized social media to link their standing frame with unmobilized citizens and to expand the movement. We identified contributing factors and limitations of the movement and drew lessons that could be applied to other sectors where workers are in vulnerable positions. © The Author(s) 2016.

Riding the Electronic Wave--Document Delivery: Proceedings of the Library of Congress Network Advisory Committee Meeting (Washington, D.C., November 29-December 1, 1989). Network Planning Paper Number 20.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC. Network Development and MARC Standards Office.

Papers delivered at the 1989 program session of the Library of Congress Network Advisory Committee (NAC) focused on ways in which newer technologies and document delivery networks are changing current practices in document delivery and information services. Charles P. Bourne, chair of the program committee, presented an overview of document…

Staff Recommendations Concerning the Delivery of Hepatitis-Related Services in County Health Departments

ERIC Educational Resources Information Center

Rainey, Jacquie

2007-01-01

Background: This paper describes a portion of a larger evaluation project of a state hepatitis prevention program. Purpose: The study explored the suggestions of key informants related to the delivery of hepatitis services in the state. Methods: Researchers conducted key informant interviews lasting 30 to 45 minutes. Results: Important findings…

Young Children with Disabilities in Israel: System of Early Intervention Service Delivery

ERIC Educational Resources Information Center

Shulman, Cory; Meadan, Hedda; Sandhaus, Yoram

2012-01-01

This article aims to analyze early intervention programs in Israel according to the Developmental Systems Model (Guralnick, 2001), in an attempt to identify strengths and areas for further development for service delivery for young children with disabilities in Israel. Early intervention in Israel is part of a comprehensive healthcare model…

Three models of community mental health services In low-income countries

PubMed Central

2011-01-01

Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models. PMID:21266051

Outcomes and Cost-Effectiveness of Integrating HIV and Nutrition Service Delivery: Pilots in Malawi and Mozambique.

PubMed

Bergmann, Julie N; Legins, Kenneth; Sint, Tin Tin; Snidal, Sarah; Amor, Yanis Ben; McCord, Gordon C

2017-03-01

This paper provides the first estimates of impact and cost-effectiveness for integrated HIV and nutrition service delivery in sub-Saharan Africa. HIV and undernutrition are synergistic co-epidemics impacting millions of children throughout the region. To alleviate this co-epidemic, UNICEF supported small-scale pilot programs in Malawi and Mozambique that integrated HIV and nutrition service delivery. We use trends from integration sites and comparison sites to estimate the number of lives saved, infections averted and/or undernutrition cases cured due to programmatic activities, and to estimate cost-effectiveness. Results suggest that Malawi's program had a cost-effectiveness of $11-29/DALY, while Mozambique's was $16-59/DALY. Some components were more effective than others ($1-4/DALY for Malawi's Male motivators vs. $179/DALY for Mozambique's One stop shops). These results suggest that integrating HIV and nutrition programming leads to a positive impact on health outcomes and should motivate additional work to evaluate impact and determine cost-effectiveness using an appropriate research design.

The influence of integrated tuberculosis and human immunodeficiency virus service delivery on patient outcomes.

PubMed

Uyei, J; Coetzee, D; Macinko, J; Weinberg, S L; Guttmacher, S

2014-03-01

Public health clinics in Cape Town, South Africa. To examine the influence of integrated tuberculosis (TB) and human immunodeficiency virus (HIV) service delivery on mortality, TB cure and successful treatment completion and loss to follow-up of TB-HIV co-infected patients on concurrent anti-tuberculosis and antiretroviral treatment (ART). A survey instrument was used to measure the degree to which TB and HIV services were jointly delivered, and patient data were collected retrospectively from clinic sites and the Department of Health. Six domains measuring integrated TB and HIV service delivery were modelled to assess their relationship with patient outcomes. Two domains, integrated TB and ART service delivery and the delivery of TB and HIV care by one clinical team, were associated with lowered odds of death. Care by the same clinical team was also associated with reduced loss to follow-up. Overall, these findings show that the organization and delivery of health services are important factors that influence health outcomes. These findings strongly support efforts by local governments to integrate TB and ART services, and may help to alleviate concerns that restructuring of TB programs could have a negative impact on long-standing gains.

Children's Program Outcome Review Team: 2001 Evaluation Results.

ERIC Educational Resources Information Center

Wade, Patricia C.

In its eighth year of evaluating children's services in the state, the Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, continued to collect and analyze data to improve service delivery to children and families involved in state custody. Using the Quality Service Review…

Collaboration between the University Pre-Service Teacher Education Program and the Local Elementary School on English Remedial Education

ERIC Educational Resources Information Center

Chien, Chin-Wen

2015-01-01

This study analyzed 24 pre-service elementary school English teachers' design and delivery of remedial education to the fifth and sixth graders in the collaboration between the university pre-service teacher education program and the local elementary school in a city in northwest Taiwan. The pre-service teachers were encouraged by the elementary…

Delivery of Education and Training in Oregon's Adult Corrections Institutions. An Analysis of Present and Future Directions.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR. Education and Work Program.

This report on education and training in Oregon corrections institutions begins with a brief discussion of trends in correctional education and funding patterns. It then examines three general models of corrections education service delivery: educational programming under institutional superintendents, statewide programming facilitated by a state…

75 FR 21617 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

... in the public vocational rehabilitation (VR) program, including individuals from minority backgrounds... programs that are funded under the Act, as well as to improve the delivery of VR services to people with... go to work for the public VR program or related rehabilitation agencies; and (3) the number of...

A Look at How Agencies Can Utilize Outcome and Performance Data To Enhance Service Delivery.

ERIC Educational Resources Information Center

Resources for Welfare Decisions, 2002

2002-01-01

This issue focuses on a variety of performance measurement and outcome data resources as they relate to evaluating service delivery performance in areas that include employment (welfare-to-work and performance bonuses for work participation) and child welfare, as well as some general Temporary Assistance to Needy Families program areas. It also…

Geropsychology Post-Doctoral Training in Public Sector Service Delivery: The USF/Tampa VA Fellowship Model

ERIC Educational Resources Information Center

Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.

2005-01-01

There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care…

Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

ERIC Educational Resources Information Center

Tucker, Jamie; And Others

Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…

Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

PubMed

Strike, Carol; Miskovic, Miroslav

2018-02-08

Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts across the world. However, more work is needed to create clearer assessment metrics and to improve access to NSP services across the world.

Intervening with High-Risk Youth. Preliminary Findings from the Children-at-Risk Program. National Institute of Justice Research Preview.

ERIC Educational Resources Information Center

Harrell, Adele

The Children-at-Risk program (CAR), a drug and delinquency prevention program, targets high-risk adolescents aged 11 to 13 who live in distressed neighborhoods. The program features integrated delivery of comprehensive services that are tailored to the community and involve close collaboration with other services providers. The Urban Institute is…

Too little but not too late: Results of a literature review to improve routine immunization programs in developing countries

PubMed Central

Ryman, Tove K; Dietz, Vance; Cairns, K Lisa

2008-01-01

Background Globally, immunization services have been the center of renewed interest with increased funding to improve services, acceleration of the introduction of new vaccines, and the development of a health systems approach to improve vaccine delivery. Much of the credit for the increased attention is due to the work of the GAVI Alliance and to new funding streams. If routine immunization programs are to take full advantage of the newly available resources, managers need to understand the range of proven strategies and approaches to deliver vaccines to reduce the incidence of diseases. In this paper, we present strategies that may be used at the sub-national level to improve routine immunization programs. Methods We conducted a systematic review of studies and projects reported in the published and gray literature. Each paper that met our inclusion criteria was rated based on methodological rigor and data were systematically abstracted. Routine-immunization – specific papers with a methodological rigor rating of greater than 60% and with conclusive results were reported. Results Greater than 11,000 papers were identified, of which 60 met our inclusion criteria and 25 papers were reported. Papers were grouped into four strategy approaches: bringing immunizations closer to communities (n = 11), using information dissemination to increase demand for vaccination (n = 3), changing practices in fixed sites (n = 4), and using innovative management practices (n = 7). Conclusion Immunization programs are at a historical crossroads in terms of developing new funding streams, introducing new vaccines, and responding to the global interest in the health systems approach to improving immunization delivery. However, to complement this, actual service delivery needs to be strengthened and program managers must be aware of proven strategies. Much was learned from the 25 papers, such as the use of non-health workers to provide numerous services at the community level. However it was startling to see how few papers were identified and in particular how few were of strong scientific quality. Further well-designed and well-conducted scientific research is warranted. Proposed areas of additional research include integration of additional services with immunization delivery, collaboration of immunization programs with new partners, best approaches to new vaccine introduction, and how to improve service delivery. PMID:18570677

Too little but not too late: results of a literature review to improve routine immunization programs in developing countries.

PubMed

Ryman, Tove K; Dietz, Vance; Cairns, K Lisa

2008-06-21

Globally, immunization services have been the center of renewed interest with increased funding to improve services, acceleration of the introduction of new vaccines, and the development of a health systems approach to improve vaccine delivery. Much of the credit for the increased attention is due to the work of the GAVI Alliance and to new funding streams. If routine immunization programs are to take full advantage of the newly available resources, managers need to understand the range of proven strategies and approaches to deliver vaccines to reduce the incidence of diseases. In this paper, we present strategies that may be used at the sub-national level to improve routine immunization programs. We conducted a systematic review of studies and projects reported in the published and gray literature. Each paper that met our inclusion criteria was rated based on methodological rigor and data were systematically abstracted. Routine-immunization - specific papers with a methodological rigor rating of greater than 60% and with conclusive results were reported. Greater than 11,000 papers were identified, of which 60 met our inclusion criteria and 25 papers were reported. Papers were grouped into four strategy approaches: bringing immunizations closer to communities (n = 11), using information dissemination to increase demand for vaccination (n = 3), changing practices in fixed sites (n = 4), and using innovative management practices (n = 7). Immunization programs are at a historical crossroads in terms of developing new funding streams, introducing new vaccines, and responding to the global interest in the health systems approach to improving immunization delivery. However, to complement this, actual service delivery needs to be strengthened and program managers must be aware of proven strategies. Much was learned from the 25 papers, such as the use of non-health workers to provide numerous services at the community level. However it was startling to see how few papers were identified and in particular how few were of strong scientific quality. Further well-designed and well-conducted scientific research is warranted. Proposed areas of additional research include integration of additional services with immunization delivery, collaboration of immunization programs with new partners, best approaches to new vaccine introduction, and how to improve service delivery.

Public service communications

NASA Technical Reports Server (NTRS)

Whalen, A. A.

1979-01-01

The purpose of the paper is to construct, for detailed analysis, satellite and terrestrial communications delivery system models. Attention is given to the Public Service Communications Delivery System Architectural Study, that takes advantage of the extensive experience which exists among the public service experimenters. The Application Test Pilot is examined, which is a program designed to help awareness, in a practical sense, of the technology available and by the users innovative talents, adapts the technology to solve their problems.

Effective Delivery of Transition Assistance to Air Force Members Leaving the Service.

DTIC Science & Technology

1997-03-01

Members Leaving the Service AF504R1/MARCH 1997 Executive Summary BACKGROUND Congress established the Transition Assistance Program (TAP) for the armed...forces in the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101-510). This program assists military members and their families...other FSC program managers are responsible for delivering some transition services, espe- cially relocation assistance , financial counseling, and

Alternative financing mechanisms for ART programs in health facilities in Uganda: a mixed-methods approach.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2017-01-23

Sub-Saharan Africa is heavily dependent on global health initiatives (GHIs) for funding antiretroviral therapy (ART) scale-up. There are indications that global investments for ART scale-up are flattening. It is unclear what new funding channels can bridge the funding gap for ART service delivery. Many previous studies have focused on domestic government spending and international funding especially from GHIs. The objective of this study was to identify the funding strategies adopted by health facilities in Uganda to sustain ART programs between 2004 and 2014 and to explore variations in financing mechanisms by ownership of health facility. A mixed-methods approach was employed. A survey of health facilities (N = 195) across Uganda which commenced ART delivery between 2004 and 2009 was conducted. Six health facilities were purposively selected for in-depth examination. Semi-structured interviews (N = 18) were conducted with ART Clinic managers (three from each of the six health facilities). Statistical analyses were performed in STATA (Version 12.0) and qualitative data were analyzed by coding and thematic analysis. Multiple funding sources for ART programs were common with 140 (72%) of the health facilities indicating at least two concurrent grants supporting ART service delivery between 2009 and 2014. Private philanthropic aid emerged as an important source of supplemental funding for ART service delivery. ART financing strategies were differentiated by ownership of health facility. Private not-for-profit providers were more externally-focused (multiple grants, philanthropic aid). For-profit providers were more client-oriented (fee-for-service, insurance schemes). Public facilities sought additional funding streams not dissimilar to other health facility ownership-types. Over the 10-year study period, health facilities in Uganda diversified funding sources for ART service delivery. The identified alternative funding mechanisms could reduce dependence on GHI funding and increase local ownership of HIV programs. Further research evaluating the potential contribution of the identified alternative financing mechanisms in bridging the global HIV funding gap is recommended.

Rethinking Student Services: Assessing and Improving Service Quality.

ERIC Educational Resources Information Center

Zammuto, Raymond F.; And Others

1996-01-01

A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…

Understanding the Impact of Organizational Differentiation in High-Poverty Schools with Alternative Models of Title I Service Delivery.

ERIC Educational Resources Information Center

Meyer, Stephen J.

American public schools historically have used a range of differentiating mechanisms to meet the needs of diverse groups of students. Examples from Title I service delivery include pullout, in-class, add-on, and replacement programs. These models have elements that differentiate the educational experience of Title I students to varying degrees and…

45 CFR 1310.14 - Inspection of new vehicles at the time of delivery.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Inspection of new vehicles at the time of delivery. 1310.14 Section 1310.14 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

45 CFR 1310.14 - Inspection of new vehicles at the time of delivery.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Inspection of new vehicles at the time of delivery. 1310.14 Section 1310.14 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD...

76 FR 19655 - Medicare Program; Waiver Designs in Connection With the Medicare Shared Savings Program and the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... Savings Program and the Innovation Center AGENCY: Centers for Medicare & Medicaid Services (CMS) and...) of the Social Security Act (of the Act), as added by the Affordable Care Act (ACA) authorizes the... payment and service delivery models by the Center for Medicare and Medicaid Innovation. This notice with...

Improving regional and rural cancer services in Western Australia.

PubMed

Platt, Violet; O'Connor, Kathleen; Coleman, Rhonda

2015-02-01

This paper examines health reform which has been designed to improve cancer services across Western Australia. Western Australia is a large state divided into nine regions each with differing demographics. The diversity of the state and the distribution of the population over a large area of land create significant challenge in ensuring equality in service delivery. A comparison was conducted looking at cancer services in Western Australia pre-2005 and service delivery in 2014. A review of the partnership initiatives and programs provides a clear discussion on the need for coordination of care between service providers. The approach undertaken in Western Australia has seen an increase in the delivery of cancer services closer to the patient's home as well as greater involvement of primary care professionals in cancer care. This work has resulted in demonstrated improvements in patient care and support. Services for cancer patients need to be accessible closer to home with distance being an appreciable barrier to treatment access.A statewide approach needs to be developed to ensure all people have equitable access to service delivery. © 2015 National Rural Health Alliance Inc.

Profile, knowledge, and work patterns of a cadre of maternal, newborn, and child health CHWs focusing on preventive and promotive services in Morogoro Region, Tanzania.

PubMed

LeFevre, Amnesty E; Mpembeni, Rose; Chitama, Dereck; George, Asha S; Mohan, Diwakar; Urassa, David P; Gupta, Shivam; Feldhaus, Isabelle; Pereira, Audrey; Kilewo, Charles; Chebet, Joy J; Cooper, Chelsea M; Besana, Giulia; Lutale, Harriet; Bishanga, Dunstan; Mtete, Emmanuel; Semu, Helen; Baqui, Abdullah H; Killewo, Japhet; Winch, Peter J

2015-12-24

Despite impressive decreases in under-five mortality, progress in reducing maternal and neonatal mortality in Tanzania has been slow. We present an evaluation of a cadre of maternal, newborn, and child health community health worker (MNCH CHW) focused on preventive and promotive services during the antenatal and postpartum periods in Morogoro Region, Tanzania. Study findings review the effect of several critical design elements on knowledge, time allocation, service delivery, satisfaction, and motivation. A quantitative survey on service delivery and knowledge was administered to 228 (of 238 trained) MNCH CHWs. Results are compared against surveys administered to (1) providers in nine health centers (n = 88) and (2) CHWs (n = 53) identified in the same districts prior to the program's start. Service delivery outputs were measured by register data and through a time motion study conducted among a sub-sample of 33 randomly selected MNCH CHWs. Ninety-seven percent of MNCH CHWs (n = 228) were interviewed: 55% male, 58% married, and 52% with secondary school education or higher. MNCH CHWs when compared to earlier CHWs were more likely to be unmarried, younger, and more educated. Mean MNCH CHW knowledge scores were <50% for 8 of 10 MNCH domains assessed and comparable to those observed for health center providers but lower than those for earlier CHWs. MNCH CHWs reported covering a mean of 186 households and were observed to provide MNCH services for 5 h weekly. Attendance of monthly facility-based supervision meetings was nearly universal and focused largely on registers, yet data quality assessments highlighted inconsistencies. Despite program plans to provide financial incentives and bicycles for transport, only 56% of CHWs had received financial incentives and none received bicycles. Initial rollout of MNCH CHWs yields important insights into addressing program challenges. The social profile of CHWs was not significantly associated with knowledge or service delivery, suggesting a broader range of community members could be recruited as CHWs. MNCH CHW time spent on service delivery was limited but comparable to the financial incentives received. Service delivery registers need to be simplified to reduce inconsistencies and yet expanded to include indicators on the timing of antenatal and postpartum visits.

Perceived Needs for Support Program for Family With Child Sexual Abuse Victim in South Korea: Focus Group Interview With Therapists and Mothers.

PubMed

Han, Suejung; Kim, Jinsook

2016-10-01

This study assessed perceived needs for psychological support program for family with victim of child sexual abuse in South Korea. We conducted two separate focus group interviews with five therapists who served child sexual abuse victims and families as well as four mothers of a child sexual abuse victim. Consensual qualitative research analysis revealed four domains: Emotional support for parents, psychoeducation, family therapy, and tailored and flexible service delivery. Core ideas of the four domains were identified. The results were consistent with the family support program contents developed in Western countries and suggested culture-specific contents and culturally sensitive service delivery. Clinical implications for developing family support program in South Korea were discussed.

Partners in Self-Sufficiency Guidebook.

ERIC Educational Resources Information Center

Department of Housing and Urban Development, Washington, DC. Office of Policy Development and Research.

This guidebook is for community leaders who are implementing the Federal Partners in Self-Sufficiency (PS-S) program, a community-based approach to service delivery that helps families get off welfare. The program offers a comprehensive package of services including housing, education, child care, transportation, counseling, and job training and…

78 FR 47778 - Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Birmingham...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

...,968B] Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Birmingham, Alabama; Verizon Business Networks Services, Inc. Senior Analysts-Sales Impletmentation (SA-SI) Service Program Delivery Division San Francisco, California; Verizon Business Networks Services, Inc.Senior...

The Impact of Educational Leadership Decisions on the Delivery of Special Education Services in School Districts

ERIC Educational Resources Information Center

Edwards, Brian S.

2012-01-01

The number of children (ages 3-21) in the United States designated as having a specific learning disability is over seven (7) million. Providing the programs, services and funding necessary to deliver appropriate programs and services to this special population is a challenge in virtually all school districts across the country. The role of school…

Maximizing the Impact of Telepractice through a Multifaceted Service Delivery Model at The Shepherd Centre, Australia

ERIC Educational Resources Information Center

Davis, Aleisha; Hopkins, Tracy; Abrahams, Yetta

2012-01-01

The Shepherd Centre is a nonprofit early intervention program in New South Wales, Australia, providing listening and spoken language services through an interdisciplinary team approach to children with hearing loss and their families. The program has been providing distance services to families in rural and remote areas of Australia and in other…

Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

PubMed

Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

2008-01-01

The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

Refocusing and Evolving Subseasonal-to-Seasonal Services in NOAA's National Weather Service

NASA Astrophysics Data System (ADS)

Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Silva, V.; Mangan, M. R.; Meyers, J. C.; Zdrojewski, J.

2017-12-01

NOAA's National Weather Service (NWS) recently completed a reorganization to better support its goal to build a Weather-Ready Nation. As part of the reorganization, NWS streamlined its 11 national service programs, including climate services, to provide a more structured approach to supporting service delivery needs. As the American public increasingly requests information at sub-seasonal and seasonal time scales for decision making, the NWS Climate Services Program is striving to meet those needs by accelerating transition of research to operations, improving delivery of products and services, and enhancing partnerships to facilitate provision of seamless weather, water, and climate products and services at regional and local scales. Additionally, NWS forecasters are requesting more tools to be able to put severe weather and water events into a climate context to provide more effective impact-based decision support services (IDSS). This paper will describe the activities to more effectively integrate climate services into the NWS suite of environmental information, the roles of the NWS offices supporting or delivering sub-seasonal and seasonal information to the US public, and engaging NWS core and deep-core partners in provision of information on climatological risks and preparedness as a part of IDSS. We will discuss the process by which we collect user requests and/or needs and the NWS process that allows us to move these requests and needs through a formal requirements validation process and thus place the requirement on a path to identify a potential solution for implementation. The validation of a NWS climate-related requirement is also key to identify research, development, and transition mission delivery needs that are supported through the Office of Oceanic and Atmospheric Research (OAR) Climate Program Office (CPO). In addition, we will present the outcomes of key actions of the first ever NWS National Climate Services Meeting (NCSM) that was held in May 2016 with the participation of more than 250 NWS climate services staff and key partners from across the country. The key actions include understanding core and deep-core partners, advancing training for NWS staff focused on IDSS, and better organization of service delivery at regional and local levels.

Comparing mandated health care reforms: the Affordable Care Act, accountable care organizations, and the Medicare ESRD program.

PubMed

Watnick, Suzanne; Weiner, Daniel E; Shaffer, Rachel; Inrig, Jula; Moe, Sharon; Mehrotra, Rajnish

2012-09-01

In addition to extending health insurance coverage, the Affordable Care Act of 2010 aims to improve quality of care and contain costs. To this end, the act allowed introduction of bundled payments for a range of services, proposed the creation of accountable care organizations (ACOs), and established the Centers for Medicare and Medicaid Innovation to test new care delivery and payment models. The ACO program began April 1, 2012, along with demonstration projects for bundled payments for episodes of care in Medicaid. Yet even before many components of the Affordable Care Act are fully in place, the Medicare ESRD Program has instituted legislatively mandated changes for dialysis services that resemble many of these care delivery reform proposals. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare's first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program. As ACOs are developed, they may benefit from the nephrology community's experience with these relatively novel models of health care payment and delivery reform. Nephrologists are in a position to assure that the ACO development will benefit from the ESRD experience. This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs. Better understanding of similarities and differences between the ESRD program and the ACO program will allow the nephrology community to have a more influential voice in shaping the future of health care delivery in the United States.

Rural Health Care Delivery and Nutrition Program Implementation: A Case Study from Highland Guatemala.

ERIC Educational Resources Information Center

Rodeheaver, Daniel G.; Rodeheaver, Denise P.

Between 1978 and 1980, qualitative and numerical data were collected in a health post facility located in Patzite, a rural village in highland Guatemala, in order to determine the effectiveness of rural health service delivery, including nutrition programs. Data were collected by: (1) interviews as to purposes and goals of general health care; (2)…

Systematizing the Delivery of Local Employment and Training Services. The Job Center Technical Assistance Guide.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Industry, Labor and Human Relations, Madison.

This technical assistance guide was developed to consolidate a statewide understanding of the effort to systematize the delivery of employment and training programs through the local formation of job centers in Wisconsin, and to provide a compilation, drawn from 20 local models, that explains how the programs are delivered. The guide is organized…

Evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothers.

PubMed

Patchen, Loral; Letourneau, Kathryn; Berggren, Erica

2013-01-01

This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.

Challenges in immunisation service delivery for refugees in Australia: A health system perspective.

PubMed

Mahimbo, A; Seale, H; Smith, M; Heywood, A

2017-09-12

Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group. A qualitative study involving 30 semi-structured interviews was undertaken with key stakeholders in immunisation service delivery across all States and Territories in Australia between December 2014 and December 2015. Thematic analysis was undertaken. Variability in accessing program funding and vaccines, lack of a national policy for catch-up vaccination, unclear roles and responsibilities for catch-up, a lack of a central immunisation register and insufficient training among general practitioners were seen as the main challenges impacting on immunisation service delivery for refugees. This study provides insight into the challenges that impact on effective immunisation service delivery for refugees. Deliberate strategies such as national funding for relevant vaccines, improved data collection nationally and increased guidance for general practitioners on catch-up immunisation for refugees would help to ensure equitable access across all age groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery.

PubMed

Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Bergeron, Sophie; Lambert, Carole

2013-05-01

This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to improve the quality of services provided to children with disabilities, their families, and their communities.

Costs of vaccine programs across 94 low- and middle-income countries.

PubMed

Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

2015-05-07

While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities. By projecting the full costs of immunization programs, our findings may aid to garner greater country and donor commitments toward adequate resource mobilization and efficient allocation. As service delivery costs have increasingly become the main driver of vaccination program costs, it is essential to pay additional consideration to health systems strengthening. Copyright © 2015 Elsevier Ltd. All rights reserved.

Client-Centered Employee Assistance Services.

ERIC Educational Resources Information Center

Bayer, Darryl Lee

This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

20 CFR 663.120 - Are displaced homemakers eligible for dislocated worker activities under WIA?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery... the adult program. ...

20 CFR 663.120 - Are displaced homemakers eligible for dislocated worker activities under WIA?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery... the adult program. ...

20 CFR 663.120 - Are displaced homemakers eligible for dislocated worker activities under WIA?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop Delivery... the adult program. ...

Creating new realities: program development and dissemination.

PubMed Central

Fixsen, D L; Blase, K A

1993-01-01

Program development and dissemination in human services present challenges and opportunities for social scientists. Over the past 27 years the Teaching-Family Model of group home treatment has moved from prototype development to widespread dissemination across North America. Reviewing concepts in industry related to product development and dissemination, the application of these concepts to a human services delivery system, and program replication and dissemination data offer information about how innovative human services can be widely adapted and adopted. PMID:8307838

New Pathways for Primary Care: An Update on Primary Care Programs From the Innovation Center at CMS

PubMed Central

Baron, Richard J.

2012-01-01

Those in practice find that the fee-for-service system does not adequately value the contributions made by primary care. The Center for Medicare and Medicaid Innovation (Innovation Center) was created by the Affordable Care Act to test new models of health care delivery to improve the quality of care while lowering costs. All programs coming out of the Innovation Center are tests of new payment and service delivery models. By changing both payment and delivery models and moving to a payment model that rewards physicians for quality of care instead of volume of care, we may be able to achieve the kind of health care patients want to receive and primary care physicians want to provide. PMID:22412007

Utilization of maternal health care services among married adolescent women: insights from the Nigeria Demographic and Health Survey, 2008.

PubMed

Rai, Rajesh Kumar; Singh, Prashant Kumar; Singh, Lucky

2012-01-01

An ongoing social catastrophe of very poor performance in maternal health coupled with an unacceptably high number of maternal deaths is evident in Nigeria, especially among adolescent women. This study examines the factors associated with selected maternity services-married adolescent women who have had at least four antenatal care (ANC) visits, those who have undergone safe delivery care, and those who received postnatal care within 42 days of delivery. Data from Nigeria Demographic and Health Survey, 2008, were used. An eligible sample of 2,434 married adolescent (aged 15-19 years) women was included in the analysis. Pearson chi-square test and binary logistic regression were performed to fulfill the study objective. It was found that about 35% of adolescent women had at least four ANC visits, a little over 25% had undergone safe delivery care, and nearly 32% received postnatal care within 42 days of delivery. Women's education, husband's education, wealth quintile, and region of residence were documented as the most important factors associated with maternal healthcare service utilization. The ANC visit was found to be vital in the utilization of safe delivery and postnatal care. Findings indicate that programs to improve maternal healthcare have not succeeded in overcoming the socioeconomic obstacles in the way of adolescents' utilizing maternity services. In the long run, the content and service delivery strategy of maternity programs must be designed in keeping with the socioeconomic context with special attention to adolescent women who are uneducated, poor, and residing in rural areas. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The preexposure prophylaxis revolution; from clinical trials to programmatic implementation.

PubMed

Mugo, Nelly R; Ngure, Kenneth; Kiragu, Michael; Irungu, Elizabeth; Kilonzo, Nduku

2016-01-01

An investment in preexposure prophylaxis (PrEP) delivery must have public health impact in reducing HIV infections. Sustainable delivery of PrEP requires policy, integration of services, and synergy with other existing HIV prevention programs. This review discusses key policy and programmatic considerations for implementation and scale up of PrEP in Africa. PrEP delivery has been delayed by concerns about adherence and delivery in 'real world' settings. Demonstration projects and clinical service delivery models are providing evidence of PrEP effectiveness with an impact much higher than that found in randomized clinical trials. Data confirm that PrEP uptake, adherence, and retention has been high, more so by persons who perceive themselves at high risk for HIV infection, and PrEP is well tolerated. PrEP delivery is more than dispensation of a pill and programs should address other risk drivers, which differ by population. In Africa, barriers to PrEP uptake and adherence include stigma among MSM and low HIV risk perception among young women. Additional data have provided insight into optimal points of service delivery, provider training requirements and quality assurance needs. Of the 2 million new HIV infections in 2014, 70% were in Africa. PrEP use is not lifelong, and use limited to periods of risk may be both effective and cost-effective for the continent. HIV prevention programs should determine strategies to identify those at substantial risk for HIV infection, formulate and deliver PrEP in combination with interventions that target social drivers of HIV vulnerability specific to each population. Policy guidance for optimal combination of interventions and service delivery avenues, clinical protocols, health infrastructure requirements are required. Cost-effectiveness and efficiency data are essential for policy guidance to navigate ethical questions over use of antiretroviral therapy for HIV-negative individuals when treatment coverage has not been attained in many parts of Africa. Countries need to invest in purposeful advocacy at both local and global forums. Failure to implement PrEP will be a failure to protect future generations.

The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

PubMed

Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

2018-05-09

Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Satellite services system analysis study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1981-01-01

Service requirements are considered. Topics include development of on-orbit operations scenarios, service equipment summary, crew interaction, and satellite features facilitating servicing. Service equipment concepts are considered. Topics include payload deployment, close proximity retrieval, on-orbit servicing, backup/contingency, delivery/retrieval of high energy payloads, Earth return, optional service, and advanced capabilities. Program requirements are assessed.

Quality of care in family planning services in Morocco.

PubMed

Brown, L; Tyane, M; Bertrand, J; Lauro, D; Abou-ouakil, M; deMaria, L

1995-01-01

This study was conducted to heighten awareness of quality of care as a programmatic issue in the Moroccan governmental family planning program and to test modified Situation Analysis instruments for measuring quality of care. Data were collected from 50 service-delivery points in five provinces to measure six elements of quality in accordance with the Bruce/Jain framework. A procedure for calculating quality-indicator scores is presented. Although facilities varied by province and within provinces, most had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service-delivery points scored well on mechanisms to ensure continuity of use. Notable shortcomings included a dearth of materials for counseling and a widespread unavailability of the Ovrette pill. This study raises issues regarding the complexity of measuring quality, the ownership of results, and the appropriateness of a centralized study of quality in a decentralized program.

A comparative analysis of the implementation of the Mais Médicos (More Doctors) Program in municipalities in the State of Rio Grande do Sul, Brazil.

PubMed

Miranda, Alcides Silva de; Melo, Diego Azevedo

2016-09-01

The Mais Médicos (More Doctors) Program has led to an increase in the number of doctors and medical treatment in primary health care services across Brazil. This article presents the results of a case-control study of groups of municipalities based on secondary data sources. It aims to explore and discuss a set of indicators of primary health care service delivery. An improvement in performance against structural indicators was observed in municipalities where the program was implemented. With respect to the outcome indicators, a slight improvement in service delivery was observed in municipalities where the program was implemented. However, no difference was observed in impacts between the case and control municipalities. These results may have been influenced by the fact that the program has only been underway for a limited time, by underreporting of doctors by the National Health Facilities Register (CNES, acronym in Portuguese), and the predominantly substitutive nature of the allocation of medical professionals under the program in the selected municipalities.

45 CFR 1635.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Definitions. 1635.2 Section 1635.2 Public Welfare... Definitions. As used in this part— (a) A case is a form of program service in which an attorney or paralegal.... (b) A matter is an action which contributes to the overall delivery of program services but does not...

45 CFR 1635.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definitions. 1635.2 Section 1635.2 Public Welfare... Definitions. As used in this part— (a) A case is a form of program service in which an attorney or paralegal.... (b) A matter is an action which contributes to the overall delivery of program services but does not...

45 CFR 1635.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definitions. 1635.2 Section 1635.2 Public Welfare... Definitions. As used in this part— (a) A case is a form of program service in which an attorney or paralegal.... (b) A matter is an action which contributes to the overall delivery of program services but does not...

45 CFR 1635.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Definitions. 1635.2 Section 1635.2 Public Welfare... Definitions. As used in this part— (a) A case is a form of program service in which an attorney or paralegal.... (b) A matter is an action which contributes to the overall delivery of program services but does not...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1635.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definitions. 1635.2 Section 1635.2 Public Welfare... Definitions. As used in this part— (a) A case is a form of program service in which an attorney or paralegal.... (b) A matter is an action which contributes to the overall delivery of program services but does not...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

45 CFR 1620.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definitions. 1620.2 Section 1620.2 Public Welfare... § 1620.2 Definitions. (a) A case is a form of program service in which an attorney or paralegal of a... (PAI) cases. (b) A matter is an action which contributes to the overall delivery of program services...

General Summary of the National Long-Term Care Channeling Demonstration. Revised.

ERIC Educational Resources Information Center

Office of the Assistant Secretary for Planning and Evaluation (DHHS), Washington, DC.

This paper summarizes the National Long-Term Care Channeling Demonstration Program, a project designed to test the feasibility and cost effectiveness of an alternative community-based long-term care service delivery concept for the frail elderly which integrated health and social services. Program management and early federal planning efforts are…

Career Education and Training for Teen Parents Program. Final Report.

ERIC Educational Resources Information Center

Whipple, Vicky

The Career Education and Training for Teen Parents Program was implemented at Kishwaukee College (Malta, Illinois) to provide educational and vocational services to teen parents (ages 14 to 21) and to establish a regional delivery system and community linkages that would integrate training, education, and support services for teen parents in the…

Design, Delivery and Evaluation of Teaching by Service Users and Carers

ERIC Educational Resources Information Center

Benbow, Susan Mary; Taylor, Louise; Mustafa, Nageen; Morgan, Kathleen

2011-01-01

Education influences individual health and social care professionals and the systems in which they work. We describe a postgraduate educational program that did this through involving service users and carers in designing and facilitating teaching programs. A module of teaching was designed and delivered in partnership with users and carers from…

Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study.

PubMed

Kim, Sunny S; Avula, Rasmi; Ved, Rajani; Kohli, Neha; Singh, Kavita; van den Bold, Mara; Kadiyala, Suneetha; Menon, Purnima

2017-02-02

Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs - Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery. Semi-structured interviews were conducted with state-level stakeholders (n = 12), district (n = 19) and block officials (n = 66), and frontline workers (FLWs, n = 48). Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers. Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities. Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes.

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 Service Delivery in a County Health Department WIC Clinic: An Application of Statistical Process Control Techniques

PubMed Central

Boe, Debra Thingstad; Parsons, Helen

2009-01-01

Local public health agencies are challenged to continually improve service delivery, yet they frequently operate with constrained resources. Quality improvement methods and techniques such as statistical process control are commonly used in other industries, and they have recently been proposed as a means of improving service delivery and performance in public health settings. We analyzed a quality improvement project undertaken at a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to reduce waiting times and improve client satisfaction with a walk-in nutrition education service. We used statistical process control techniques to evaluate initial process performance, implement an intervention, and assess process improvements. We found that implementation of these techniques significantly reduced waiting time and improved clients' satisfaction with the WIC service. PMID:19608964

Using 340B drug discounts to provide a financially sustainable medication discharge service.

PubMed

Wu, Timothy; Williams, Carla; Vranek, Kathryn; Mattingly, T Joseph

2018-03-27

The 340B Drug Pricing Program was intended to stretch federal resources by providing significant discounts to covered entities providing care to underserved populations. Program implementation and evidence of expanding services to higher income patients has brought more scrutiny and calls for elimination of the program. While additional review and reform may be warranted, profitability from 340B discounts enables covered entities to provide additional services that may not be feasible in absence of the program. This case report demonstrates one institution's use of 340B discounts to financially justify providing bedside medication delivery services for patients at the time of discharge from an inpatient admission. A simple financial model was developed using hospital data and inputs from available literature to estimate gross profit and earnings before interest, taxes, depreciation, and amortization (EBITDA) with and without 340B discounts. Without the 340B drug price discounts, the service would operate at a financial loss, and further investigation must be done to determine whether other clinical or economic benefits would warrant discharge medication delivery at the institution. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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

PubMed

Chitete, Lusungu; Puoane, Thandi

2015-01-01

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

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

PubMed

Teklehaimanot, Hailay D; Teklehaimanot, Awash

2013-08-20

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

How To Stretch Your Food Service Dollars

ERIC Educational Resources Information Center

Anderson, B. Robert

1973-01-01

The implications of any program as large as food service suggests that the administrator be conversant with the total field of food service distribution and the extras'' available as part of a burgeoning industry. An administrator has the right to expect competitive prices, excellent quality, good delivery, and superior peripheral services.…

Design and Implementation of the Texas Medicaid DSRIP Program.

PubMed

Begley, Charles; Hall, Jessica; Shenoy, Amrita; Hanke, June; Wells, Rebecca; Revere, Lee; Lievsay, Nicole

2017-04-01

Texas is one of 8 states that have received a Medicaid 1115 Transformation Waiver in which federal supplemental payments are being used to incentivize delivery system reform. Under the Texas Transformation Waiver's 5-year Delivery System Reform Incentive Payment (DSRIP) program, hospitals and other providers have established regional health care partnerships, conducted regional needs assessments, and developed and implemented projects addressing local gaps in service. The projects were selected from menus, supplied by the Texas Health and Human Services Commission and the Centers for Medicare & Medicaid Services, which defined acceptable infrastructure development and/or program innovation and redesign initiatives. Providers receive payment for planning the projects and achieving metrics and milestones related to project implementation and performance. This article describes the major features of the Texas DSRIP model and the resulting implementation and performance to date in the most populous region of the state.

Performance-based financing to increase utilization of maternal health services: Evidence from Burkina Faso.

PubMed

Steenland, Maria; Robyn, Paul Jacob; Compaore, Philippe; Kabore, Moussa; Tapsoba, Boukary; Zongo, Aloys; Haidara, Ousmane Diadie; Fink, Günther

2017-12-01

Performance-based financing (PBF) programs are increasingly implemented in low and middle-income countries to improve health service quality and utilization. In April 2011, a PBF pilot program was launched in Boulsa, Leo and Titao districts in Burkina Faso with the objective of increasing the provision and quality of maternal health services. We evaluate the impact of this program using facility-level administrative data from the national health management information system (HMIS). Primary outcomes were the number of antenatal care visits, the proportion of antenatal care visits that occurred during the first trimester of pregnancy, the number of institutional deliveries and the number of postnatal care visits. To assess program impact we use a difference-in-differences approach, comparing changes in health service provision post-introduction with changes in matched comparison areas. All models were estimated using ordinary least squares (OLS) regression models with standard errors clustered at the facility level. On average, PBF facilities had 2.3 more antenatal care visits (95% CI [0.446-4.225]), 2.1 more deliveries (95% CI [0.034-4.069]) and 9.5 more postnatal care visits (95% CI [6.099, 12.903]) each month after the introduction of PBF. Compared to the service provision levels prior to the interventions, this implies a relative increase of 27.7 percent for ANC, of 9.2 percent for deliveries, and of 118.7 percent for postnatal care. Given the positive results observed during the pre-pilot period and the limited resources available in the health sector, the PBF program in Burkina Faso may be a low-cost, high impact intervention to improve maternal and child health.

Recent changes in Medicaid policy and their possible effects on mental health services.

PubMed

Buck, Jeffrey A

2009-11-01

As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.

Improving the delivery of preventive care services.

PubMed

Hung, Dorothy Y

2007-05-01

Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

Increasing Access to Oral Health Care for People Living with HIV/AIDS in Rural Oregon

PubMed Central

Jones, Jill; Mofidi, Mahyar; Bednarsh, Helene; Gambrell, Alan; Tobias, Carol R.

2012-01-01

Access to oral health care for people living with HIV/AIDS is a severe problem. This article describes the design and impact of an Innovations in Oral Health Care Initiative program, funded through the Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance (SPNS) program, that expanded oral health-care services for these individuals in rural Oregon. From April 2007 to August 2010, 473 patients received dental care (exceeding the target goal of 410 patients) and 153 dental hygiene students were trained to deliver oral health care to HIV-positive patients. The proportion of patients receiving oral health care increased from 10% to 65%, while the no-show rate declined from 40% to 10%. Key implementation components were leveraging SPNS funding and services to create an integrated delivery system, collaborations that resulted in improved service delivery systems, using dental hygiene students to deliver oral health care, enhanced care coordination through the services of a dental case manager, and program capacity to adjust to unanticipated needs. PMID:22547878

Linking HIV-Negative Youth to Prevention Services in 12 U.S. Cities: Barriers and Facilitators to Implementing the HIV Prevention Continuum.

PubMed

Doll, Mimi; Fortenberry, J Dennis; Roseland, Denise; McAuliff, Kathleen; Wilson, Craig M; Boyer, Cherrie B

2018-04-01

Linkage of HIV-negative youth to prevention services is increasingly important with the development of effective pre-exposure prophylaxis that complements behavioral and other prevention-focused interventions. However, effective infrastructure for delivery of prevention services does not exist, leaving many programs to address HIV prevention without data to guide program development/implementation. The objective of this study was to provide a qualitative description of barriers and facilitators of linkage to prevention services among high-risk, HIV-negative youth. Thematic analysis of structured interviews with staff implementing linkage to prevention services programs for youth aged 12-24 years. Twelve adolescent medicine HIV primary care programs as part of larger testing research program focused on young sexual minority men of color. The study included staff implementing linkage to prevention services programs along with community-based HIV testing programs. The main outcomes of the study were key barriers/facilitators to linkage to prevention services. Eight themes summarized perspectives on linkage to prevention services: (1) relationships with community partners, (2) trust between providers and youth, (3) youth capacity to navigate prevention services, (4) pre-exposure prophylaxis specific issues, (5) privacy issues, (6) gaps in health records preventing tailored services, (7) confidentiality of care for youth accessing services through parents'/caretakers' insurance, and (8) need for health-care institutions to keep pace with models that prioritize HIV prevention among at-risk youth. Themes are discussed in the context of factors that facilitated/challenged linkage to prevention services. Several evidence-based HIV prevention tools are available; infrastructures for coordinated service delivery to high-risk youth have not been developed. Implementation of such infrastructures requires attention to community-, provider-, and youth-related issues. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

State Services for California Indians. FY 1980-81.

ERIC Educational Resources Information Center

Sanderson, Jack

Through cooperative efforts of state and federal officials and with concerned California Indians, State program delivery systems are constantly being monitored, evaluated, and adjusted to assure increasingly fair services for California Indians. The report divides State services into five general categories: cultural preservation; educational…

The Effects of Experiential, Service-Learning Summer Learning Programs on Youth Outcomes

ERIC Educational Resources Information Center

Greenman, Adam

2014-01-01

This study examines whether summer programming that relies on the delivery of a hands-on, experiential service learning curriculum to deliver content is able to reduce or eliminate summer learning loss in middle school students. Using Alexander, Entwisle, and Olson's (2001) faucet theory as a theoretical framework and a qualitative case study…

What? Another Form? The Process of Measuring and Comparing Service Utilization in a Community Mental Health Program Model.

ERIC Educational Resources Information Center

Dewa, Carolyn S.; Horgan, Salinda; Russell, Marc; Keates, Jane

2001-01-01

Describes experiences in developing a multi-program economic evaluation and costing study of Assertive Community Treatment (ACT), a widely studied community mental health treatment model. The project description shows how the worlds of research and service delivery can collaborate to come to symbiotic resolutions. (Author/SLD)

The Delivery of Recreation Programs: Students Gain Entry Level Management Skills through Service Learning

ERIC Educational Resources Information Center

Zimmermann, Jo An M.; Dupree, Jessica; Hodges, Jan S.

2014-01-01

Service learning is a well established pedagogy within higher education. Specifically, service learning allows students to engage in "real world" activities to practice skills and reflect upon their own competence. To enhance the effectiveness of service learning, instructors need to consider a multitude of learning influences. This…

Outcome Measures for Early Childhood Intervention Services.

ERIC Educational Resources Information Center

Accreditation Council on Services for People with Disabilities, Landover, MD.

This collection of 21 suggested outcome measures for early childhood intervention services is intended to apply to all types of service and support program models for children (birth to age 5) with various developmental delays and/or disabilities. The measures are appropriate for either home-based or center-based service delivery models. Section 1…

Comprehensive School Alienation Program, Guidelines.

ERIC Educational Resources Information Center

Hawaii State Dept. of Education, Honolulu. Office of Instructional Services.

This document presents guidelines developed by the Hawaii State Department of Education's Comprehensive School Alienation Program to consolidate and strengthen the delivery of services to alienated students. It is intended to assist district staff, school administrators, and project personnel in planning and implementing program activities and…

Converting Student Support Services to Online Delivery.

ERIC Educational Resources Information Center

Brigham, David E.

2001-01-01

Uses a systems framework to analyze the creation of student support services for distance education at Regents College: electronic advising, electronic peer network, online course database, online bookstore, virtual library, and alumni services website. Addresses the issues involved in converting distance education programs from print-based and…

Managing the Web-Enhanced Geographic Information Service.

ERIC Educational Resources Information Center

Stephens, Denise

1997-01-01

Examines key management issues involved in delivering geographic information services on the World Wide Web, using the Geographic Information Center (GIC) program at the University of Virginia Library as a reference. Highlights include integrating the Web into services; building collections for Web delivery; and evaluating spatial information…

20 CFR 669.300 - What are the general responsibilities of the NFJP grantees?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF LABOR NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The... a service delivery strategy described in its approved grant plan. These services must reflect the...

Ecosystem-Based Management and the Sustainable Delivery of Marine Ecosystem Services

NASA Astrophysics Data System (ADS)

Fogarty, M.; Schwing, F. B.

2016-12-01

Ecosystem-Based Management can provide an essential framework for the sustainable delivery of a broad spectrum of marine Ecosystem Services (ES) essential to human well being. Key elements of the approach involve the specification of clearly articulated goals for EBM; the development of an accompanying Marine Ecosystem Services Assessment (MESA) designed to evaluate the status of delivery of these services; and strategies for the implementation of management options designed to achieve the stated goals of the program. The specification of goals is the purview of managers. In the United States under the provisions of the National Ocean Policy, Regional Planning Bodies are charged with the responsibility of articulating goals and developing strategies to meet these goals. Government agencies, in concert with the broader scientific community, hold the responsibility for assessing the status of the delivery of ecosystem services in relation to designated objectives and advising on appropriate management strategies. In this presentation, I will illustrate the specification of a MESA for the Northwest U.S Continental Shelf Large Marine Ecosystem (NES LME). The approach focuses on the evaluation of ES indicators and additional metrics related to threats and impacts to the sustainable delivery of these services. Results are combined into an overall index of status of the NES LME.

Occupational lead poisoning: who should conduct surveillance and training?

PubMed

Keogh, J P; Gordon, J

1994-11-01

This commentary challenges the current employer-controlled model for delivering occupational health services. Problems emanating from traditional employer-based medical surveillance and worker education programs for occupational lead poisoning are identified. A new public health model for delivering these services is proposed. This model utilizes a case-based and hazard-based method for bringing workplaces and employers into the program and features direct delivery of surveillance and training services by public health agencies.

How much does it cost to achieve coverage targets for primary healthcare services? A costing model from Aceh, Indonesia.

PubMed

Abdullah, Asnawi; Hort, Krishna; Abidin, Azwar Zaenal; Amin, Fadilah M

2012-01-01

Despite significant investment in improving service infrastructure and training of staff, public primary healthcare services in low-income and middle-income countries tend to perform poorly in reaching coverage targets. One of the factors identified in Aceh, Indonesia was the lack of operational funds for service provision. The objective of this study was to develop a simple and transparent costing tool that enables health planners to calculate the unit costs of providing basic health services to estimate additional budgets required to deliver services in accordance with national targets. The tool was developed using a standard economic approach that linked the input activities to achieving six national priority programs at primary healthcare level: health promotion, sanitation and environment health, maternal and child health and family planning, nutrition, immunization and communicable diseases control, and treatment of common illness. Costing was focused on costs of delivery of the programs that need to be funded by local government budgets. The costing tool consisting of 16 linked Microsoft Excel worksheets was developed and tested in several districts enabled the calculation of the unit costs of delivering of the six national priority programs per coverage target of each program (such as unit costs of delivering of maternal and child health program per pregnant mother). This costing tool can be used by health planners to estimate additional money required to achieve a certain level of coverage of programs, and it can be adjusted for different costs and program delivery parameters in different settings. Copyright © 2012 John Wiley & Sons, Ltd.

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

PubMed Central

Ponnusamy, Vellapandian; Grove, J. Robert

2014-01-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes.

PubMed

Ponnusamy, Vellapandian; Grove, J Robert

2014-09-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.

20 CFR 669.220 - What is the role of the NFJP grantee in the One-Stop delivery system?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the role of the NFJP grantee in the One-Stop delivery system? 669.220 Section 669.220 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the...

Variation in outpatient mental health service utilization under capitation.

PubMed

Chou, Ann F; Wallace, Neal; Bloom, Joan R; Hu, Teh-Wei

2005-03-01

To improve the financing of Colorado's public mental health system, the state designed, implemented, and evaluated a pilot program that consisted of three reimbursement models for the provision of outpatient services. Community mental health centers (CMHCs), the primary providers of comprehensive mental health services to Medicaid recipients in Colorado, had to search for innovative ways to provide cost-effective services. This study assessed outpatient service delivery to Medicaid-eligible consumers under this program. This paper is among the first to study variations in the delivery of specific types of outpatient mental health services under capitated financing systems. This study uses claims data (1994-1997) from Colorado's Medicaid and Mental Health Services Agency. The fee-for-service (FFS) model served as the comparison model. Two capitated models under evaluation are: (i) direct capitation (DC), where the state contracts with a non-profit entity to provide both the services and administers the capitated financing, and (ii) managed behavioral health organization (MBHO), which is a joint venture between a for-profit company who manages the capitated financing and a number of non-profit entities who deliver the services. A sample of severely mentally ill patients who reported at least one inpatient visit was included in the analysis. Types of outpatient services of interest are: day-treatment visits, group therapy, individual therapy, medication monitoring, case management, testing, and all other services. Comparisons were set up to examine differences in service utilization and cost between FFS and each of the two capitated models, using a two-part model across three time periods. Results showed differences in service delivery among reimbursement models over time. Capitated providers had higher initial utilization in most outpatient service categories than their FFS counterparts and as a result of capitation, outpatient services delivered under these providers decreased to converge to the FFS pattern. Findings also suggest substitution between group therapy and individual psychotherapy. Overall, more service integration was observed and less complex service packages were provided post capitation. IMPLICATION FOR HEALTH CARE PROVISION AND POLICIES: Financing models and organizational arrangements have an impact on mental health service delivery. Changes in utilization and costs of specific types of outpatient services reflect the effects of capitation. Understanding the mechanism for these changes may lead to more streamlined service delivery allowing extra funding for expanding the range of cost-effective treatment alternatives. These changes pose implications for improving the financing of public mental health systems, coordination of mental health services with other healthcare and human services, and provision of services through a more efficient financing system.

Perspectives of Therapist's Role in Care Coordination between Medical and Early Intervention Services

ERIC Educational Resources Information Center

Ideishi, Roger I.; O'Neil, Margaret E.; Chiarello, Lisa A.; Nixon-Cave, Kim

2010-01-01

This study explored perspectives of therapist's role in care coordination between early intervention (EI) and medical services, and identified strategies for improving service delivery. Fifty adults participated in one of six focus groups. Participants included parents, pediatricians, and therapists working in hospital and EI programs. Structured…

20 CFR 632.10 - Eligibility requirements for designation as a Native American grantee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Interior, Health and Human Services or Education as the primary service delivery organization for the provision of human resource development services to Indians or Native Americans within the organization's... JTPA and other human resource development programs, including but not limited to those providing for...

20 CFR 632.10 - Eligibility requirements for designation as a Native American grantee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Interior, Health and Human Services or Education as the primary service delivery organization for the provision of human resource development services to Indians or Native Americans within the organization's... JTPA and other human resource development programs, including but not limited to those providing for...

Variety and Service Highlight the 2010 Effective and Innovative Practices Award Winners

ERIC Educational Resources Information Center

Facilities Manager, 2010

2010-01-01

APPA's Effective & Innovative Practices Award continues to highlight the best of the most creative and practical programs and processes that enhance and transform service delivery, lower costs, increase productivity, improve customer service, generate revenue, or otherwise benefit an educational institution. This article features five 2010…

13 CFR 130.350 - Specific program responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Specific program responsibilities. 130.350 Section 130.350 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS... Program policies and procedures to improve the delivery of services by SBDCs to the small business...

13 CFR 130.350 - Specific program responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Specific program responsibilities. 130.350 Section 130.350 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS... Program policies and procedures to improve the delivery of services by SBDCs to the small business...

Drugs and Gender: A Women's Recovery Program.

ERIC Educational Resources Information Center

Levers, Lisa Lopez; Hawes, Anderson R.

1990-01-01

Describes a drug treatment program designed and implemented for women which takes into account gender differences. Claims by paying attention to the actual life worlds and needs of women, the program effectively modified the service delivery system to accommodate these women and facilitate their treatment. (ABL)

A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

PubMed

Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

2018-04-01

Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

Effective and Innovative Practices for Stronger Facilities Management.

ERIC Educational Resources Information Center

Banick, Sarah

2002-01-01

Describes the five winners of the APPA's Effective & Innovative Practices Award. These facilities management programs and processes were recognized for enhancing service delivery, lowering costs, increasing productivity, improving customer service, generating revenue, or otherwise benefiting the educational institution. (EV)

Urban poor program launched.

PubMed

1991-01-01

The government of the Philippines has launched a program to deal with the rapidly growing urban poor population. 60 cities (including Metro Manila) are expected to increase their bloated population by 3.8% over 1990 which would be 27.7 million for 1991. Currently there is an exodus of people from the rural areas and by 2000 half the urban population will be squatters and slum dwellers. Basic services like health and nutrition are not expected to be able to handle this type of volume without a loss in the quality of service. The basic strategy of the new program is to recruit private medical practitioners to fortify the health care delivery and nutrition services. Currently the doctor/urban dweller ration is 1:9000. The program will develop a system to pool the efforts of government and private physicians in servicing the target population. Barangay Escopa has been chosen as the pilot city because it typifies the conditions of a highly populated urban area. The projects has 2 objectives: 1) demonstrate the systematic delivery of health and nutrition services by the private sector through the coordination of the government, 2) reduce mortality and morbidity in the community, especially in the 0-6 age group as well as pregnant women and lactating mothers.

Vouchers for family planning and sexual and reproductive health services: a review of voucher programs involving Marie Stopes International among 11 Asian and African countries.

PubMed

Eva, Gillian; Quinn, Andrew; Ngo, Thoai D

2015-08-01

To evaluate provision of vouchers for family planning and sexual and reproductive health (SRH) services. A review was conducted to assess the effects of 24 voucher programs in Marie Stopes International programs across 11 countries in Asia and Africa between 2005 and the present. The outcome measures were uptake of services; service use among specific subgroups; user satisfaction with service quality; and efficiency of service delivery. Twelve of the 24 programs covered family planning only, whereas the other 12 programs covered family planning and/or SRH. Service uptake increased following implementation, although voucher redemption rates varied by program (44.1%-92.4%). Most programs were successful in reaching subgroups, such as the poor and young (under 25years), although this outcome depended on the targeting approach. Most programs recorded high user satisfaction; however, the evidence regarding efficiency was mixed. Vouchers increased uptake of services and, in some cases, improved service quality and reach to specific groups. Nevertheless, robust evaluation designs are required to measure efficiency. Copyright © 2015. Published by Elsevier Ireland Ltd.

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

PubMed Central

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

2010-01-01

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

Maternal and child health services in India with special focus on perinatal services.

PubMed

Singh, M; Paul, V K

1997-01-01

India has an excellent infrastructural layout for the delivery of MCH services in the community through a network of subcenters, primary health centers, community health centers, district hospitals, state medical college hospitals, and other hospitals in the public and private sectors. However, the health pyramid does not function effectively because of limited resources, communication delays, a lack of commitment on the part of health professionals, and, above all, a lack of managerial skills, supervision, and political will. The allocation of financial resources for the delivery of health care continues to be meager. Nevertheless, in spite of obvious constraints, the country has made laudable progress in reducing post-neonatal mortality in recent years. Indeed, the focus has shifted to the young infants and the perinates. Under the CSSM program, a massive expansion of MCH services has occurred at the sub-district and the district levels. The RCH program, to be launched shortly, aims at effective utilization of these facilities to ensure delivery of integrated services of assured quality through decentralized planning. Simultaneously, as a result of the ongoing economic liberalization, the MCH care in the private sector will also expand rapidly. Indeed, India is on the threshold of an extraordinary improvement in the status of its neonatal-perinatal health.

Assessment of a postdeployment Yellow Ribbon Reintegration Program for National Guard members and supporters.

PubMed

Scherrer, Jeffrey F; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi K

2014-11-01

The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP's delivery of information and assistance during the postdeployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and avenues for help, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed information delivery on education being met (76.8% and 78.2%, respectively) and were least likely to endorse legal information delivery (63.5% and 60%, respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health, while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2 to 4 months after a deployment. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Competent statistical programmer: Need of business process outsourcing industry

PubMed Central

Khan, Imran

2014-01-01

Over the last two decades Business Process Outsourcing (BPO) has evolved as much mature practice. India is looked as preferred destination for pharmaceutical outsourcing over a cost arbitrage. Among the biometrics outsourcing, statistical programming and analysis required very niche skill for service delivery. The demand and supply ratios are imbalance due to high churn out rate and less supply of competent programmer. Industry is moving from task delivery to ownership and accountability. The paradigm shift from an outsourcing to consulting is triggering the need for competent statistical programmer. Programmers should be trained in technical, analytical, problem solving, decision making and soft skill as the expectations from the customer are changing from task delivery to accountability of the project. This paper will highlight the common issue SAS programming service industry is facing and skills the programmers need to develop to cope up with these changes. PMID:24987578

Competent statistical programmer: Need of business process outsourcing industry.

PubMed

Khan, Imran

2014-07-01

Over the last two decades Business Process Outsourcing (BPO) has evolved as much mature practice. India is looked as preferred destination for pharmaceutical outsourcing over a cost arbitrage. Among the biometrics outsourcing, statistical programming and analysis required very niche skill for service delivery. The demand and supply ratios are imbalance due to high churn out rate and less supply of competent programmer. Industry is moving from task delivery to ownership and accountability. The paradigm shift from an outsourcing to consulting is triggering the need for competent statistical programmer. Programmers should be trained in technical, analytical, problem solving, decision making and soft skill as the expectations from the customer are changing from task delivery to accountability of the project. This paper will highlight the common issue SAS programming service industry is facing and skills the programmers need to develop to cope up with these changes.

Integrated Payment and Delivery Models Offer Opportunities and Challenges for Residential Care Facilities

PubMed Central

Grabowski, David C.; Caudry, Daryl J.; Dean, Katie M.; Stevenson, David G.

2016-01-01

Under health care reform, a series of new financing and delivery models are being piloted to integrate health and long-term care services for older adults. To date, these programs have not encompassed residential care facilities, with most programs focusing on long-term care recipients in the community or the nursing home. Our analyses indicate that individuals living in residential care facilities have similarly high rates of chronic illness and Medicare utilization when compared with similar populations in the community and nursing home. These results suggest the residential care facility population could benefit greatly from models that coordinate health and long-term care. However, few providers have invested in integrated delivery models. Several challenges exist toward greater integration including the private payment of residential care facility services and the fact that residential care facilities do not share in any Medicare savings due to improved coordination of care. PMID:26438740

A situation analysis of public health interventions, barriers, and opportunities for improving maternal nutrition in Bihar, India.

PubMed

Noznesky, Elizabeth A; Ramakrishnan, Usha; Martorell, Reynaldo

2012-06-01

Maternal underweight and anemia are highly prevalent in Bihar, especially among adolescent girls aged 15 to 19 years. Although numerous programs and platforms exist for delivering efficacious interventions for improving maternal nutrition, the coverage and quality of these interventions are low. To examine existing interventions for reducing maternal undernutrition in Bihar and identify barriers to and opportunities for expanding their coverage and quality. The research was conducted in New Delhi and Bihar between May and August 2010. Forty-eight key informant interviews were conducted with policy makers, program managers, and service providers at multiple levels. Secondary data were collected from survey reports and program documents. All data were analyzed thematically. Barriers to the delivery and uptake of interventions to improve maternal nutrition include the shortage of essential inputs, low prioritization of maternal undernutrition, sterilization bias within the family planning program, weak management systems, poverty, gender inequality, caste discrimination, and flooding. In order to overcome barriers and improve service delivery, the current government and its partners have introduced structural reforms within the public health system, launched new programs for underserved groups, developed innovative approaches, and experimented with new technologies. Since coming to power, the Government of Bihar has achieved impressive increases in the coverage of prioritized health services, such as institutional deliveries and immunization. This success presents it with an excellent opportunity to further reduce maternal and infant mortality by turning its attention to the serious problem of maternal undernutrition and low birthweight.

10 CFR 13.8 - Service of complaint.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Service of complaint. 13.8 Section 13.8 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.8 Service of complaint. (a) Service of a complaint must be made by certified or registered mail or by delivery in any manner authorized by Rule 4(d) of...

Episode-Based Payment and Direct Employer Purchasing of Healthcare Services: Recent Bundled Payment Innovations and the Geisinger Health System Experience.

PubMed

Slotkin, Jonathan R; Ross, Olivia A; Newman, Eric D; Comrey, Janet L; Watson, Victoria; Lee, Rachel V; Brosious, Megan M; Gerrity, Gloria; Davis, Scott M; Paul, Jacquelyn; Miller, E Lynn; Feinberg, David T; Toms, Steven A

2017-04-01

One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms. The Patient Protection and Affordable Care Act has allowed many care delivery systems to partner with Medicare in episode-based payment programs such as the Bundled Payments for Care Improvement (BPCI) initiative, and in patient-based models such as the Medicare Shared Savings Program. Several employer purchasers of healthcare services are experimenting with innovative payment models to include episode-based bundled rate destination centers of excellence programs and the direct purchasing of accountable care organization services. The Geisinger Health System has over 10 years of experience with episode-based payment bundling coupled with the care delivery reengineering which is integral to its ProvenCare® program. Recent experiences at Geisinger have included participation in BPCI and also partnership with employer-purchasers of healthcare through the Pacific Business Group on Health (representing Walmart, Lowe's, and JetBlue Airways). As the shift towards value-focused care delivery and patient experience progresses forward, bundled payment arrangements and direct purchasing of healthcare will be critical financial drivers in effecting change. Copyright © 2017 by the Congress of Neurological Surgeons.

Integrated Outdoor Education and Adventure Programs.

ERIC Educational Resources Information Center

Schleien, Stuart J.; And Others

This guide presents a comprehensive framework for the development and provision of outdoor education and adventure programs for people of all abilities, including those who significantly challenge the service delivery system. Chapter 1 provides a rationale for the integration of disabled persons into outdoor education and adventure programs, and…

The adherence impact of a program offering specialty pharmacy services to patients using retail pharmacies.

PubMed

Moore, Janice M; Matlin, Olga S; Lotvin, Alan M; Brennan, Troyen A; Falkenrath, Randy; Kymes, Steven; Singh, Surya C; Kyrychenko, Pavlo; Shrank, William H

2016-01-01

A new service model integrates the specialty pharmacy's comprehensive service with the retail pharmacy's patient contact, giving patients options for medication delivery to home, pharmacy, or doctor's office. Evaluate the impact of the new service model on medication adherence. Retrospective cohort study One hundred fifteen CVS retail stores in Philadelphia participated in a pilot from May 2012 to October 2013, and 115 matched CVS retail stores from around the nation served as controls. All eligible patients from the intervention and control stores received specialty medications through CVS retail pharmacies prior to implementation of the new service model. The intervention patients were transitioned from retail pharmacy service to the specialty pharmacy with delivery options. The control patients received standard retail pharmacy services. Proportion of days covered and first fill persistence were tracked for 12 months before and after program implementation. Under the new service model, 228 patients new to therapy in the post period had a 17.5% increase in the rate of obtaining a second fill as compared to matched controls. Patients on therapy in both the pre- and the post-periods had a pre-post increase of 6.6% in average adherence rates and a pre-post increase of 10.8% in optimal adherence rates as compared to 326 matched controls. The study demonstrated significant improvement in both adherence to therapy and first-fill persistence among patients in the new service model integrating specialty pharmacy's comprehensive services with the retail pharmacy's patient contact and medication delivery choices. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys.

PubMed

Kosec, Katrina; Avula, Rasmi; Holtemeyer, Brian; Tyagi, Parul; Hausladen, Stephanie; Menon, Purnima

2015-06-17

In Bihar, India, coverage of essential health and nutrition interventions is low. These interventions are provided by 2 national programs--the Integrated Child Development Services (ICDS) and Health/National Rural Health Mission (NRHM)--through Anganwadi workers (AWWs) and Accredited Social Health Activists (ASHAs), respectively. Little is known, however, about factors that predict effective service delivery by these frontline workers (FLWs) or receipt of services by households. This study examined the predictors of use of 4 services: (1) immunization information and services, (2) food supplements, (3) pregnancy care information, and (4) general nutrition information. Data are from a 2012 cross-sectional survey of 6,002 households in 400 randomly selected villages in 1 district of Bihar state, as well as an integrated survey of 377 AWWs and 382 ASHAs from the same villages. For each of the 4 service delivery outcomes, logistic regression models were specified using a combination of variables hypothesized to be supply- and demand-side drivers of service utilization. About 35% of households reported receiving any of the 4 services. Monetary immunization incentives for AWWs (OR = 1.55, CI = 1.02-2.36) and above-median household head education (OR = 1.39, CI = 1.05-1.82) were statistically significant predictors of household receipt of immunization services. Higher household socioeconomic status was associated with significantly lower odds of receiving food supplements (OR = 0.87, CI = 0.79-0.96). ASHAs receiving incentives for institutional delivery (OR = 1.52, CI = 0.99-2.33) was marginally associated with higher odds of receiving pregnancy care information, and ASHAs who maintained records of pregnant women was significantly associated with households receiving such information (OR = 2.25, CI = 1.07-4.74). AWWs receiving immunization incentives was associated with significantly higher odds of households receiving general nutrition information (OR = 1.92, CI = 1.08-3.41), suggesting a large spillover effect of incentives from product- to information-oriented services. Product-oriented incentives affect delivery of both product- and information-oriented services, although household factors are also important. In India, existing government programs can mitigate supply- and demand-side constraints to receiving essential interventions by optimizing existing incentives for FLWs in national programs, helping FLWs better organize their work, and raising awareness among groups who are less likely to access services. © Kosec et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

PubMed

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

PubMed Central

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem. PMID:29042819

How to Succeed with Academically Underprepared Students: A Catalog of Successful Practices.

ERIC Educational Resources Information Center

Noel, Lee, Ed.; Levitz, Randi, Ed.

Program descriptions, articles, an annotated bibliography, and a survey report on programs and services for students who are underprepared for college work as freshmen are presented. The survey report considers program design and delivery strategies at about 300 colleges, and the program descriptions concern: advising, basic skills instruction and…

Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

PubMed

Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

2017-08-01

We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

Second Life®: A 3D Virtual Immersive Environment for Teacher Preparation Courses in a Distance Education Program

ERIC Educational Resources Information Center

Hartley, Melissa D.; Ludlow, Barbara L.; Duff, Michael C.

2015-01-01

Many colleges and universities rely upon online programs to support distance delivery of personnel preparation programs in special education and related services. These distance education programs enable individuals who live or work in rural communities to access training programs to earn teaching certification and assist rural schools in…

Learning To Hope: A Study of the Adult Education for the Homeless Program.

ERIC Educational Resources Information Center

Drury, Darrel; Koloski, Judy

A comprehensive study of the Adult Education for the Homeless Program (AEH) was conducted using data from the following sources: program files; focus groups conducted with state project administrators; site visits to 9 local programs in 3 states; surveys of 32 state projects, 230 local programs, 588 service delivery sites, and 2,943 program…

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach

PubMed Central

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation. PMID:26689199

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

PubMed

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation.

7 CFR 249.23 - Records and reports.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM (SFMNP) Miscellaneous Provisions § 249..., delivery receipts, equipment purchases and inventory, nutrition education, fair hearings, and civil rights...

7 CFR 249.23 - Records and reports.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM (SFMNP) Miscellaneous Provisions § 249..., delivery receipts, equipment purchases and inventory, nutrition education, fair hearings, and civil rights...

7 CFR 249.23 - Records and reports.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SENIOR FARMERS' MARKET NUTRITION PROGRAM (SFMNP) Miscellaneous Provisions § 249..., delivery receipts, equipment purchases and inventory, nutrition education, fair hearings, and civil rights...

Federal Educational Assistance Programs Available to Service Members: Program Features and Recommendations for Improved Delivery

DTIC Science & Technology

2015-01-01

psychology, this would be referred to as an untreated control group design with pretest and posttest (those who did not use the program with those who...3 Using primarily a qualitative approach, Steele, Salcedo, and Coley, 2011, conducted surveys and on -campus focus groups with Post-9/11 GI Bill...historical information on participants’ and a control group of nonparticipants’ sociodemo- graphic characteristics and service-related characteristics (e.g

A new analytical framework of 'continuum of prevention and care' to maximize HIV case detection and retention in care in Vietnam

PubMed Central

2012-01-01

Background The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Results Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART) with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in mountainous remote areas; and no systematic monitoring of referral services. Conclusions Our COPC analytical framework was instrumental in identifying system-related strengths and constraints that contribute to HIV case detection and retention in care. The national HIV program plans to strengthen provincial programming by re-defining various service linkages and accelerate the transition from project-based approach to integrated service delivery in line with the ‘Treatment 2.0’ initiative. PMID:23272730

A new analytical framework of 'continuum of prevention and care' to maximize HIV case detection and retention in care in Vietnam.

PubMed

Fujita, Masami; Poudel, Krishna C; Do, Thi Nhan; Bui, Duc Duong; Nguyen, Van Kinh; Green, Kimberly; Nguyen, Thi Minh Thu; Kato, Masaya; Jacka, David; Cao, Thi Thanh Thuy; Nguyen, Thanh Long; Jimba, Masamine

2012-12-29

The global initiative 'Treatment 2.0' calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART) with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in mountainous remote areas; and no systematic monitoring of referral services. Our COPC analytical framework was instrumental in identifying system-related strengths and constraints that contribute to HIV case detection and retention in care. The national HIV program plans to strengthen provincial programming by re-defining various service linkages and accelerate the transition from project-based approach to integrated service delivery in line with the 'Treatment 2.0' initiative.

Using Facebook for Health-related Research Study Recruitment and Program Delivery

PubMed Central

Pedersen, Eric R.; Kurz, Jeremy

2015-01-01

Facebook has become an important tool for recruiting research participants and for program delivery. Given the wide use of Facebook, there is much potential for the site to help with recruitment efforts in both physical and behavioral health care arenas; reaching groups typically difficult to recruit and providing outreach to individuals that may not have received services elsewhere. Health studies using Facebook have generally reported success, including cost-effectiveness, recruitment of samples in brief periods of time, and ability to locate participants for follow-up research. Still, the use of Facebook for research and program delivery is a relatively new area that warrants more research attention and guidance around issues like validity of data, representativeness of samples, and protections of human subjects. PMID:26726313

Using Facebook for Health-related Research Study Recruitment and Program Delivery.

PubMed

Pedersen, Eric R; Kurz, Jeremy

2016-05-01

Facebook has become an important tool for recruiting research participants and for program delivery. Given the wide use of Facebook, there is much potential for the site to help with recruitment efforts in both physical and behavioral health care arenas; reaching groups typically difficult to recruit and providing outreach to individuals that may not have received services elsewhere. Health studies using Facebook have generally reported success, including cost-effectiveness, recruitment of samples in brief periods of time, and ability to locate participants for follow-up research. Still, the use of Facebook for research and program delivery is a relatively new area that warrants more research attention and guidance around issues like validity of data, representativeness of samples, and protections of human subjects.

Human and Animal Vaccination Delivery to Remote Nomadic Families, Chad

PubMed Central

Bechir, Mahamat; Ahmed, Mahamat Abdoulaye; Wyss, Kaspar; Randolph, Thomas F.; Zinsstag, Jakob

2007-01-01

Vaccination services for people and livestock often fail to achieve sufficient coverages in Africa’s remote rural settings because of financial, logistic, and service delivery constraints. In Chad from 2000 through 2005, we demonstrated the feasibility of combining vaccination programs for nomadic pastoralists and their livestock. Sharing of transport logistics and equipment between physicians and veterinarians reduced total costs. Joint delivery of human and animal health services is adapted to and highly valued by hard-to-reach pastoralists. In intervention zones, for the first time ≈10% of nomadic children (>1–11 months of age) were fully immunized annually and more children and women were vaccinated per day during joint vaccination rounds than during vaccination of persons only and not their livestock (130 vs. 100, p<0.001). By optimizing use of limited logistical and human resources, public health and veterinary services both become more effective, especially at the district level. PMID:17552089

Quality management in home care: models for today's practice.

PubMed

Verhey, M P

1996-01-01

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

Social work practice with LGBT seniors.

PubMed

Gratwick, Steve; Jihanian, Lila J; Holloway, Ian W; Sanchez, Marisol; Sullivan, Kathleen

2014-01-01

The Los Angeles Gay & Lesbian Center began providing services to LGBT seniors in 2008. Since then, the Center's seniors program has grown to over 3,300 clients. It provides a variety of enrichment and support services with the overarching goal of empowering seniors to successfully age in place. This article outlines the service delivery program of the Center's Seniors Services Department and describes its successes and challenges in meeting the needs of diverse LGBT seniors. It offers future directions for social work practice, policy, and research with LGBT older adults.

Teenagers at Risk: A National Perspective of State Level Services for Adolescents with Chronic Illness or Disability.

ERIC Educational Resources Information Center

Minnesota Univ., Minneapolis. National Center for Youth with Disabilities.

This report presents the findings of a study which examined the service delivery system for adolescents with chronic illness, through a survey of 248 directors of public agencies and programs of the 50 states and the District of Columbia, with a 73 percent response rate. The seven programs surveyed within each state were Maternal and Child Health…

Integrating Community Services for Young Children and Their Families. Policy Briefs, Report 3, 1993.

ERIC Educational Resources Information Center

Kunesh, Linda G.; Farley, Joanne

This policy brief reports on the status of state policies and programs that relate to integrating community services for children and families. Problems with the current service delivery system are discussed, and guidelines for creating a profamily system through effective collaboration are outlined. Information from a questionnaire on early…

Managing Mergers of Human Service Agencies: People, Programs, and Procedures.

ERIC Educational Resources Information Center

Taylor, Joseph; And Others

1992-01-01

Offers detailed guidelines that could be used as standard operating procedures for the merger of voluntary social service agencies. Discusses a survey of 32 agencies that merged during the years 1973 to 1986. Issues related to the roles of organization, staff, and service delivery in such mergers receive particular attention. (Author/BB)

BOCES: A Delivery System for Special Education. Special Education: Innovative Programs

ERIC Educational Resources Information Center

Colella, Henry V.; Foster, Herbert

1974-01-01

New York State's Boards of Cooperative Educational Services (BOCES) now serve approximately 30,000 handicapped children, whose disabilities range from mild to severe. BOCES provide shared services to two or more member school districts that initiate the request when one or the other is unable to provide such services economically or efficiently…

An employee assistance program for caregiver support.

PubMed

Mains, Douglas A; Fairchild, Thomas J; René, Antonio A

2006-01-01

The Comprehensive Caregiver Choices Program provided support for employee caregivers of elderly people for employees at a hospital in Fort Worth, Texas. Key informant interviews and focus groups provided direction for program development and implementation. A full-time MSW and professionals with expertise in gerontology/geriatrics provided education and care coordination services to caregivers. Approximately 4% of the hospital's workforce participated in the program. Attendees evaluated educational sessions and follow-up interviews were conducted with program participants. Caregiver support programs must continue to seek innovative and creative marketing and service delivery methods to reach out and assist working caregivers in need of support.

Maximizing the Use of Electronic Individualized Education Program Software

ERIC Educational Resources Information Center

More, Cori M.; Hart, Juliet E.

2013-01-01

With the growing use of technology in today's schools, electronic IEP programs are being adopted by many school districts around the nation as part of special education service delivery. These programs provide a useful technology that can facilitate compliance with IDEA requirements in IEP development while concurrently lessening teacher paperwork…

Outcome Measures of Health Programs: What and How?

ERIC Educational Resources Information Center

Chen, Martin K.

With the proliferation of new health programs, such as Health Maintenance Organizations (HMO's) and Professional Service Review Organizations (PSRO's), the task of evaluating the impact of such programs on the health delivery systems and on the health of the American people becomes more urgent. Thus far no experimental or quasi-experimental…

A Practical Approach to Rural Drug Abuse Programming.

ERIC Educational Resources Information Center

Rozelle, George R.; And Others

1980-01-01

Reviews characteristics of rural drug abuse and general considerations for rural service delivery. Describes the Prevention Project, a rural drug abuse program in Florida, and explains its development, philosophy, and teaching techniques, including a basic educational module for use with rural youth. Includes recommendations for similar programs.…

What Family Support Specialists Do: Examining Service Delivery

PubMed Central

Wisdom, Jennifer P.; Lewandowski, R. Eric; Pollock, Michele; Acri, Mary; Shorter, Priscilla; Olin, S. Serene; Armusewicz, Kelsey; Horwitz, Sarah; Hoagwood, Kimberly E.

2013-01-01

This study describes services provided by family support specialists (FSS), peer advocates in programs for children with serious psychiatric conditions, to delineate differences between recommended components of FSS services and services actually provided. An analysis of qualitative interview and observational data and quantitative survey data from 63 staff at 21 mental health programs in New York identified that FSS and other staff have generally similar ideas about FSS services, and that these perceptions of activities are generally congruent with what FSS actually did. Implications of findings are discussed in the context of developing competencies and quality indicators for FSS. PMID:24174330

Mental health in the Solomon Islands: developing reforms and partnerships.

PubMed

Ryan, Brigid; Orotaloa, Paul; Araitewa, Stephen; Gaoifa, Daniel; Moreen, John; Kiloe, Edwin; Same, William; Goding, Margaret; Ng, Chee

2015-12-01

The Solomon Islands face significant shortages and geographical imbalances in the distribution of skilled health workers and resources, which severely impact the delivery of mental health services. The government's Integrated Mental Health Service has emphasised the importance of greater community ownership and involvement in community-based mental health care, and of moving from centralised services to increased local and accessible care. From 2012 to 2014, the Solomon Islands Integrated Mental Health service worked with Asia-Australia Mental Health to build workforce capacity and deliver sustainable community mental health programs. Supported by the Australian Aid Program's Public Sector Linkages Program, this project shared resources and fostered links between public sector agencies in Australia, Fiji and the Solomon Islands. Key learning points from the collaboration included the critical need to establish partnerships with community stakeholders, the importance of sustaining a well-functioning mental health team, and optimising the strengths of the local resources in the Solomon Islands. Through this project, national policies, promotion and service delivery were strengthened, through the exchange of experiences and mobilisation of north-south (Australia-Solomon Islands) and south-south (Solomon Islands-other Pacific nations) technical expertise. This project demonstrates the potential for international partnerships to contribute to the development of culturally-appropriate and integrated mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Partners in Collaboration: The Homan Square Project.

ERIC Educational Resources Information Center

Hollinger-Smith, Linda

1998-01-01

Collaboration between a community coalition and a nursing school in Chicago resulted in a primary health care clinic, school-based health centers, family education and counseling programs, and screening services. It provides a unique opportunity to combine service delivery and academic education. (SK)

78 FR 52770 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... Project Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery--NEW... Services (OSELS), Public Health Surveillance and Informatics Program Office (PHSIPO), Informatics Research... Collection Request (Generic ICR): ``Generic Clearance for the Collection of Qualitative Feedback on Agency...

Rural Child Sexual Abuse Prevention and Treatment.

ERIC Educational Resources Information Center

Ray, JoAnn; Murty, Susan A.

1990-01-01

Reviews literature on rural child sexual abuse and treatment. Surveys providers in rural Washington treatment programs. Responses describe agency characteristics, services, delivery problems, and suggested solutions. Reports providers' perceptions of service quality and interagency cooperation. Cites as problems heavy caseloads, lack of staff, and…

Women veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans.

PubMed

Washington, Donna L; Bean-Mayberry, Bevanne; Hamilton, Alison B; Cordasco, Kristina M; Yano, Elizabeth M

2013-07-01

The number of women Veterans (WVs) utilizing the Veterans Health Administration (VA) has doubled over the past decade, heightening the importance of understanding their healthcare delivery preferences and utilization patterns. Other studies have identified healthcare issues and behaviors of WVs in specific military service eras (e.g., Vietnam), but delivery preferences and utilization have not been examined within and across eras on a population basis. To identify healthcare delivery preferences and healthcare use of WVs by military service era to inform program design and patient-centeredness. Cross-sectional 2008-2009 survey of a nationally representative sample of 3,611 WVs, weighted to the population. Healthcare delivery preferences measured as importance of selected healthcare features; types of healthcare services and number of visits used; use of VA or non-VA; all by military service era. Military service era differences were present in types of healthcare used, with World War II and Korea era WVs using more specialty care, and Vietnam era-to-present WVs using more women's health and mental health care. Operations Enduring Freedom, Iraqi Freedom, New Dawn (OEF/OIF/OND) WVs made more healthcare visits than WVs of earlier military eras. The greatest healthcare delivery concerns were location convenience for Vietnam and earlier WVs, and cost for Gulf War 1 and OEF/OIF/OND WVs. Co-located gynecology with general healthcare was also rated important by a sizable proportion of WVs from all military service eras. Our findings point to the importance of ensuring access to specialty services closer to home for WVs, which may require technology-supported care. Younger WVs' higher mental health care use reinforces the need for integration and coordination of primary care, reproductive health and mental health care.

42 CFR 421.112 - Considerations relating to the effective and efficient administration of the program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... as— (i) Program emphasis on the number or type of providers to be served; or (ii) Changes in data... delivery of intermediary services; (7) Duplication in the availability of intermediaries; (8) Conflict of...

Expanding Cervical Cancer Screening and Treatment in Tanzania: Stakeholders’ Perceptions of Structural Influences on Scale-Up

PubMed Central

Giattas, Mary Rose; Sahasrabuddhe, Vikrant V.; Jolly, Pauline E.; Martin, Michelle Y.; Usdan, Stuart Lawrence; Kohler, Connie; Lisovicz, Nedra

2015-01-01

Tanzania has the highest burden of cervical cancer in East Africa. This study aims to identify perceived barriers and facilitators that influence scale-up of regional and population-level cervical cancer screening and treatment programs in Tanzania. Convenience sampling was used to select participants for this qualitative study among 35 key informants. Twenty-eight stakeholders from public-sector health facilities, academia, government, and nongovernmental organizations completed in-depth interviews, and a seven-member municipal health management team participated in a focus group discussion. The investigation identified themes related to the infrastructure of health services for cervical cancer prevention, service delivery, political will, and sociocultural influences on screening and treatment. Decentralizing service delivery, improving access to screening and treatment, increasing the number of trained health workers, and garnering political will were perceived as key facilitators for enhancing and initiating screening and treatment services. In conclusion, participants perceived that system-level structural factors should be addressed to expand regional and population-level service delivery of screening and treatment. Implications for Practice: Tanzanian women have a high burden of cervical cancer. Understanding the perceived structural factors that may influence screening coverage for cervical cancer and availability of treatment may be beneficial for program scale-up. This study showed that multiple factors contribute to the challenge of cervical cancer screening and treatment in Tanzania. In addition, it highlighted systematic developments aimed at expanding services. This study is important because the themes that emerged from the results may help inform programs that plan to improve screening and treatment in Tanzania and potentially in other areas with high burdens of cervical cancer. PMID:25926351

Economic evaluation of the DiAMOND randomized trial: cost and outcomes of 2 decision aids for mode of delivery among women with a previous cesarean section.

PubMed

Hollinghurst, Sandra; Emmett, Clare; Peters, Tim J; Watson, Helen; Fahey, Tom; Murphy, Deirdre J; Montgomery, Alan

2010-01-01

Maternal preferences should be considered in decisions about mode of delivery following a previous cesarean, but risks and benefits are unclear. Decision aids can help decision making, although few studies have assessed costs in conjunction with effectiveness. Economic evaluation of 2 decision aids for women with 1 previous cesarean. Cost-consequences analysis. Data sources were self-reported resource use and outcome and published national unit costs. The target population was women with 1 previous cesarean. The time horizon was 37 weeks' gestation and 6 weeks postnatal. The perspective was health care delivery system. The interventions were usual care, usual care plus an information program, and usual care plus a decision analysis program. The outcome measures were costs to the National Health Service (NHS) in the United Kingdom (UK), score on the Decisional Conflict Scale, and mode of delivery. RESULTS OF MAIN ANALYSIS: Cost of delivery represented 84% of the total cost; mode of delivery was the most important determinant of cost differences across the groups. Mean (SD) total cost per mother and baby: 2033 (677) for usual care, 2069 (738) for information program, and 2019 (741) for decision analysis program. Decision aids reduced decisional conflict. Women using the decision analysis program had fewest cesarean deliveries. Applying a cost premium to emergency cesareans over electives had little effect on group comparisons. Conclusions were unaffected. Disparity in timing of outcomes and costs, data completeness, and quality. Decision aids can reduce decisional conflict in women with a previous cesarean section when deciding on mode of delivery. The information program could be implemented at no extra cost to the NHS. The decision analysis program might reduce the rate of cesarean sections without any increase in costs.

Statewide program to promote institutional delivery in Gujarat, India: who participates and the degree of financial subsidy provided by the Chiranjeevi Yojana program.

PubMed

Sidney, Kristi; Iyer, Veena; Vora, Kranti; Mavalankar, Dileep; De Costa, Ayesha

2016-01-27

The Chiranjeevi Yojana (CY) is a large public-private partnership program in Gujarat, India, under which the state pays private sector obstetricians to provide childbirth services to poor and tribal women. The CY was initiated statewide in 2007 because of the limited ability of the public health sector to provide emergency obstetric care and high out-of-pocket expenditures in the private sector (where most qualified obstetricians work), creating financial access barriers for poor women. Despite a million beneficiaries, there have been few reports studying CY, particularly the proportion of vulnerable women being covered, the expenditures they incur in connection with childbirth, and the level of subsidy provided to beneficiaries by the program. Cross-sectional facility based the survey of participants in three districts of Gujarat in 2012-2013. Women were interviewed to elicit sociodemographic characteristics, out-of-pocket expenditures, and CY program details. Descriptive statistics, chi square, and a multivariable logistic regression were performed. Of the 901 women surveyed in 129 facilities, 150 (16 %) were CY beneficiaries; 336 and 415 delivered in government and private facilities, respectively. Only 36 (24 %) of the 150 CY beneficiaries received a completely cashless delivery. Median out-of-pocket for vaginal/cesarean delivery among CY beneficiaries was $7/$71. The median degree of subsidy for women in CY who delivered vaginally/cesarean was 85/71 % compared to out-of-pocket expenditure of $44/$208 for vaginal/cesarean delivery paid by non-program beneficiaries in the private health sector. CY beneficiaries experienced a substantially subsidized childbirth compared to women who delivered in non-accredited private facilities. However, despite the government's efforts at increasing access to delivery services for poor women in the private sector, uptake was low and very few women experienced a cashless delivery. While the long-term focus remains on strengthening the public sector's ability to provide emergency obstetric care, the CY program is a potential means by which the state can ensure its poor mothers have access to necessary care if uptake is increased.

A Mexico City-Based Immersion Education Program: Training Mental Health Clinicians for Practice with Latino Communities

ERIC Educational Resources Information Center

Platt, Jason James

2012-01-01

This article describes the philosophical foundations and educational methods of a Spanish language and cultural immersion program based in Mexico City, Mexico. The program is designed to assist U.S. graduate students in marriage and family therapy and clinical psychology programs to improve clinical service delivery with Latino clients. Utilizing…

Scaling-up public sector childhood diarrhea management program: Lessons from Indian states of Gujarat, Uttar Pradesh and Bihar.

PubMed

Kumar, Sanjeev; Roy, Rajashree; Dutta, Sucharita

2015-12-01

Diarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling-up zinc and ORS for childhood diarrhea management in the public sector in three Indian states. The project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale-up. 140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2-59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled-up. It is feasible and viable to introduce and scale-up zinc and ORS for childhood diarrhea treatment through public sector. Community-based service delivery, timely and adequate supplies, trained staff and pro-active engagement with government were essential for program success.

Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

PubMed

Arunasalam, Mark; Paulson, Albert; Wallace, William

2003-01-01

Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

76 FR 79193 - Medicare Program; Independence at Home Demonstration Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... physician and nurse practitioner directed home-based primary care teams aimed at improving health outcomes... Demonstration will test a service delivery model that utilizes physician and nurse practitioner directed primary... physicians, nurse practitioners, physician assistants, pharmacists, social workers, and other supporting...

A Prototype Gerontological Information Program.

ERIC Educational Resources Information Center

Brindle, Elizabeth A.; And Others

This paper describes research on the kinds of information needed by individuals in human service delivery and older persons' organizations. The Gerontological Information Program (GRIP) uses an integrated approach to gerontological information: research, systems development, and education. An information needs assessment questionnaire survey of 65…

75 FR 16446 - Office of Elementary and Secondary Education

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... DEPARTMENT OF EDUCATION Office of Elementary and Secondary Education Overview Information; Migrant Education Program (MEP) Consortium Incentive Grants Program; Notice inviting applications for new awards for... entity to improve the delivery of services to migrant children whose education is interrupted. Through...

Project UCARE : Uniform Commuter Assistance Reporting and Evaluation for transportation demand management programs.

DOT National Transportation Integrated Search

2013-09-01

Moving Ahead for Progress in the 21st Century Act (MAP-21) places emphasis upon results and better management of programs for effective and efficient service delivery. With an increased focus on measuring performance, the transportation demand manage...

Health systems and noncommunicable diseases in the Asia-Pacific region: a review of the published literature.

PubMed

Mannava, Priya; Abdullah, Asnawi; James, Chris; Dodd, Rebecca; Annear, Peter Leslie

2015-03-01

Addressing the growing burden of noncommunicable diseases (NCDs) in countries of the Asia-Pacific region requires well-functioning health systems. In low- and middle-income countries (LMICs), however, health systems are generally characterized by inadequate financial and human resources, unsuitable service delivery models, and weak information systems. The aims of this review were to identify (a) health systems interventions being implemented to deliver NCD programs and services and their outcomes and (b) the health systems bottlenecks impeding access to or delivery of these programs and services in LMICs of the Asia-Pacific region. A search of 4 databases for literature published between 1990 and 2010 retrieved 36 relevant studies. For each study, information on basic characteristics, type of health systems bottleneck/intervention, and outcome was extracted, and methodological quality appraised. Health systems interventions and bottlenecks were classified as per the World Health Organization health systems building blocks framework. The review identified interventions and bottlenecks in the building blocks of service delivery, health workforce, financing, health information systems, and medical products, vaccines, and technologies. Studies, however, were heterogeneous in methodologies used, and the overall quality was generally low. There are several gaps in the evidence base around NCDs in the Asia-Pacific region that require further investigation. © 2013 APJPH.

20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

Code of Federal Regulations, 2011 CFR

2011-04-01

... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through...

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Code of Federal Regulations, 2011 CFR

2011-04-01

... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services...

How Changing Views about Collaborative Service Delivery Models for Children and Their Families Affect Preservice Teacher Education Programs: The GIFTTS Project.

ERIC Educational Resources Information Center

Hibbard, Katherine L.

The Guilford Initiative for Training and Treatment Services (GIFTTS) Project is a collaborative effort between the University of North Carolina at Greensboro, Guilford County Schools, the Department of Social Services, Juvenile Courts, the Health Department, and the Mental Health division of the local Mental Health/Development…

76 FR 5755 - Medicare and Medicaid Programs; Patient Notification of Right To Access State Survey Agencies and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... skilled nursing care and related services to residents that require medical or nursing care or... primarily engaged in providing to residents: Skilled nursing care and related services for residents who... provided home health services to 3.2 million patients nationwide in FY 2006. The effective delivery of...

"New Choices" for women with addictions: perceptions of program participants

PubMed Central

Sword, Wendy; Niccols, Alison; Fan, Aimei

2004-01-01

Background Substance use in pregnancy is a major public health problem. It can have profound effects on pregnancy outcomes, and childhood health and development. Additionally, women who use substances have their own health-related issues. Although intervention is important, these women often have difficulty using traditional systems of care. The New Choices program is a centralized, multi-sector approach to service delivery that has attempted to overcome barriers to care by offering one-stop shopping in a supportive environment. As part of an evaluation of this program designed for women who are pregnant and/or parenting young children, interviews were conducted with participants to gain insight into their experiences in New Choices and perceptions of any changes attributed to program involvement. Methods A qualitative, exploratory design was used to guide data collection and analysis. Four women participated in a focus group interview and seven women agreed to individual interviews over the course of the program evaluation (N = 11). A semi-structured interview guide was used to explore women's experiences in New Choices and their perceptions of the program and its impact. The interview data were analyzed using NVivo software and an inductive approach to data analysis. Results The emergent themes captured women's motivations for attending New Choices, benefits of participation, and overall quality of the program. Children were the primary motivating factor for program enrollment. Perceived benefits included decreased substance use, improved maternal health, enhanced opportunity for employment, increased access to other resources, enhanced parenting skills, and improved child behaviour and development. Women highly valued the comprehensive and centralized approach to service delivery that provided a range of informal and formal supports. Conclusions Interview findings endorse the appropriateness and potential efficacy of a collaborative, centralized approach to service provision for women with substance use issues. Although the findings provide insight into an alternative model of service delivery for women with addictions, future research is needed to evaluate the effectiveness of the intervention. Research also is needed to determine which program components or constellation of components contribute to desired outcomes, and to learn more about processes that underlie changes in behaviour. PMID:15086957

Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study.

PubMed

Afework, Mesganaw Fantahun; Admassu, Kesteberhan; Mekonnen, Alemayehu; Hagos, Seifu; Asegid, Meselech; Ahmed, Saifuddin

2014-04-04

Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. The objective of the study is to assess the role of Health Extension Workers in improving women's utilization of antenatal care, delivery at health facility and postnatal care services. A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. The non-adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. In general HEWs visit during pregnancy improved utilization of maternal health services. Health facility delivery is heavily affected by other factors. Meaningful improvement in skilled attendance at birth (health facility delivery) should include addressing other factors on top of visits by HEWs during pregnancy and specific target oriented interventions during visits by HEWs to support skilled attendance at birth.

Geographic information systems (GIS): an emerging method to assess demand and provision for rehabilitation services.

PubMed

Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl

2013-09-01

To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.

Multidimensional Implementation Evaluation of a Residential Treatment Program for Adolescent Substance Abuse

ERIC Educational Resources Information Center

Faw, Leyla; Hogue, Aaron; Liddle, Howard A.

2005-01-01

The authors applied contemporary methods from the evaluation literature to measure implementation in a residential treatment program for adolescent substance abuse. A logic model containing two main components was measured. Program structure (adherence to the intended framework of service delivery) was measured using data from daily activity logs…

Delivery of Hardware for Syracuse University Faculty Loaner Program.

ERIC Educational Resources Information Center

Jares, Terry

This paper describes the Faculty Assistance and Computing Education Services (FACES) loaner program at Syracuse University and the method used by FACES staff to deliver and keep track of hardware, software, and documentation. The roles of the various people involved in the program are briefly discussed, i.e., the administrator, who handles the…

A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa.

PubMed

Koon, Adam D; Goudge, Jane; Norris, Shane A

2013-10-26

The health of adolescents is increasingly seen as an important international priority because the world's one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services. We reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading 'sub-Saharan Africa' to identify English language abstracts of original research articles on generalist and specialist CHWs. A total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services. This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted.

A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa

PubMed Central

2013-01-01

Background The health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services. Methods We reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs. Results A total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services. Conclusions This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted. PMID:24160988

75 FR 70165 - Medicare Program; Request for Information Regarding Accountable Care Organizations and the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

..., phone 1-800-743-3951. I. Background The Affordable Care Act seeks to improve the quality of health care services and to lower health care costs by encouraging providers to create integrated health care delivery... incentives for health care providers to enhance health care quality and lower costs. One important delivery...

SILVAH-OAK: ensuring adoption by engaging users in the full cycle of forest research

Treesearch

Susan L. Stout; Pat Brose; Kurt Gottschalk; Gary Miller; Pete Knopp; Gary Rutherford; Mark Deibler; Gary Frank; Gary Gilmore

2007-01-01

Recent Forest Service Research and Development (FS R&D) logic modeling efforts focused on program delivery stated that an important precondition for effective science delivery was the engagement of users and partners throughout the full research and development cycle. The ongoing partnership among the Pennsylvania Department of Conservation and Natural Resources...

49 CFR 1548.7 - Approval, amendment, annual renewal, and withdrawal of approval of the security program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... behalf of it and other indirect air carriers that co-sign the proposal. (1) Within 30 calendar days after... accomplished by personal delivery, certified mail, or express courier. Documents served on an indirect air... personal delivery; (ii) If served by certified mail, the mailing date shown on the certificate of service...

Web-Based Course Delivery and Administration Using Scheme.

ERIC Educational Resources Information Center

Salustri, Filippo A.

This paper discusses the use at the University of Windsor (Ontario) of a small World Wide Web-based tool for course delivery and administration called HAL (HTML-based Administrative Lackey), written in the Scheme programming language. This tool was developed by the author to provide Web-based services for a large first-year undergraduate course in…

Patient and family psychoeducation: Service development and implementation in a center in Iran.

PubMed

Mirsepassi, Zahra; Tabatabaee, Maryam; Sharifi, Vandad; Mottaghipour, Yasaman

2018-02-01

Family and patient psychoeducation have demonstrated significant improvement in clinical and social outcomes for patients suffering from severe mental disorders and their families. However, these evidence-based practices are not widely implemented at service delivery level and into routine clinical practice, especially in less developed countries. The aim of this article is to report the processes of development and implementation of a psychoeducational service for patients with severe mental illnesses and their families in Iran. The program was developed at Roozbeh Hospital in Tehran, Iran. A group of clinicians worked on the development phase of the program and drafting the manuals. Then, a series of workshops and supervision sessions were held to train group leaders for implementation of the group psychoeducation for patients and families. In the pilot phase, the services were delivered to two groups of patients and families, and then the manual was revised based on the feedback from group leaders and participants. The program consisted of eight 90-minute weekly patient group sessions and 6 weekly multiple family group sessions. Two manuals for patient education (schizophrenia and bipolar disorder) were developed. Several information sheets were developed and distributed during different sessions of family and patient psychoeducation related to the content of each session. Despite providing the hospital clinicians with the information regarding these new services, less than 10% of the admitted patients were referred by their clinicians. Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.

Creativity Marks the 2009 Effective and Innovative Practices Award Winners

ERIC Educational Resources Information Center

Jackson, Charles A.; Lentz, Laurie D.; Plant, Frederick W.; Rowley, Shawna; List, Daniel

2009-01-01

APPA's Effective & Innovative Practices Award continues to highlight an ever-growing list of creative and practical programs and processes that enhance and transform service delivery, lower costs, increase productivity, improve customer service, generate revenue, or otherwise benefit an educational institution. The five 2009 award-winning…

Under One Cover. Maintaining Momentum: Implementing the Least Restrictive Environment.

ERIC Educational Resources Information Center

Hasazi, Susan E., Ed.

The document provides a collection of 33 previously published articles on implementing special education services in the least restrictive environment. Articles are divided into five sections (models for delivery of special education services in the least restrictive environment, training of professionals, individualized education programs,…

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

PubMed Central

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-01-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users. PMID:25276564

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.

PubMed

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users.

Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study

PubMed Central

2013-01-01

Background Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men’s perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Methods Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Results Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even ‘forced’, their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men’s participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Conclusion Although men reported to facilitate their wives’ utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting men, exploring promotion of joint HIV testing and counselling, staff training, and design of couple friendly antenatal and delivery units. PMID:23800139

Global fund financing of tuberculosis services delivery in prisons.

PubMed

Lee, Donna; Lal, S S; Komatsu, Ryuichi; Zumla, Alimuddin; Atun, Rifat

2012-05-15

Despite concerted efforts to scale up tuberculosis control with large amounts of international financing in the last 2 decades, tuberculosis continues to be a social issue affecting the world's most marginalized and disadvantaged communities. This includes prisoners, estimated at about 10 million globally, for whom tuberculosis is a leading cause of mortality and morbidity. The Global Fund to Fight AIDS, Tuberculosis and Malaria has emerged as the single largest international donor for tuberculosis control, including funding support in delivering tuberculosis treatment for the confined population. The Global Fund grants database, with an aggregate approved investment of $21.7 billion in 150 countries by the end of 2010, was reviewed to identify tuberculosis and human immunodeficiency virus/tuberculosis grants and activities that monitored the delivery of tuberculosis treatment and support activities in penitentiary settings. The distribution and trend of number of countries with tuberculosis prison support was mapped by year, geographic region, tuberculosis or multidrug-resistant tuberculosis burden, and prison population rate. We examined the types of grant recipients managing program delivery, their performance, and the nature and range of services provided. Fifty-three of the 105 countries (50%) with Global Fund-supported tuberculosis programs delivered services within prison settings. Thirty-two percent (73 of 228) of tuberculosis grants, representing $558 million of all disbursements of Global Fund tuberculosis support by the end of 2010, included output indicators related to tuberculosis services delivered in prisons. Nearly two-thirds (64%) of these grants were implemented by governments, with the remaining by civil society and other partners. In terms of services, half (36 of 73) of grants provided diagnosis and treatment and an additional 27% provided screening and monitoring of tuberculosis for prisoners. The range of services tracked was limited in scope and scale, with 69% offering only 1 type of service and less than one-fifth offering 2 types of service. This study is a preliminary attempt to examine Global Fund investments in the fight against tuberculosis in prison settings. Tuberculosis services delivered in prisons have increased in the last decade, but systematic information on funding levels and gaps, services provided, and cost-effective delivery models for delivering tuberculosis services in prisons are lacking.

Phased implementation of spaced clinic visits for stable HIV-positive patients in Rwanda to support Treat All.

PubMed

Nsanzimana, Sabin; Remera, Eric; Ribakare, Muhayimpundu; Burns, Tracy; Dludlu, Sibongile; Mills, Edward J; Condo, Jeanine; Bucher, Heiner C; Ford, Nathan

2017-07-21

In 2016, Rwanda implemented "Treat All," requiring the national HIV programme to increase antiretroviral (ART) treatment coverage to all people living with HIV. Approximately half of the 164,262 patients on ART have been on treatment for more than five years, and long-term retention of patients in care is an increasing concern. To address these challenges, the Ministry of Health has introduced a differentiated service delivery approach to reduce the frequency of clinical visits and medication dispensing for eligible patients. This article draws on key policy documents and the views of technical experts involved in policy development to describe the process of implementation of differentiated service delivery in Rwanda. Implementation of differentiated service delivery followed a phased approach to ensure that all steps are clearly defined and agreed by all partners. Key steps included: definition of scope, including defining which patients were eligible for transition to the new model; definition of the key model components; preparation for patient enrolment; considerations for special patient groups; engagement of implementing partners; securing political and financial support; forecasting drug supply; revision, dissemination and implementation of ART guidelines; and monitoring and evaluation. Based on the outcomes of the evaluation of the new service delivery model, the Ministry of Health will review and strategically reduce costs to the national HIV program and to the patient by exploring and implementing adjustments to the service delivery model.

20 CFR 617.23 - Selection of training methods and programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... establish linkages with other public and private agencies, Workforce Investment Boards (WIBs), employers, and Workforce Investment Act (WIA) service delivery area (SDA) grant recipients, as appropriate, which return adversely affected workers to employment as soon as possible. (b) Firm-specific retraining program...

Reading, Pa.: Programming for the Future.

ERIC Educational Resources Information Center

Burns, Red; Elton, Lynne

1978-01-01

Describes the community takeover of the Berks Community Television, an experiment in interactive cable television for delivery of social services to senior citizens in Reading (Pennsylvania). Programing and production involve the community at locations such as neighborhood centers, City Hall, County Court House, and other sites. (JMF)

Small Business Training Models for Community Growth.

ERIC Educational Resources Information Center

Jellison, Holly M., Ed.

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

Developing and integrating a practice model for health finance reform into wound healing programs: an examination of the triple aim approach.

PubMed

Flattau, Anna; Thompson, Maureen; Meara, Anne

2013-10-01

Throughout the United States, government and private payers are exploring new payment models such as accountable care organizations and shared savings agreements. These models are widely based on the construct of the Triple Aim, a set of three principles for health services reform: improving population-based outcomes, improving patient care experiences, and reducing costs through better delivery systems. Wound programs may adapt to the new health financing environment by incorporating initiatives known to promote the Triple Aim, such as diabetes amputation reduction and pressure ulcer prevention programs, and by rethinking how health services can best be delivered to meet these new criteria. The existing literature supports that programmatic approaches can improve care, quality, and cost, especially in the field of diabetic foot ulcers. Wound healing programs have opportunities to develop new business plan models that provide quality, cost-efficient care to their patient population and to be leaders in the development of new types of partnerships with payers and health delivery organizations.

Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

PubMed

Ayoub, C; Jacewitz, M M

1982-01-01

The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

Advancing Care Within an Adult Mental Health Day Hospital: Program Re-Design and Evaluation.

PubMed

Taube-Schiff, Marlene; Mehak, Adrienne; Marangos, Sandy; Kalim, Anastasia; Ungar, Thomas

2017-11-13

Day hospital mental health programs provide alternate care to individuals of high acuity that do not require an inpatient psychiatric stay. Ensuring provision of best practice within these programs is essential for patient stabilization and recovery. However, there is scant literature to review when creating such a program. This paper provides an overview of the steps an acute care hospital took when designing and implementing new programming within a day hospital program. Qualitative data was collected following initial program rollout. This data helped to inform the ongoing modification of groups offered, group scheduling and content, as well as ensuring patient satisfaction and adequate skill delivery during the rollout period and beyond. The goal of this paper is to inform health service delivery for other programs when attempting to build or re-design a day hospital program.

Building community resilience through mental health infrastructure and training in post-Katrina New Orleans.

PubMed

Springgate, Benjamin F; Wennerstrom, Ashley; Meyers, Diana; Allen, Charles E; Vannoy, Steven D; Bentham, Wayne; Wells, Kenneth B

2011-01-01

To describe a disaster recovery model focused on developing mental health services and capacity-building within a disparities-focused, community-academic participatory partnership framework. Community-based participatory, partnered training and services delivery intervention in a post-disaster setting. Post-Katrina Greater New Orleans community. More than 400 community providers from more than 70 health and social services agencies participated in the trainings. Partnered development of a training and services delivery program involving physicians, therapists, community health workers, and other clinical and non-clinical personnel to improve access and quality of care for mental health services in a post-disaster setting. Services delivery (outreach, education, screening, referral, direct treatment); training delivery; satisfaction and feedback related to training; partnered development of training products. Clinical services in the form of outreach, education, screening, referral and treatment were provided in excess of 110,000 service units. More than 400 trainees participated in training, and provided feedback that led to evolution of training curricula and training products, to meet evolving community needs over time. Participant satisfaction with training generally scored very highly. This paper describes a participatory, health-focused model of community recovery that began with addressing emerging, unmet mental health needs using a disparities-conscious partnership framework as one of the principle mechanisms for intervention. Population mental health needs were addressed by investment in infrastructure and services capacity among small and medium sized non-profit organizations working in disaster-impacted, low resource settings.

Predictors of Essential Health and Nutrition Service Delivery in Bihar, India: Results From Household and Frontline Worker Surveys

PubMed Central

Kosec, Katrina; Avula, Rasmi; Holtemeyer, Brian; Tyagi, Parul; Hausladen, Stephanie; Menon, Purnima

2015-01-01

Background: In Bihar, India, coverage of essential health and nutrition interventions is low. These interventions are provided by 2 national programs—the Integrated Child Development Services (ICDS) and Health/National Rural Health Mission (NRHM)—through Anganwadi workers (AWWs) and Accredited Social Health Activists (ASHAs), respectively. Little is known, however, about factors that predict effective service delivery by these frontline workers (FLWs) or receipt of services by households. This study examined the predictors of use of 4 services: (1) immunization information and services, (2) food supplements, (3) pregnancy care information, and (4) general nutrition information. Methods: Data are from a 2012 cross-sectional survey of 6,002 households in 400 randomly selected villages in 1 district of Bihar state, as well as an integrated survey of 377 AWWs and 382 ASHAs from the same villages. For each of the 4 service delivery outcomes, logistic regression models were specified using a combination of variables hypothesized to be supply- and demand-side drivers of service utilization. Results: About 35% of households reported receiving any of the 4 services. Monetary immunization incentives for AWWs (OR = 1.55, CI = 1.02–2.36) and above-median household head education (OR = 1.39, CI = 1.05–1.82) were statistically significant predictors of household receipt of immunization services. Higher household socioeconomic status was associated with significantly lower odds of receiving food supplements (OR = 0.87, CI = 0.79–0.96). ASHAs receiving incentives for institutional delivery (OR = 1.52, CI = 0.99–2.33) was marginally associated with higher odds of receiving pregnancy care information, and ASHAs who maintained records of pregnant women was significantly associated with households receiving such information (OR = 2.25, CI = 1.07–4.74). AWWs receiving immunization incentives was associated with significantly higher odds of households receiving general nutrition information (OR = 1.92, CI = 1.08–3.41), suggesting a large spillover effect of incentives from product- to information-oriented services. Conclusion: Product-oriented incentives affect delivery of both product- and information-oriented services, although household factors are also important. In India, existing government programs can mitigate supply- and demand-side constraints to receiving essential interventions by optimizing existing incentives for FLWs in national programs, helping FLWs better organize their work, and raising awareness among groups who are less likely to access services. PMID:26085022

The Use of Market Analysis in Determining Resource Allocations for the Exceptional Family Member Program in USAREUR Landstuhl Army Regional Medical Center, Landsthul, Germany

DTIC Science & Technology

1984-08-01

tests, interviews, and behavioral evaluations. (5) Planning and managing a program of psychological services, including psychological counseling for...Establish capability to provide health related services at realistic levels at OCONUS locations consistent with prevalence rates of manageable ...Health Care Delivery in the United States, New Yori: Springer Publishing Ccmpany, 1981. Kotler , Philip. varketing NLaagement, Ne Jersey: Prentice-Hall

76 FR 30751 - Bureau of Political-Military Affairs: Directorate of Defense Trade Controls; Notifications to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-26

... transmitting, herewith, certification of a proposed manufacturing license agreement for the manufacture of... services to support the design, manufacture and delivery of the Es'Hail Satellite Program. The United... defense articles, including technical data, and defense services to support the design, manufacture...

Evaluation of a Multicomponent Online Communication Professional Development Program for Early Interventionists

ERIC Educational Resources Information Center

Brown, Jennifer A.; Woods, Juliann J.

2012-01-01

Collaborative early intervention (EI) service delivery is enhanced by professional development focused on knowledge and skills in the content and process of delivering services. This article describes a multicomponent online professional development course designed to build infant toddler specialists' capacity to support children with…

Family Fun Nights: Collaborative Parent Education Accessible for Diverse Learning Abilities

ERIC Educational Resources Information Center

Knowles, Christen; Harris, Anne; Van Norman, Renee

2017-01-01

Quality early childhood education programs have a responsibility to provide enriched educational services to preschool students paired with parent support, education, and outreach. Pearl Buck Preschool, a non-profit organization devoted to the delivery of preschool services for children of parents with intellectual disabilities or learning…

42 CFR 400.203 - Definitions specific to Medicaid.

Code of Federal Regulations, 2011 CFR

2011-10-01

... program, any individual or entity that is engaged in the delivery of health care services and is legally... 42 Public Health 2 2011-10-01 2011-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 400.203 - Definitions specific to Medicaid.

Code of Federal Regulations, 2012 CFR

2012-10-01

... program, any individual or entity that is engaged in the delivery of health care services and is legally... 42 Public Health 2 2012-10-01 2012-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 400.203 - Definitions specific to Medicaid.

Code of Federal Regulations, 2010 CFR

2010-10-01

... program, any individual or entity that is engaged in the delivery of health care services and is legally... 42 Public Health 2 2010-10-01 2010-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 400.203 - Definitions specific to Medicaid.

Code of Federal Regulations, 2014 CFR

2014-10-01

... program, any individual or entity that is engaged in the delivery of health care services and is legally... 42 Public Health 2 2014-10-01 2014-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 400.203 - Definitions specific to Medicaid.

Code of Federal Regulations, 2013 CFR

2013-10-01

... program, any individual or entity that is engaged in the delivery of health care services and is legally... 42 Public Health 2 2013-10-01 2013-10-01 false Definitions specific to Medicaid. 400.203 Section 400.203 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

Making Schools Work

ERIC Educational Resources Information Center

Bruns, Barbara; Filmer, Deon; Patrinos, Harry Anthony

2011-01-01

This book is about the threats to education quality in the developing world that cannot be explained by lack of resources. It reviews the observed phenomenon of service delivery failures in public education: cases where programs and policies increase the inputs to education but do not produce effective services where it counts--in schools and…

78 FR 22253 - Agency Information Collection Activities; Comment Request; Study of the Delivery of Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... DEPARTMENT OF EDUCATION [Docket No.: ED-2013-ICCD-0049] Agency Information Collection Activities... Program AGENCY: Office of Special Education and Rehabilitative Services (OSERS), Department of Education.... Department of Education, 400 Maryland Avenue SW., LBJ, Room 2E105, Washington, DC 20202-4537. FOR FURTHER...

Gerontological Information Systems and Services. Research Study No. 5.

ERIC Educational Resources Information Center

Dosa, Marta L.; And Others

This publication contains three papers concerning the role of information systems in the field of social gerontology. The first, A Prototype Gerontological Information Program, describes research carried out at Syracuse University on the kinds of information needed by individuals in human service delivery and older persons' organizations, and…

42 CFR § 512.725 - Data sharing for FFS-CR participants.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL CR Incentive Payment Model for EPM and Medicare Fee-for-Service Participants Provisions for Ffs-Cr Participants § 512... quality. (3) Enhance efficiencies in the delivery of care. (4) Otherwise achieve the goals of the model...

77 FR 76044 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... delivery of services for women who have limited access to health care and elevated risk factors for cardiovascular disease (CVD). The program focuses on reducing CVD risk factors and provides screening services for select risk factors such as elevated blood cholesterol, hypertension and abnormal blood glucose...

Practical Innovations Mark the 2011 Effective & Innovative Practices Award Winners

ERIC Educational Resources Information Center

Facilities Manager, 2011

2011-01-01

APPA's Effective & Innovative Practices Award continues to highlight the best of the most creative and practical programs and processes that enhance and transform service delivery, lower costs, increase productivity, improve customer service, generate revenue, or otherwise benefit an educational institution. This article features five 2011…

Audit Culture: Unintended Consequences of Accountability Practices in Evidence-Based Programs

ERIC Educational Resources Information Center

Owczarzak, Jill; Broaddus, Michelle; Pinkerton, Steven

2016-01-01

Evaluation has become expected within the nonprofit sector, including HIV prevention service delivery through community-based organizations (CBOs). While staff and directors at CBOs may acknowledge the potential contribution of evaluation data to the improvement of agency services, the results of evaluation are often used to demonstrate fiscal…

The ALL-OUT Library; A Design for Computer-Powered, Multidimensional Services.

ERIC Educational Resources Information Center

Sleeth, Jim; LaRue, James

1983-01-01

Preliminary description of design of electronic library and home information delivery system highlights potentials of personal computer interface program (applying for service, assuring that users are valid, checking for measures, searching, locating titles) and incorporation of concepts used in other information systems (security checks,…

Effectively Addressing Mental Health Issues in Permanency-Focused Child Welfare Practice

ERIC Educational Resources Information Center

Ornelas, Laura A.; Silverstein, Deborah N.; Tan, Sherylle

2007-01-01

Children and families built by adoption or relative caregiving have specialized needs. This paper proposes a rubric for the central elements of permanency-focused mental health services in child welfare practice. Kinship Center provides an innovative mental health service delivery system, weaving foster and adoptive placement programs, adoption…

Evaluating complex health financing interventions: using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi.

PubMed

McMahon, Shannon A; Brenner, Stephan; Lohmann, Julia; Makwero, Christopher; Torbica, Aleksandra; Mathanga, Don P; Muula, Adamson S; De Allegri, Manuela

2016-08-19

Gaps remain in understanding how performance-based incentive (PBI) programs affect quality of care and service quantity, whether programs are cost effective and how programs could be tailored to meet client and provider needs while remaining operationally viable. In 2014, Malawi's Ministry of Health launched the Service Delivery Integration-PBI (SSDI-PBI) program. The program is unique in that no portion of performance bonuses are paid to individual health workers, and it shifts responsibility for infrastructure and equipment procurement from facility staff to implementing partners. This protocol outlines an approach that analyzes processes and outcomes, considers expected and unexpected consequences of the program and frames the program's outputs relative to its costs. Findings from this evaluation will inform the intended future scale-up of PBI in Malawi. This study employs a prospective controlled before-and-after triangulation design to assess effects of the PBI program by analyzing quantitative and qualitative data from intervention and control facilities. Guided by a theoretical framework, the evaluation consists of four main components: service provision, health worker motivation, implementation processes and costing. Quality and access outcomes are assessed along four dimensions: (1) structural elements (related to equipment, drugs, staff); (2) process elements (providers' compliance with standards); (3) outputs (service utilization); (4) experiential elements (experiences of service delivery). The costing component includes costs related to start-up, ongoing management, and the cost of incentives themselves. The cost analysis considers costs incurred within the Ministry of Health, funders, and the implementing agency. The evaluation relies on primary data (including interviews and surveys) and secondary data (including costing and health management information system data). Through the lens of a PBI program, we illustrate how complex interventions can be evaluated via not only primary, mixed-methods data collection, but also through a wealth of secondary data from program implementers (including monitoring, evaluation and financial data), and the health system (including service utilization and service readiness data). We also highlight the importance of crafting a theory and using theory to inform the nature of data collected. Finally, we highlight the need to be responsive to stakeholders in order to enhance a study's relevance.

Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning.

The Children's Services Delivery System in California: Preliminary Report--Phase I.

ERIC Educational Resources Information Center

Commission on California State Government Organization and Economy, Sacramento.

Concerned because California now annually administers an estimated $5.9 billion in funding for children's services programs, the Little Hoover Commission initiated a study on the state's provision for children's services. This report, on Phase I of the study, identifies the extent of the problem in 23 findings and provides a plan of action in 15…

The Development and Evolution of an Introductory Statistics Course for In-Service Middle-Level Mathematics Teachers

ERIC Educational Resources Information Center

Schmind, Kendra K.; Blankenship, Erin E.; Kerby. April T.; Green, Jennifer L.; Smith, Wendy M.

2014-01-01

The statistical preparation of in-service teachers, particularly middle school teachers, has been an area of concern for several years. This paper discusses the creation and delivery of an introductory statistics course as part of a master's degree program for in-service mathematics teachers. The initial course development took place before the…

Mental Retardation: Prevention Strategies That Work.

ERIC Educational Resources Information Center

President's Committee on Mental Retardation, Washington, DC.

The report by the President's Committee on Mental Retardation reviews the current state of knowledge in the area of biological and environmental prevention of mental retardation and describes programs on the frontiers of research or service delivery. Section I examines programs that are effectively preventing mental retardation through biomedical…

Integrated multimedia information system on interactive CATV network

NASA Astrophysics Data System (ADS)

Lee, Meng-Huang; Chang, Shin-Hung

1998-10-01

In the current CATV system architectures, they provide one- way delivery of a common menu of entertainment to all the homes through the cable network. Through the technologies evolution, the interactive services (or two-way services) can be provided in the cable TV systems. They can supply customers with individualized programming and support real- time two-way communications. With a view to the service type changed from the one-way delivery systems to the two-way interactive systems, `on demand services' is a distinct feature of multimedia systems. In this paper, we present our work of building up an integrated multimedia system on interactive CATV network in Shih Chien University. Besides providing the traditional analog TV programming from the cable operator, we filter some channels to reserve them as our campus information channels. In addition to the analog broadcasting channel, the system also provides the interactive digital multimedia services, e.g. Video-On- Demand (VOD), Virtual Reality, BBS, World-Wide-Web, and Internet Radio Station. These two kinds of services are integrated in a CATV network by the separation of frequency allocation for the analog broadcasting service and the digital interactive services. Our ongoing work is to port our previous work of building up a VOD system conformed to DAVIC standard (for inter-operability concern) on Ethernet network into the current system.

Efficiency in Vocational Rehabilitation Program Service Delivery: The Impact of Socioeconomic Context

ERIC Educational Resources Information Center

Gere, Bryan O.; Burnett, Royce D.; Flowers, Carl R.; Akaaboune, Ouadie

2017-01-01

Background: State-federal (VR) program efficiency is the focus of empirical research because of increases in the magnitude and types of program requests, possibly funding cuts and class for models to more appropriately measure and evaluate performance. Objective: The purpose of this study was to examine the impact socioeconomic diversity has on…

From Blue to Green: The Development and Implementation of a Therapeutic Horticulture Program for Residents of a Battered Women's Shelter.

PubMed

Renzetti, Claire M; Follingstad, Diane R

2015-01-01

The delivery of therapeutic services to clients is influenced by service providers' understanding of the "fit" of a specific program with their service mandate as well as their perceptions of the potential benefits of the program. This article discusses the development and implementation of a therapeutic horticulture (TH) program at a battered women's shelter that serves 17 counties in Central Kentucky. Through semistructured interviews, we gauge the shelter staff's perceptions of the relationship of the TH program to the shelter's overall mission; their sense of the program's benefits for residents, for the shelter as a community organization, and for themselves; and their concerns about the TH program. We consider how these findings may impact future programming at the shelter, and we discuss plans for further evaluation of the TH program in terms of its impact on shelter residents' long-term outcomes.

20 CFR 663.100 - What is the role of the adult and dislocated worker programs in the One-Stop delivery system?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What is the role of the adult and dislocated... AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through...

20 CFR 663.100 - What is the role of the adult and dislocated worker programs in the One-Stop delivery system?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What is the role of the adult and dislocated... AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

20 CFR 663.100 - What is the role of the adult and dislocated worker programs in the One-Stop delivery system?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the role of the adult and dislocated... AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through the One-Stop...

20 CFR 663.100 - What is the role of the adult and dislocated worker programs in the One-Stop delivery system?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What is the role of the adult and dislocated... AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through...

20 CFR 663.100 - What is the role of the adult and dislocated worker programs in the One-Stop delivery system?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What is the role of the adult and dislocated... AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services Through...

“If Only Someone Had Told Me…”: Lessons From Rural Providers

PubMed Central

Chipp, Cody; Dewane, Sarah; Brems, Christiane; Johnson, Mark E.; Warner, Teddy D.; Roberts, Laura W.

2010-01-01

Purpose Health care providers face challenges in rural service delivery due to the unique circumstances of rural living. The intersection of rural living and health care challenges can create barriers to care that providers may not be trained to navigate, resulting in burnout and high turnover. Through the exploration of experienced rural providers’ knowledge and lessons learned, this study sought to inform future practitioners, educators, and policy makers in avenues through which to enhance training, recruiting, and maintaining a rural workforce across multiple health care domains. Methods Using a qualitative study design, 18 focus groups were conducted, with a total of 127 health care providers from Alaska and New Mexico. Transcribed responses from the question, “What are the 3 things you wish someone would have told you about delivering health care in rural areas?” were thematically coded. Findings Emergent themes coalesced into 3 overarching themes addressing practice-related factors surrounding the challenges, adaptations, and rewards of being a rural practitioner. Conclusion Based on the themes, a series of recommendations are offered to future rural practitioners related to community engagement, service delivery, and burnout prevention. The recommendations offered may help practitioners enter communities more respectfully and competently. They can also be used by training programs and communities to develop supportive programs for new practitioners, enabling them to retain their services and help practitioners integrate into the community. Moving toward an integrative paradigm of health care delivery wherein practitioners and communities collaborate in service delivery will be the key to enhancing rural health care and reducing disparities. PMID:21204979

Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review.

PubMed

Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

2009-11-30

Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials. A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery) were analyzed. Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery. Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%-80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.

Institutional capacity to provide psychosocial oncology support services: A report from the Association of Oncology Social Work.

PubMed

Zebrack, Brad; Kayser, Karen; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Nelson, Krista; Fineberg, Iris C

2016-06-15

This study reports cancer-treating institutions' capacity to deliver comprehensive psychosocial support services. Oncology care providers at 60 cancer-treating institutions completed surveys assessing the capacity of their institutions to provide psychosocial care. Capacity was assessed with the Cancer Psychosocial Care Matrix (CPCM) from the National Cancer Institute (NCI). Scores represented individuals' perceptions of their cancer program's performance with respect to 10 fundamental elements of psychosocial care. Among 2134 respondents, 62% reported a mid-level capacity for ≥5 of 10 CPCM items. In comparison with other types of cancer programs (eg, NCI-designated, academic, or comprehensive centers), providers at community cancer programs reported a significantly greater capacity with respect to patient-provider communication, psychosocial needs assessment, and continuity in the delivery of psychosocial care over time. Nurses and primary medical providers reported a significantly lower capacity for linking patients and families with needed psychosocial services within their respective cancer programs. They also reported a significantly higher capacity for conducting follow-up, re-evaluations, and adjustments of psychosocial treatment plans. Cancer programs are performing moderately well in terms of communicating to patients the importance of psychosocial care, identifying patient psychosocial needs, and referring patients and families to psychosocial services. They are doing less well with respect to the provision of that care over time. Findings suggest that gaps in psychosocial service capacity are a function of patient, provider, and system characteristics. These results may be useful in formulating strategies to enhance psychosocial care delivery. Cancer 2016;122:1937-45. © 2016 American Cancer Society. © 2016 American Cancer Society.

Needs and Preferences for Receiving Mental Health Information in an African American Focus Group Sample

PubMed Central

Mishra, Shiraz I.; Lucksted, Alicia; Gioia, Deborah; Barnet, Beth; Baquet, Claudia R.

2013-01-01

The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. We conducted four focus groups (n=42) among African American adults currently unconnected with the mental health system. Participants expressed fear of stigma and perceptions of racism as major barriers to seeking information and/or services and discussed some normalizing strategies to address these barriers. African Americans harbor cultural and traditional beliefs regarding mental illness which could also act as barriers. Findings have implications for imparting acceptable and culturally-sensitive mental health education and service delivery programs in community settings. PMID:18633704

Using Technology to Deliver Mental Health Services to Children and Youth: A Scoping Review

PubMed Central

Boydell, Katherine M.; Hodgins, Michael; Pignatiello, Antonio; Teshima, John; Edwards, Helen; Willis, David

2014-01-01

Objective: To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. Method: A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Results: Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. Conclusion: The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity. PMID:24872824

Using technology to deliver mental health services to children and youth: a scoping review.

PubMed

Boydell, Katherine M; Hodgins, Michael; Pignatiello, Antonio; Teshima, John; Edwards, Helen; Willis, David

2014-05-01

To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of findings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity.

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

The Ethical Imperative to Move to a Seven-Day Care Model.

PubMed

Bell, Anthony; McDonald, Fiona; Hobson, Tania

2016-06-01

Whilst the nature of human illness is not determined by time of day or day of week, we currently structure health service delivery around a five-day delivery model. At least one country is endeavouring to develop a systems-based approach to planning a transition from five- to seven-day healthcare delivery models, and some services are independently instituting program reorganization to achieve these ends as research, amongst other things, highlights increased mortality and morbidity for weekend and after-hours admissions to hospitals. In this article, we argue that this issue does not merely raise instrumental concerns but also opens up a normative ethical dimension, recognizing that clinical ethical dilemmas are impacted on and created by systems of care. Using health policy ethics, we critically examine whether our health services, as currently structured, are at odds with ethical obligations for patient care and broader collective goals associated with the provision of publicly funded health services. We conclude by arguing that a critical health policy ethics perspective applying relevant ethical values and principles needs to be included when considering whether and how to transition from five-day to seven-day models for health delivery.

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea.

PubMed

Tynan, Anna; Hill, Peter S; Kelly, Angela; Kupul, Martha; Aeno, Herick; Naketrumb, Richard; Siba, Peter; Kaldor, John; Vallely, Andrew

2013-08-13

The success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described. A multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software. A number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success. Difficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico-legal requirements, compared to existing socio-cultural interests. Community participatory approaches offer important opportunities to explore and design culturally safe, specific and accessible programs.

The Alberta Hereditary Diseases Program: a regional model for delivery of genetic services.

PubMed Central

Lowry, R B; Bowen, P

1990-01-01

Genetic counselling and related services are generally provided at major university medical centres because they are very specialized. The need for rurally based genetic services prompted the inclusion of an outreached program in the Alberta Hereditary Diseases Program (AHDP), which was established in 1979; the AHDP was designed to provide services to the entire province through two regional centres and seven outreach clinics. There is a community health nurse in almost every health unit whose duties are either totally or partially devoted to the AHDP; thus, genetic help and information are as close as a rural health unit. The AHDP is designed to provide complete clinical (diagnostic, counselling and some management) services and laboratory (cytogenetic, biochemical and molecular) services for genetic disorders. In addition, the program emphasizes education and publishes a quarterly bulletin, which is sent free of charge to all physicians, hospitals, public health units, social service units, major radio and television stations, newspapers and public libraries and to selected individuals and groups in Alberta. PMID:2302614

A mixed-method evaluation of the feasibility and acceptability of a telehealth-based parent-mediated intervention for children with autism spectrum disorder.

PubMed

Pickard, Katherine E; Wainer, Allison L; Bailey, Kathryn M; Ingersoll, Brooke R

2016-10-01

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents' perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents' experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child's social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder. © The Author(s) 2016.

Programming for the Emotionally Handicapped: Administrative Considerations. A Document for Planning.

ERIC Educational Resources Information Center

Coordinating Office for Regional Resource Centers, Lexington, KY.

Presented are 10 papers given at a conference on the design and implementation of comprehensive educational programs and the delivery of related services to emotionally handicapped children. Entries include the following titles and authors: "Seriously Emotionally Disturbed Children" (J. Spence); "The Rutland Center--Developmental Therapy Model: A…

78 FR 8535 - Medicare Program: Comprehensive End-Stage Renal Disease Care Model Announcement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... develop and test innovative health care payment and service delivery models that show promise of reducing program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid, and... disease (ESRD). This population has complex health care needs, typically with comorbid conditions and...

Exemplary Youth Employment Programs Survey Report.

ERIC Educational Resources Information Center

Geldof, Dick J.; And Others

Service Delivery Areas (SDAs) and Private Industry Councils (PICs) were surveyed concerning their implementation of Exemplary Youth Employment Programs described in Section 205 of the Job Training Partnership Act. Surveys were mailed to over 500 agencies. Of the 219 responding agencies, 77 percent were operating at least one Exemplary Youth…

Adapting Job Analysis Methodology to Improve Evaluation Practice

ERIC Educational Resources Information Center

Jenkins, Susan M.; Curtin, Patrick

2006-01-01

This article describes how job analysis, a method commonly used in personnel research and organizational psychology, provides a systematic method for documenting program staffing and service delivery that can improve evaluators' knowledge about program operations. Job analysis data can be used to increase evaluators' insight into how staffs…

Integrated Adult Education Data System. Policy Option Paper on Strategic Recommendation 8. First Edition.

ERIC Educational Resources Information Center

Porter, Dennis

This document addresses the recommendation contained in the 1989 California Strategic Plan for Adult Education for an integrated adult education data system. The recommendation proposes collecting and organizing community adult education information into groups of data on: program services, program delivery, learner characteristics, and learning…

7 CFR 210.4 - Cash and donated food assistance to States.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., delivery, and storage of donated foods. The school food authority may have all or part of these cash... of July 1 through June 30 multiplied by the total number of lunches served during the school year... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NATIONAL SCHOOL LUNCH PROGRAM Reimbursement...

Career Development and Social Inclusion at St Patrick's College: A Case Study

ERIC Educational Resources Information Center

Hughes, Cathy

2010-01-01

Consistent with the Commonwealth government's social inclusion agenda, the mission statement of St Patrick's College advocates the development and delivery of career development services and programs that promote social justice and social inclusion. This case study describes the evolving career development program at St Patrick's College, which…

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

Evaluating Infrastructure Development in Complex Home Visiting Systems

ERIC Educational Resources Information Center

Hargreaves, Margaret; Cole, Russell; Coffee-Borden, Brandon; Paulsell, Diane; Boller, Kimberly

2013-01-01

In recent years, increased focus on the effectiveness and accountability of prevention and intervention programs has led to greater government funding for the implementation and spread of evidence-based health and human service delivery models. In particular, attention has been paid to programs that require significant infrastructure investment…

Outreach and Program Evaluation: Some Measurement Issues.

ERIC Educational Resources Information Center

Richard, Alan J.; And Others

1996-01-01

The experience of 10 years evaluating HIV risk-reduction intervention for drug users leads to the argument that program outreach workers are part of the intervention continuum and have important effects on service delivery. Improving pre-enrollment data collection will address evaluation issues raised by pre-enrollment outreach contacts. (SLD)

Focus. No. 7, Winter, 1971.

ERIC Educational Resources Information Center

National Center for Health Services Research and Development (DHEW/PHS), Rockville, MD.

One of a series of periodical reports from the Center, the document summarizes the research and development program of the Center's third year. The research program is directed at creating and testing the essential components of comprehensive community health care delivery systems that will increase the supply of services where they are most…

Community-level effect of the reproductive health vouchers program on out-of-pocket spending on family planning and safe motherhood services in Kenya.

PubMed

Obare, Francis; Warren, Charlotte; Kanya, Lucy; Abuya, Timothy; Bellows, Ben

2015-08-25

Although vouchers can protect individuals in low-income countries from financial catastrophe and impoverishment arising from out-of-pocket expenditures on healthcare, their effectiveness in achieving this goal depends on whether both service and transport costs are subsidized as well as other factors such as service availability in a given locality and community perceptions about the quality of care. This paper examines the community-level effect of the reproductive health vouchers program on out-of-pocket expenditure on family planning, antenatal, delivery and postnatal care services in Kenya. Data are from two rounds of cross-sectional household surveys in voucher and non-voucher sites. The first survey was conducted between May 2010 and July 2011 among 2,933 women aged 15-49 years while the second survey took place between July and October 2012 among 3,094 women of similar age groups. The effect of the program on out-of-pocket expenditure is determined by difference-in-differences estimation. Analysis entails comparison of changes in proportions, means and medians as well as estimation of multivariate linear regression models with interaction terms between indicators for study site (voucher or non-voucher) and period of study (2010-2011 or 2012). There were significantly greater declines in the proportions of women from voucher sites that paid for antenatal, delivery and postnatal care services at health facilities compared to those from non-voucher sites. The changes were also consistent with increased uptake of the safe motherhood voucher in intervention sites over time. There was, however, no significant difference in changes in the proportions of women from voucher and non-voucher sites that paid for family planning services. The results further show that there were significant differences in changes in the amount paid for family planning and antenatal care services by women from voucher compared to those from non-voucher sites. Although there were greater declines in the average amount paid for delivery and postnatal care services by women from voucher compared to those from non-voucher sites, the difference-in-differences estimates were not statistically significant. The reproductive health vouchers program in Kenya significantly contributed to reductions in the proportions of women in the community that paid out-of-pocket for safe motherhood services at health facilities.

Skilled delivery service utilization and its association with the establishment of Women's Health Development Army in Yeky district, South West Ethiopia: a multilevel analysis.

PubMed

Negero, Melese Girmaye; Mitike, Yifru Berhan; Worku, Abebaw Gebeyehu; Abota, Tafesse Lamaro

2018-01-30

Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as "Women's Health Development Army" (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. About 45% of women have received skilled delivery care. A significant heterogeneity was observed between "Women's Health Development Teams (clusters)" for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level variables were identified to predict skilled delivery service utilization. Encouraging women to have frequent ANC visits (- 4 and above), enhancing awareness creation towards the delivery care attendance, constructing more health facilities and roads in hard to reach areas and establishing telemedicine services are recommended.

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

PubMed Central

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

PubMed

Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

2017-02-01

Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

Do guidelines influence the implementation of health programs? — Uganda’s experience

PubMed Central

2012-01-01

Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their utilization, and provide feedback was noted. Conclusions Guideline effectiveness is compromised by the development process. To ensure the production of high-quality guidelines, efforts must be employed at the country and regional levels. The regional level can facilitate pooling resources and expertise in knowledge generation, methodology development, guideline repositories, and capacity building. Countries should establish and enforce systems and guidance on guideline development. PMID:23068082

Findings from case studies of state and local immunization programs.

PubMed

Fairbrother, G; Kuttner, H; Miller, W; Hogan, R; McPhillips, H; Johnson, K A; Alexander, E R

2000-10-01

As part of its examination of federal support for immunization services during the past decade, the Institute of Medicine (IOM) Committee on Immunization Finance Policies and Practices (IFPP) commissioned eight case studies of the states of Alabama, Maine, Michigan, New Jersey, North Carolina, Texas, and Washington; and a two-county study of Los Angeles and San Diego in California. Specifically, the IOM Committee and these studies reviewed the use of Section 317 grants by the states. Section 317 is a discretionary grant program that supports vaccine purchase and other immunization-related program activities. These studies afforded the Committee an in-depth look at local policy choices, the performance of immunization programs, and federal and state spending for immunization during the past decade. The case-study reports were developed through interviews with state and local health department officials, including immunization program directors, Medicaid agency staff, budget analysts, and Centers for Disease Control and Prevention public health advisors to the jurisdiction. Other sources included state and federal administrative records and secondary sources on background factors and state-level trends. The case studies were supplemented by site visits to Detroit, Houston, Los Angeles, Newark, and San Diego. The nature of immunization "infrastructure" supported by the Section 317 program is shifting from primarily service delivery to a broader set of roles that puts the public effort at the head of a broad immunization partnership among public health, health financing, and other entities in both the public and private sectors. The rate and intensity of transition vary across the case-study areas. In the emerging pattern, service delivery increasingly takes place in the private sector and is related to managed care. "Infrastructure" is moving beyond supporting a core state staff and local health department service delivery to include such activities as immunization registries, quality improvement, and coordination with programs outside public health agencies. At the same time, the recent decline in federal Section 317 support is forcing difficult choices between old and new activities at the state and local levels. Immunization programs function as an organic component of the local health care financing and delivery systems of which they are a part. Immunization efforts are organized and conducted within distinctive state and local fiscal, economic, and health care contexts. Section 317 Financial Assistance grants, while playing a vital role in supporting immunization "infrastructure," have been too unstable and unpredictable to elicit the strategic planning, programming, and own-source spending that would be optimal for state and local programs. The predominant immunization function of state and local public health agencies is becoming assurance of age-appropriate immunization throughout the lifespan. To be successful in this emerging role, the health agencies must be supported with appropriate staffing, interagency collaboration, and clearly articulated authority.

42 CFR 414.914 - Terms of contract.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Drugs and Biologicals... CAP vendor discovers evidence of misconduct related to payment or delivery of drugs or biologicals...

42 CFR 440.165 - Nurse-midwife service.

Code of Federal Regulations, 2012 CFR

2012-10-01

... program for preparing registered nurses to furnish gynecological and obstetrical care to women during pregnancy, delivery, and the postpartum period, and care to normal newborns, and was practicing as a nurse...

42 CFR 440.165 - Nurse-midwife service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... program for preparing registered nurses to furnish gynecological and obstetrical care to women during pregnancy, delivery, and the postpartum period, and care to normal newborns, and was practicing as a nurse...

42 CFR 440.165 - Nurse-midwife service.

Code of Federal Regulations, 2014 CFR

2014-10-01

... program for preparing registered nurses to furnish gynecological and obstetrical care to women during pregnancy, delivery, and the postpartum period, and care to normal newborns, and was practicing as a nurse...

42 CFR 440.165 - Nurse-midwife service.

Code of Federal Regulations, 2013 CFR

2013-10-01

... program for preparing registered nurses to furnish gynecological and obstetrical care to women during pregnancy, delivery, and the postpartum period, and care to normal newborns, and was practicing as a nurse...

76 FR 34669 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

..., Information and Records Management Services, Office of Management. Federal Student Aid Type of Review... administration and delivery of Title IV programs. Institutions volunteer to become an experimental site to...

Active Implementation Frameworks for Successful Service Delivery: Catawba County Child Wellbeing Project

ERIC Educational Resources Information Center

Metz, Allison; Bartley, Leah; Ball, Heather; Wilson, Dawn; Naoom, Sandra; Redmond, Phil

2015-01-01

Traditional approaches to disseminating research based programs and innovations for children and families, which rely on practitioners and policy makers to make sense of research on their own, have been found insufficient. There is growing interest in strategies that "make it happen" by actively building the capacity of service providers…

Barter to Beat Inflation: Developing a Neighborhood Network for Swapping Services on Behalf of the Aged.

ERIC Educational Resources Information Center

Noberini, Mary Rose; Berman, Rochel U.

1983-01-01

Presents an urban neighborhood network barter model which can facilitate service delivery to the elderly and offers recommendations for implementing a similar program. Community outreach, good publicity, and a successful conference were key factors in producing a greater sense of cohesiveness within the community. (JAC)

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Code of Federal Regulations, 2012 CFR

2012-04-01

... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Code of Federal Regulations, 2014 CFR

2014-04-01

... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Code of Federal Regulations, 2013 CFR

2013-04-01

... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated...

The Administrative Manual for Special Education Services (AMSES). Revised.

ERIC Educational Resources Information Center

Delaware State Dept. of Education, Dover.

This manual addresses the state and federal requirements for the administration and delivery of services and supports for children with disabilities under the age of 21 in Delaware. It is designed to provide a single source of regulatory requirements which apply to programs for children with disabilities, a cross reference of federal and state…

Cooperative Services for the Rural Frail Elderly.

ERIC Educational Resources Information Center

Neely, Margery A.; And Others

These three papers describe a cooperative outreach program designed to counsel older rural residents about available community services through use of a door-to-door information effort. The packaging and delivery of the training conference for the outreach workers involved in the outreach project are described in the paper highlighting the work of…

Academic Advising: Organizing and Delivering Services for Student Success. New Directions for Community Colleges, Number 82.

ERIC Educational Resources Information Center

King, Margaret C., Ed.

1993-01-01

Offering new perspectives on academic advising in community colleges, this book defines developmental academic advising, describes the organization and delivery of advising services, and discusses key components of effective programs. The following 10 chapters are included: (1) "Developmental Academic Advising," by Thaddeus M. Raushi,…

Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

ERIC Educational Resources Information Center

Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

2012-01-01

The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests…

Formulating Social Policy vis-a-vis Immigrants: Win-Win or Zero-Sum Game?

ERIC Educational Resources Information Center

Kissam, Ed

This paper examines the effectiveness of social services provided to Mexican immigrants in rural California. In addition, the paper offers recommendations for service delivery models and for rethinking the objectives of immigrant social policy. At the most basic level, current social program planning and associated analyses of policy options fail…

Nursing Faculty Collaborate with Embedded Librarians to Serve Online Graduate Students in a Consortium Setting

ERIC Educational Resources Information Center

Guillot, Ladonna; Stahr, Beth; Meeker, Bonnie Juve'

2010-01-01

Nursing and library faculty face many information literacy challenges when graduate nursing programs migrate to online course delivery. The authors describe a collaborative model for providing cost-effective online library services to new graduate students in a three-university consortium. The embedded librarian service links a health sciences…

The Delivery of Services to Mentally Retarded Persons Living in Rural Areas: Context, Problems and Issues.

ERIC Educational Resources Information Center

Horejsi, Charles R.

Strategies and techniques for developing community-based programs for mentally retarded persons in rural areas must take into consideration local circumstances, resources, and characteristics. Rural norms such as overt racial segregation, social conformity, the importance of church, and the stigma of obtaining human services for personal problems…

Transitioning Design and Technology Education from Physical Classrooms to Virtual Spaces: Implications for Pre-Service Teacher Education

ERIC Educational Resources Information Center

Best, Marnie; MacGregor, Denise

2017-01-01

Technology-mediated teaching and learning enables access to educational opportunities, irrespective of locality, ruruality or remoteness. The design, development and delivery of technology enhanced learning in pre-service teacher education programs is therefore gaining momentum, both in Australia and internationally. Much research regarding…

The Status of Technology-Enhanced Education and Service Delivery in Rehabilitation Counselor Education

ERIC Educational Resources Information Center

Oswald, Gina R.; Huber, Mary J.; Wilson, Josephine F.; Embree, Jared

2015-01-01

Purpose: The purpose of this article is to discuss the upsurge of technology-enhanced rehabilitation education programs and telerehabilitation services, to provide examples of these advancements, and to discuss the implications of this technology for education and the field including the unique advantage to developing technological skills through…

Proceedings of the National Conference on the Delivery of Family Planning Services in Rural America (1st, Atlanta, Georgia, October, 1977).

ERIC Educational Resources Information Center

Alan Guttmacher Inst., New York, NY.

Although family planning services in rural America are becoming more accessible to women who need and want them, only one-fourth of low- and marginal-income nonmetropolitan women at risk of unintended pregnancy have been served by organized family planning programs. About 150 participants, generally providers of family planning services in…

Job Training Partnership Act: Participants, Services, and Outcomes. Statement before the Committee on Education and Labor, United States House of Representatives.

ERIC Educational Resources Information Center

Thompson, Lawrence H.

The U.S. General Accounting Office studied the characteristics of individual participants in training provided by the Job Training Partnership Act (JTPA), the kinds and intensity of services they received, and the occupations in which they were employed after leaving the program. Visits to 63 randomly selected service delivery areas provided…

20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the eligibility criteria for core... the One-Stop Delivery System § 663.110 What are the eligibility criteria for core services for adults in the adult and dislocated worker programs? To be eligible to receive core services as an adult in...

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the eligibility criteria for core... Through the One-Stop Delivery System § 663.115 What are the eligibility criteria for core services for dislocated workers in the adult and dislocated worker programs? (a) To be eligible to receive core services...

Low-cost space flight for attached payloads

NASA Astrophysics Data System (ADS)

Perkins, Frederick W.

1991-07-01

An important addition to the emerging commercial space sector is Standard Space Platforms Corporation's comprehensive low-cost flight service delivery system for small and developmental payloads. Standard provides a privately funded, proprietary, value-added transportation service which dramatically reduces cost and program duration for compliant payloads. It also provides a business-to-business service which is compatible with business investment decision timing and technology development cycles.

Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

PubMed

Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

2013-06-01

Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program components as planned and has documented achievements in improving household production and intake of micronutrient-rich foods, it is likely that strengthening delivery and increasing utilization of some program components would increase its potential for nutritional impacts. This research has highlighted the importance of designing a program theory framework and assessing the components that lie along the primary program impact pathways to optimize program service delivery and utilization and, in turn, potential for impact.

Combining service marketing and strategic alliances in health care.

PubMed

Lazarus, I R

1993-11-01

With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.

Moderating effects of parental well-being on parenting efficacy outcomes by intervention delivery model of the early risers conduct problems prevention program.

PubMed

Piehler, Timothy F; Lee, Susanne S; Bloomquist, Michael L; August, Gerald J

2014-10-01

Parent-focused preventive interventions for youth conduct problems are efficacious when offered in different models of delivery (e.g., individual in-home, group center-based). However, we know little about the characteristics of parents associated with a positive response to a particular model of delivery. We randomly assigned the parents of an ethnically diverse sample of kindergarten through second grade students (n = 246) displaying elevated levels of aggression to parent-focused program delivery models emphasizing receiving services in a community center largely with groups (Center; n = 121) or receiving services via an individualized in-home strategy (Outreach; n = 125). In both delivery models, parents received parent skills training and goal setting/case management/referrals over an average of 16 months. Structural equation modeling revealed a significant interaction between parental well-being at baseline and intervention delivery model in predicting parenting efficacy at year 2, while controlling for baseline levels of parenting efficacy. Within the Outreach model, parents with lower levels of well-being as reported at baseline appeared to show greater improvements in parenting efficacy than parents with higher levels of well-being. Within the Center model, parental well-being did not predict parenting efficacy outcomes. The strong response of low well-being parents within the Outreach model suggests that this may be the preferred model for these parents. These findings provide support for further investigation into tailoring delivery model of parent-focused preventive interventions using parental well-being in order to improve parenting outcomes.

Moderating Effects of Parental Well-Being on Parenting Efficacy Outcomes by Intervention Delivery Model of the Early Risers Conduct Problems Prevention Program

PubMed Central

Piehler, Timothy F.; Lee, Susanne S.; Bloomquist, Michael L.; August, Gerald J.

2014-01-01

Parent-focused preventive interventions for youth conduct problems are efficacious when offered in different models of delivery (e.g., individual in-home, group center-based). However, we know little about the characteristics of parents associated with a positive response to a particular model of delivery. We randomly assigned the parents of an ethnically diverse sample of kindergarten through second grade students (n = 246) displaying elevated levels of aggression to parent-focused program delivery models emphasizing receiving services in a community center largely with groups (Center; n = 121) or receiving services via an individualized in-home strategy (Outreach; n = 125). In both delivery models, parents received parent skills training and goal setting/case management/referrals over an average of 16 months. Structural equation modeling revealed a significant interaction between parental well-being at baseline and intervention delivery model in predicting parenting efficacy at year two, while controlling for baseline levels of parenting efficacy. Within the Outreach model, parents with lower levels of well-being as reported at baseline appeared to show greater improvements in parenting efficacy than parents with higher levels of well-being. Within the Center model, parental well-being did not predict parenting efficacy outcomes. The strong response of low well-being parents within the Outreach model suggests that this may be the preferred model for these parents. These findings provide support for further investigation into tailoring delivery model of parent-focused preventive interventions using parental well-being in order to improve parenting outcomes. PMID:25037843

How Long after? A Natural Experiment Assessing the Impact of the Length of Aftercare Service Delivery on Recidivism

ERIC Educational Resources Information Center

Kurlychek, Megan C.; Wheeler, Andrew P.; Tinik, Leigh A.; Kempinen, Cynthia A.

2011-01-01

Although aftercare programs have been gaining popularity as a mechanism for helping offenders readjust to society, evaluations of their success remain varied. This is most likely due to the diversity of programs labeled as aftercare and the inability of research to isolate specific program components. The current study capitalizes on a natural…

Parent Participation within Community Center or In-Home Outreach Delivery Models of the Early Risers Conduct Problems Prevention Program

ERIC Educational Resources Information Center

Bloomquist, Michael L; August, Gerald J.; Lee, Susanne S.; Piehler, Timothy F.; Jensen, Marcia

2012-01-01

A variety of predictors of parent participation in prevention programming have been identified in past research, but few studies have investigated how those predictors may vary by implementation context. Patterns of parent participation were examined in the Early Risers Conduct Problems Prevention Program using two family-focused service delivery…

Reimbursement for school nursing health care services: position statement.

PubMed

Lowe, Janet; Cagginello, Joan; Compton, Linda

2014-09-01

Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.

Recruitment and retention in an SMS-based health education program: Lessons learned from Text2BHealthy.

PubMed

Speirs, Katherine E; Grutzmacher, Stephanie K; Munger, Ashley L; Messina, Lauren A

2016-09-01

While text messages or short messaging service programs are increasingly utilized for delivering health education, few studies have explored the unique challenges of recruiting and retaining participants in such programs. This study utilizes survey and focus group data from Text2BHealthy, a short messaging service-based nutrition and physical activity promotion program, to examine barriers to enrollment and facilitators of retention among parents of elementary school students. Results show that participants were hard to reach with recruitment materials, had difficulty with self-enrollment, and were apprehensive about program costs. However, 89-90 percent of participants were retained. Results suggest that providing manual enrollment options, alternative program delivery methods (e.g. email messages), and opportunities to reenroll may facilitate participation in short messaging service-based health education and promotion programs. © The Author(s) 2015.

Challenges of NGO-to-state Referral in the Delivery of HIV Prevention Programs in Ukraine Supported by the Global Fund

PubMed Central

McGill, Svetlana

2015-01-01

Background: Ukraine has one of the world’s fastest growing HIV rates and was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF). The objective of this study was to close the gaps in the literature on the delivery of HIV prevention services by NGOs and the perceptions of NGO delivered services, using as an example HIV prevention programs in Ukraine funded by the GF. Methods: The aim of this qualitative study was to determine how NGO-based services were implemented in the context of a state-owned healthcare system of Ukraine. An ethnographic study, which included 50 participant interviews, was conducted in three oblasts in Ukraine and in the capital, Kyiv, between 2011 and 2013. This article presents some of the findings that emerged from the analysis. Results: Participants reported that NGOs were focused more on reporting numbers of rapid tests, and less on motivating clients to continue onto treatment. The role division between NGOs and the state in HIV services was largely perceived by participants as unclear and challenging. Overall, lack of clarity on the role of government healthcare providers and NGOs in providing HIV services compromised the process of finding, referring, and retaining HIV patients in care. Conclusions: Gaps in linking HIV patients to the HIV care continuum have been identified as a potentially problematic issue in delivery of HIV prevention services by GF funded NGOs. With an anticipated GF exit from Ukraine, the lack of clearly defined NGO-to-state referrals of HIV patients complicates the transition of NGO run services into state funding. Further steps to improve referral systems are necessary to ensure a smooth transition and enable Ukraine to fight its HIV epidemic effectively. PMID:29138720

Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

PubMed

Gudu, William; Addo, Bright

2017-05-31

Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great potential of improving uptake of skilled delivery services.

Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

PubMed

Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

2015-06-01

Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

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.

Use of pharmacy delivery robots in intensive care units.

PubMed

Summerfield, Marc R; Seagull, F Jacob; Vaidya, Neelesh; Xiao, Yan

2011-01-01

The use of pharmacy delivery robots in an institution's intensive care units was evaluated. In 2003, the University of Maryland Medical Center (UMMC) began a pilot program to determine the logistic capability and functional utility of robotic technology in the delivery of medications from satellite pharmacies to patient care units. Three satellite pharmacies currently used the robotic system. Five data sources (electronic robot activation records, logs, interviews, surveys, and observations) were used to assess five key aspects of robotic delivery: robot use, reliability, timeliness, cost minimization, and acceptance. A 19-item survey using a 7-point Likert-type scale was developed to determine if pharmacy delivery robots changed nurses' perception of pharmacy service. The components measured included general satisfaction, reliability, timeliness, stat orders, services, interaction with pharmacy, and status tracking. A total of 23 pre-implementation, 96 post-implementation, and 30 two-year follow-up surveys were completed. After implementation of the robotic delivery system, time from fax to label, order preparation time, and idle time for medications to be delivered decreased, while nurses' general satisfaction with the pharmacy and opinion of the reliability of pharmacy delivery significantly increased. Robotic delivery did not influence the perceived quality of delivery service or the timeliness of orders or stat orders. Robot reliability was a major issue for the technician but not for pharmacists, who did not have as much interaction with the devices. By considering the needs of UMMC and its patients and matching them with available technology, the institution was able to improve the medication-use process and timeliness of medication departure from the pharmacy.

Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

PubMed

Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

2016-07-29

Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a persistent pro-rich inequity but also a significant rural-urban equity gap in the uptake of maternal health care services. An equity perspective in policy interventions is much needed to ensure safe motherhood and childbirth in Bangladesh.

Learning together for effective collaboration in school-based occupational therapy practice.

PubMed

Villeneuve, Michelle A; Shulha, Lyn M

2012-12-01

School-based occupational therapy (SBOT) practice takes place within a complex system that includes service recipients, service providers, and program decision makers across health and education sectors. Despite the promotion of collaborative consultation at a policy level, there is little practical guidance about how to coordinate multi-agency service and interprofessional collaboration among these stakeholders. This paper reports on a process used to engage program administrators in an examination of SBOT collaborative consultation practice in one region of Ontario to provide an evidence-informed foundation for decision making about implementation of these services. Within an appreciative inquiry framework (Cooperrider, Whitney, & Stavros, 2008), Developmental Work Research methods (Engeström, 2000) were used to facilitate shared learning for improved SBOT collaborative consultation. Program administrators participated alongside program providers and service recipients in a series of facilitated workshops to develop principles that will guide future planning and decision making about the delivery of SBOT services. Facilitated discussion among stakeholders led to the articulation of 12 principles for effective collaborative practice. Program administrators used their shared understanding to propose a new model for delivering SBOT services. Horizontal and vertical learning across agency and professional boundaries led to the development of powerful solutions for program improvement.

The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act.

PubMed

Buck, Jeffrey A

2011-08-01

Public substance abuse treatment services have largely operated as an independent part of the overall health care system, with unique methods of administration, funding, and service delivery. The Affordable Care Act of 2010 and other recent health care reforms, coupled with declines in state general revenue spending, will change this. Overall funding for these substance abuse services should increase, and they should be better integrated into the mainstream of general health care. Reform provisions are also likely to expand the variety of substance abuse treatment providers and shift services away from residential and stand-alone programs toward outpatient programs and more integrated programs or care systems. As a result, patients should have better access to care that is more medically based and person-centered.

Mississippi Company Using NASA Software Program to Provide Unique Imaging Service: DATASTAR Success Story

NASA Technical Reports Server (NTRS)

2001-01-01

DATASTAR, Inc., of Picayune, Miss., has taken NASA's award-winning Earth Resources Laboratory Applications (ELAS) software program and evolved it to the point that the company is now providing a unique, spatial imagery service over the Internet. ELAS was developed in the early 80's to process satellite and airborne sensor imagery data of the Earth's surface into readable and useable information. While there are several software packages on the market that allow the manipulation of spatial data into useable products, this is usually a laborious task. The new program, called the DATASTAR Image Processing Exploitation, or DIPX, Delivery Service, is a subscription service available over the Internet that takes the work out of the equation and provides normalized geo-spatial data in the form of decision products.

Case management for the subacute patient in a skilled nursing facility.

PubMed

Carr, D D

2000-01-01

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries

PubMed Central

2013-01-01

Background Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Methods Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Results Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. Conclusion In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning, having a metric that captures the impact of a range of diverse services and allows comparisons will be increasingly important. However, standardizing reporting will be essential to make such comparisons useful. While not widespread, errors in self-reported data appear to have included social marketing distribution data in social franchising reporting, requiring clearer data collection and reporting guidelines. Differences noted above must be interpreted cautiously as a result. PMID:23902679

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries.

PubMed

Montagu, Dominic; Ngamkitpaiboon, Lek; Duvall, Susan; Ratcliffe, Amy

2013-01-01

Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning, having a metric that captures the impact of a range of diverse services and allows comparisons will be increasingly important. However, standardizing reporting will be essential to make such comparisons useful. While not widespread, errors in self-reported data appear to have included social marketing distribution data in social franchising reporting, requiring clearer data collection and reporting guidelines. Differences noted above must be interpreted cautiously as a result.

Understanding Teachers' Perceptions of Student Support Systems in Relation to Teachers' Stress

ERIC Educational Resources Information Center

Ball, Annahita; Anderson-Butcher, Dawn

2014-01-01

Expanded school mental health (ESMH) programs are critical for addressing children's social and emotional development in schools. As broad, multisystem approaches, ESMH programs rely on teachers for effective and sustainable primary, secondary, and tertiary school mental health service delivery. In light of the increasing mental health needs…

Evaluating the Effects of Comprehensive Substance Abuse Intervention on Successful Reunification

ERIC Educational Resources Information Center

Brook, Jody; McDonald, Thomas P.

2007-01-01

Objective: This study examines permanency outcomes of families with children in foster care who participated in a comprehensive service-delivery program designed to assist families and communities in dealing with alcohol and other drug (AOD) problems. Method: Survival analysis is used to measure the impact of program participation on family…

Poverty Alleviation and Integrated Service Delivery: Literacy, Early Child Development and Health

ERIC Educational Resources Information Center

Nordtveit, Bjorn Harald

2008-01-01

This paper argues that many internationally financed literacy programs do not sufficiently take into consideration important daily life issues of the learners, including nutritional deficiencies that may hinder learning, or of children-parent-society interactions that may improve learning. As a result, many programs have become synonymous with…

7 CFR 278.6 - Disqualification of retail food stores and wholesale food concerns, and imposition of civil money...

Code of Federal Regulations, 2011 CFR

2011-01-01

... providers, and shelters for battered women and children which the wholesale food concern was authorized to... addict and alcoholic treatment program, homeless meal providers, or shelters for battered women and... program, group living arrangement, homeless meal provider, meal delivery service, or shelter for battered...

7 CFR 278.6 - Disqualification of retail food stores and wholesale food concerns, and imposition of civil money...

Code of Federal Regulations, 2010 CFR

2010-01-01

... providers, and shelters for battered women and children which the wholesale food concern was authorized to... addict and alcoholic treatment program, homeless meal providers, or shelters for battered women and... program, group living arrangement, homeless meal provider, meal delivery service, or shelter for battered...

Model Adoption Exchange Payment System: Technical Specifications and User Instructions.

ERIC Educational Resources Information Center

Ambrosino, Robert J.

This user's manual, designed to meet the needs of adoption exchange administrators and program managers for a formal tool to assist them in the overall management and operation of their program, presents the Model Adoption Exchange Payment System (MAEPS), which was developed to improve the delivery of adoption exchange services throughout the…

One Kid at a Time: Evaluative Case Studies and Description of the Alaska Youth Initiative Demonstration Project.

ERIC Educational Resources Information Center

Burchard, John D.; And Others

This monograph presents an evaluative description of the Alaska Youth Initiative (AYI), a community-based interagency program serving children and adolescents with severe emotional and behavioral disorders. Principles of the program include a no reject policy and a "wraparound" service delivery approach. The monograph offers information…

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2011 CFR

2011-04-01

... TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do the Welfare-to... improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a One-Stop...

How Well Does Your IEP Measure Up?: Quality Indicators for Effective Service Delivery.

ERIC Educational Resources Information Center

Twachtman-Cullen, Diane; Twachtman-Reilly, Jennifer

This book is intended to offer guidance in writing individualized education programs (IEPs) that deliver high-quality, need-based educational programming for students with autism spectrum disorders. Following an introductory historical overview of special education law, the remaining chapters in part 1 address the quality indicators for each of…

20 CFR 669.210 - How does an eligible entity become an NFJP grantee?

Code of Federal Regulations, 2014 CFR

2014-04-01

... LABOR (CONTINUED) NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the National Farmworker Jobs Program § 669.210 How does an eligible entity... strategy for meeting the needs of eligible migrant and seasonal farmworkers in the geographic area the...

20 CFR 669.210 - How does an eligible entity become an NFJP grantee?

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABOR (CONTINUED) NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the National Farmworker Jobs Program § 669.210 How does an eligible entity... strategy for meeting the needs of eligible migrant and seasonal farmworkers in the geographic area the...

20 CFR 669.210 - How does an eligible entity become an NFJP grantee?

Code of Federal Regulations, 2011 CFR

2011-04-01

... LABOR NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the National Farmworker Jobs Program § 669.210 How does an eligible entity become an... for meeting the needs of eligible migrant and seasonal farmworkers in the geographic area the entity...

20 CFR 669.210 - How does an eligible entity become an NFJP grantee?

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABOR (CONTINUED) NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the National Farmworker Jobs Program § 669.210 How does an eligible entity... strategy for meeting the needs of eligible migrant and seasonal farmworkers in the geographic area the...

An Afrocentric program for African American males in the juvenile justice system.

PubMed

Harvey, A R; Coleman, A A

1997-01-01

Though the juvenile justice system provides an array of interventions, culturally relevant programs are necessary to deal with the myriad social problems, including an escalating crime rate, facing high-risk African American adolescent males. This article presents an Afrocentric approach to service delivery for these youths and their families.

Marketing Adult Literacy Programs: Meeting the Challenges in the Twenty-First Century. Research to Practice.

ERIC Educational Resources Information Center

Michael, Steve Olu; Hogard, Elaine

In the current environment of increasing competition for shrinking resources and the dramatic changes in educational service delivery in response to recent technological advances, marketing is becoming increasingly important to the success of adult literacy programs. Individual attitudes toward marketing in the educational sector differ greatly…

Community Action, Urban Reform, and the Fight against Poverty: The Ford Foundation's Gray Areas Program.

ERIC Educational Resources Information Center

O'Connor, Alice

1996-01-01

Describes the process by which experimental Ford Foundation programs designed to stem the urban crisis evolved into more narrowly constructed interventions to reform service delivery systems and alleviate poverty in inner-city neighborhoods. Related themes are highlighted and limitations caused by problems of institutional constraints, political…

Parent Feedback about Individualized Education Program Team Meetings for Students in Kindergarten through Grade 12

ERIC Educational Resources Information Center

Cooper-Martin, Elizabeth; Wilson, Heather M.

2014-01-01

This report presents parent feedback from a study that focused on experiences at Individualized Education Program (IEP) team meetings and also explored parent satisfaction with delivery of special education services. The study included all parents of Montgomery County (Maryland) Public Schools (MCPS) students who had educational disabilities, were…

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program.

PubMed

Vellakkal, Sukumar; Reddy, Hanimi; Gupta, Adyya; Chandran, Anil; Fledderjohann, Jasmine; Stuckler, David

2017-04-01

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a 'natural event' that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Experiences from an interprofessional student-assisted chronic disease clinic.

PubMed

Frakes, Kerrie-Anne; Brownie, Sharon; Davies, Lauren; Thomas, Janelle; Miller, Mary-Ellen; Tyack, Zephanie

2014-11-01

Faced with significant health and workforce challenges in the region, the Central Queensland Health Service District (CQHSD) commenced a student-assisted clinical service. The Capricornia Allied Health Partnership (CAHP) is an interprofessional clinical placement program in which pre-entry students from exercise physiology, nutrition and dietetics, occupational therapy, pharmacy, podiatry and social work are embedded in a collaborative chronic disease service delivery model. The model coordinates multiple student clinical placements to: address service delivery gaps for previously underserved people with chronic disease in need of early intervention and management; provide an attractive clinical placement opportunity for students that will potentially lead to future recruitment success, and demonstrate leadership in developing future health workforce trainees to attain appropriate levels of interprofessional capacity. The CAHP clinic commenced student placements and client services in February 2010. This report provides early evaluative information regarding student experiences included self-reported changes in practice.

Healthcare reform: the role of coordinated critical care.

PubMed

Cerra, F B

1993-03-01

To evaluate and editorialize the evolving role of the discipline of critical care as a healthcare delivery system in the process of healthcare reform. The sources included material from the Federal Office of Management and Budget, Health Care Financing Review, President Bush's Office, Association of American Medical Colleges, and publications of the Society of Critical Care Medicine. Data were selected that the author felt was relevant to the healthcare reform process and its implications for the discipline of critical care. The data were extracted by the author to illustrate the forces behind healthcare reform, the implications for the practice of critical care, and role of critical care as a coordinated (managed) care system in the process of healthcare reform. Healthcare reform has been initiated because of a number of considerations that arise in evaluating the current healthcare delivery system: access, financing, cost, dissatisfactions with the mechanisms of delivery, and political issues. The reform process will occur with or without the involvement of critical care practitioners. Reforms may greatly alter the delivery of critical care services, education, training, and research in critical care. Critical care has evolved into a healthcare delivery system that provides services to patients who need and request them and provides these services in a coordinated (managed) care model. Critical care practitioners must become involved in the healthcare reform process, and critical care services that are effective must be preserved, as must the education, training, and research programs. Critical care as a healthcare delivery system utilizing a coordinated (managed) care model has the potential to provide services to all patients who need them and to deliver them in a manner that is cost effective and recognized as providing added value.

A Study to Determine the Cost Advantage of Establishing an Internal Champus Partnership with Civilian Providers for the Delivery of Mental Health Services in the Catchment Area of the Naval Medical Clinic Annapolis, MD

DTIC Science & Technology

1992-06-12

DoD Instruction 6010.12, it is the policy of DoD that the Partnership Program be utilized to intergrate civilian and military health care resources (2...care programs, such as PPO’s, as alternative approaches for delivering mental health services due to their cost containment potential (Trauner, 32...government must fill the role of both payer and broker. The CHAMPUS Partnership Program represents an innovative attempt at approaching a system of managed

An Information Technology Framework for Strengthening Telehealthcare Service Delivery

PubMed Central

Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

2012-01-01

Abstract Objective: Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. Materials and Methods: The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. Results: The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. Conclusions: The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances. PMID:23061641

An information technology framework for strengthening telehealthcare service delivery.

PubMed

Chen, Li-Chin; Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

2012-10-01

Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.

Endometriosis education in schools: A New Zealand model examining the impact of an education program in schools on early recognition of symptoms suggesting endometriosis.

PubMed

Bush, Deborah; Brick, Emily; East, Michael C; Johnson, Neil

2017-08-01

Menstrual morbidity plays a significant role in adolescent females' lives. There are no studies to date reporting such data from menstrual health education programs in schools. The aim of our study was to report results from an audit of a menstrual health and endometriosis education program in secondary schools and observe age patterns of young women presenting for menstrual morbidity care. Audit data from education in secondary schools and audit data of patients from an Endometriosis and Pelvic Pain Coaching clinic operating in a private endometriosis specialised centre are reported. In a region of consistent delivery of the education program, student awareness of endometriosis was 32% in 2015. Overall in 2015, 13% of students experienced distressing menstrual symptoms and 27% of students sometimes or always missed school due to menstrual symptoms. Further, in one region of consistent delivery of the menstrual health education program, data show an increase in younger patients attending for specialised endometriosis care. There is strong suggestive evidence that consistent delivery of a menstrual health education program in schools increases adolescent student awareness of endometriosis. In addition, there is suggestive evidence that in a geographical area of consistent delivery of the program, a shift in earlier presentation of young women to a specialised health service is observed. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Characteristics of Indigenous primary health care service delivery models: a systematic scoping review.

PubMed

Harfield, Stephen G; Davy, Carol; McArthur, Alexa; Munn, Zachary; Brown, Alex; Brown, Ngiare

2018-01-25

Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified - accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment. While the eight characteristics were clearly distinguishable within the review, the interdependence between each characteristic was also evident. These findings were used to develop a new Indigenous PHC Service Delivery Model, which clearly demonstrates some of the unique characteristics of Indigenous specific models.

Framing the Dialogue: Strategies, Issues and Opportunities

DTIC Science & Technology

1993-05-01

issue is the relationship between the declining Federal financing of public works and the Federal interest in providing infrastructure services. Large...programs and projects are significant. lmprove Infrastructure Managmnt : Management improvements closely parallel the issues associated with strategic... Relationship Between Examination of the linkage between standards GKY & Standards & and the delivery of goods and services from Associates Performance

20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

Code of Federal Regulations, 2013 CFR

2013-04-01

... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker...

20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

Code of Federal Regulations, 2012 CFR

2012-04-01

... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker...

20 CFR 663.110 - What are the eligibility criteria for core services for adults in the adult and dislocated worker...

Code of Federal Regulations, 2014 CFR

2014-04-01

... services for adults in the adult and dislocated worker programs? 663.110 Section 663.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker...

Parent Volunteer Program. School of the Future: San Antonio.

ERIC Educational Resources Information Center

Iscoe, Louise

The Hogg Foundation for Mental Health created the School of the Future (SoF) project to enable selected Texas schools to coordinate and implement school-based social and health services on their campuses and to demonstrate the effectiveness of this method of service delivery by evaluating the project. This booklet focuses on the Parent Volunteer…

Translation of a Dementia Caregiver Intervention for Delivery in Homecare as a Reimbursable Medicare Service: Outcomes and Lessons Learned

ERIC Educational Resources Information Center

Gitlin, Laura N.; Jacobs, Mimi; Earland, Tracey Vause

2010-01-01

Purpose: Families of dementia patients receiving skilled homecare do not receive supportive services. We evaluated whether a proven intervention, Environmental Skill-building Program (ESP), which reduces caregiver burden and enhances skills managing patient functioning, can be integrated into homecare practices of occupational therapists (OTs) and…

Service-Learning and Integrated Course Redesign: Principles of Management and the Campus Kitchen Metaproject

ERIC Educational Resources Information Center

Flannery, Brenda L.; Pragman, Claudia H.

2010-01-01

This article describes the process of redesigning a Principles of Management course to integrate a service-learning metaproject. The metaproject was Campus Kitchen, a food recovery and delivery program operated on a handful of university campuses across the United States. We used L. Dee Fink's integrated course design approach as well as systems…

Trauma-Informed Day Services for Individuals with Intellectual/Developmental Disabilities: Exploring Staff Understanding and Perception within an Innovative Programme

ERIC Educational Resources Information Center

Keesler, John M.

2016-01-01

Background: Trauma-informed care (TIC) is a systems-level philosophy of service delivery which integrates choice, collaboration, empowerment, safety and trust to create an organizational culture sensitive to trauma. This study explores staff understandings and perceptions within an innovative trauma-informed day program for individuals with…

Treatment Services for Drug Dependent Women. Volume 1. Treatment Research Monograph Series.

ERIC Educational Resources Information Center

Beschner, George M., Ed.; And Others

This book is the first of two volumes designed to highlight and integrate current knowledge about drug dependent women, with a focus on needed services and appropriate delivery systems, as well as to provide useful information for counselors and treatment program developers. The special problems, needs, and characteristics of women drug abusers…

Critical interactions between the Global Fund-supported HIV programs and the health system in Ghana.

PubMed

Atun, Rifat; Pothapregada, Sai Kumar; Kwansah, Janet; Degbotse, D; Lazarus, Jeffrey V

2011-08-01

The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated care delivery. Ghana has benefited from US $175 million of approved Global Fund support to address the HIV epidemic, accounting for almost 85% of the National AIDS Control Program budget. Investments in infrastructure, human resources, and commodities have enabled HIV interventions to increase exponentially. Global Fund-supported activities have been well integrated into key health system functions to strengthen them, especially financing, planning, service delivery, and demand generation. Yet, with governance and monitoring and evaluation functions, parallel structures to national systems have emerged, leading to inefficiencies. This case study demonstrates that interactions and integration are highly varied across different health system functions, and strong government leadership has facilitated the integration of Global Fund-supported activities within national programs.

Special Education Audit. Evaluation Department Report No. 429 and Description of the District's Special Education Programs. Evaluation Department Report No. 429A (Supplement to Report No. 429).

ERIC Educational Resources Information Center

San Diego City Schools, CA. Planning, Research and Evaluation Div.

An independent audit of the San Diego (California) special education department was commissioned to examine: (1) whether programs exceed mandates of federal and state law, (2) whether the district has maximized funding sources in reporting programs and costs; and (3) whether alternative service delivery models or community interagency…

Non-traditional vs. Traditional Academic Delivery Systems: Comparing ETS Scores for Undergraduate Students in Business Programs, 1996-1999. AIR 1999 Annual Forum Paper.

ERIC Educational Resources Information Center

Jonas, Peter M.; Weimer, Don

This two-year study involving five colleges and universities compared the academic achievement, as measured by the Educational Testing Service (ETS) Major Field Achievement Test (MFAT) in Business of students in traditional undergraduate programs and those in non-traditional accelerated adult degree programs. The study also compared the subjects'…

Developing Printed Supplementary Materials to Accompany Satellite Programming for Junior High School Students. Satellite Technology Demonstration, Technical Report No. 0508.

ERIC Educational Resources Information Center

Lonsdale, Helen C.; O'Neill, Donald W.

To implement a career education program for junior high school students in the rural, isolated areas of the Rocky Mountain States, Satellite Technology Demonstration (STD) tested the use of a satellite-assisted communications system for the delivery of social services. A magazine was designed to promote acceptance of the television programing and…

Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

PubMed Central

Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

2009-01-01

Aim Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials. Method A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery) were analyzed. Results Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery. Conclusions Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%–80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes. PMID:21197303

FIELD NOTES: PEOPLE, PROGRAMS, & POLICIES Farmers' Market Produce Delivery Program for Mitigating Nutritional Risk in Older Adults.

PubMed

Dover, Sally E; Buys, David R; Allocca, Sally; Locher, Julie L

2013-01-01

Community-dwelling older adults in disadvantaged neighborhoods may face nutritional risks not mitigated by existing programs. The Senior Market Basket Program, administered by nonprofit organization P.E.E.R., Inc., is a unique approach to serving community-dwelling senior adults and a valuable model for integrating targeted social services into local food systems. The program ensures access to fresh produce during the growing season for a defined target population.

Resource Consumption of a Diffusion Model for Prevention Programs: The PROSPER Delivery System

PubMed Central

Crowley, Daniel M.; Jones, Damon E.; Greenberg, Mark T.; Feinberg, Mark E.; Spoth, Richard L.

2012-01-01

Purpose To prepare public systems to implement evidence-based prevention programs for adolescents, it is necessary to have accurate estimates of programs’ resource consumption. When evidence-based programs are implemented through a specialized prevention delivery system, additional costs may be incurred during cultivation of the delivery infrastructure. Currently, there is limited research on the resource consumption of such delivery systems and programs. In this article, we describe the resource consumption of implementing the PROSPER (PROmoting School–Community–University Partnerships to Enhance Resilience) delivery system for a period of 5 years in one state, and how the financial and economic costs of its implementation affect local communities as well as the Cooperative Extension and University systems. Methods We used a six-step framework for conducting cost analysis, using a Cost–Procedure–Process–Outcome Analysis model (Yates, Analyzing costs, procedures, processes, and outcomes in human services: An introduction, 1996; Yates, 2009). This method entails defining the delivery System; bounding cost parameters; identifying, quantifying, and valuing systemic resource Consumption, and conducting sensitivity analysis of the cost estimates. Results Our analyses estimated both the financial and economic costs of the PROSPER delivery system. Evaluation of PROSPER illustrated how costs vary over time depending on the primacy of certain activities (e.g., team development, facilitator training, program implementation). Additionally, this work describes how the PROSPER model cultivates a complex resource infrastructure and provides preliminary evidence of systemic efficiencies. Conclusions This work highlights the need to study the costs of diffusion across time and broadens definitions of what is essential for successful implementation. In particular, cost analyses offer innovative methodologies for analyzing the resource needs of prevention systems. PMID:22325131

Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

PubMed

Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

2014-09-01

The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

Effects of the West Africa Ebola Virus Disease on Health-Care Utilization – A Systematic Review

PubMed Central

Brolin Ribacke, Kim J.; Saulnier, Dell D.; Eriksson, Anneli; von Schreeb, Johan

2016-01-01

Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries, and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reviews. A total of 3354 articles were identified for screening, and while 117 articles were read in full, 22 studies were included in the final review. Utilization of maternal health services decreased during the outbreak. The number of cesarean sections and facility-based deliveries declined and followed a similar pattern in Guinea, Liberia, and Sierra Leone. A change in the utilization of antenatal and postnatal care and family planning services was also seen, as well as a drop in utilization of children’s health services, especially in terms of vaccination coverage. In addition, the uptake of HIV/AIDS and malaria services, general hospital admissions, and major surgeries decreased as well. Interestingly, it was the uptake of health service provision by the population that decreased, rather than the volume of health service provision. Estimates from the various studies suggest that non-Ebola morbidity and mortality have increased after the onset of the outbreak in Sierra Leone, Guinea, and Liberia. Reproductive, maternal, and child health services were especially affected, and the decrease in facility deliveries, cesarean sections, and volume of antenatal and postnatal care visits might have significant adverse effects on maternal and newborn health. The impact of Ebola stretches far beyond Ebola cases and deaths. This review indicates that indirect health service effects are substantial and both short and long term, and highlights the importance of support to maintain routine health service delivery and the maintenance of vaccination programs as well as preventative and curative malaria programs, both in general but especially in times of a disaster. PMID:27777926

Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

PubMed

McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

2012-05-17

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

Payment for Environmental Services: Hypotheses and Evidence

PubMed Central

Alston, Lee J.; Andersson, Krister; Smith, Steven M.

2014-01-01

The use of payment for environmental services (PES) is not a new type of contract, but PES programs have become more in vogue because of the potential for sequestering carbon by paying to prevent deforestation and degradation of forestlands. We provide a framework utilizing transaction costs to hypothesize which services are more likely to be provided effectively. We then interpret the literature on PES programs to see the extent to which transaction costs vary as predicted across the type of service and to assess the performance of PES programs. As predicted, we find that transaction costs are the least for club goods like water and greatest for pure public goods like carbon reduction. Actual performance is difficult to measure and varies across the examples. More work and experimentation are needed to gain a better outlook on what elements support effective delivery of environmental services. PMID:25143798

Implementation of evidence-based supported employment in regional Australia.

PubMed

Morris, Adrienne; Waghorn, Geoffrey; Robson, Emma; Moore, Lyndell; Edwards, Emma

2014-06-01

To implement the Individual Placement and Support (IPS) approach at 4 locations in regional New South Wales, Australia. Outcomes attained were compared with a national non-IPS program and with international trials of IPS within and outside the United States. Four IPS programs were established through formal partnerships between mental health services and disability employment services. Ninety-five mental health service clients commenced employment assistance and were tracked for a minimum of 12 months. Two sites achieved good fidelity to IPS principles, and 2 sites achieved fair fidelity. IPS clients had 3.5 times greater odds of attaining 13 weeks' employment than those receiving assistance in the national network of disability employment services. Implementing IPS is challenging in the Australian service delivery context. Factors other than program fidelity appear to contribute to excellent employment outcomes. Further research is needed to identify these factors.

Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

PubMed Central

Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2015-01-01

Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of variations in VMMC service productivity, which are important for program planning. PMID:25706119

Consolidation of trauma programs in the era of large health care delivery networks.

PubMed

Trooskin, S Z; Faucher, M B; Santora, T A; Talucci, R C

1999-03-01

To review the development of an integrated trauma program at two separate campuses brought about by the merger of two medical-affiliated hospitals, each with an integrated program and a common trauma administrator, medical director, and educational coordinator. Each campus has an associate trauma medical director for on-site administrative management, a nurse coordinator, and a registrar. The integration resulted in a reduction of 1.5 full-time equivalents and "cost" savings by consolidated use of the helicopter, outreach, prevention, research, and educational programs. Regular "integration meetings," ad hoc committees, and video-linked conferences were used to institute common quality improvement programs, morbidity and mortality discussions, policies, and clinical management protocols. Reaccreditation by an outside agency, elimination of duplicated services, and maintenance of pre-merger clinical volume results. This integrated trauma program may serve as a model in this era of individual hospitals merging into large health care delivery networks.

Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

PubMed

Goldfeld, Sharon; Price, Anna; Kemp, Lynn

2018-05-01

Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

Availability and Accessibility of Student-Specific Weight Loss Programs and Other Risk Prevention Health Services on College Campuses

PubMed Central

Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina

2016-01-01

Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate enrollment of 41,122 (7657) students were examined. The websites of the universities were assessed to determine the availability of weight loss programs. Services for high-risk health needs common to university campuses (ie, alcohol and other drugs, victim services, sexual health, and eating disorders) were searched. Results Of the universities searched, 3 (30%, 3/10) offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools (100%, 10/10) offered no-cost and continual enrollment programming for the other high-risk health needs. Conclusions There are limited weight loss services available to undergraduate students compared with other university services. Collaboration between existing college health service providers is suggested for the delivery of appropriate programming for overweight and obese undergraduates wanting to lose weight. PMID:27278261

Integrating telemedicine and telehealth: putting it all together.

PubMed

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care organizations. Telemedicine programs should perform ongoing assessments of activities, ranging from service usage to quality of service assessments, to ongoing analyses of financial performance. The financial assessments should include evaluations of costs and benefits, coding issues, reimbursement, account receivables, bad debt and network utilization. Long-range strategic planning for a telemedicine and telehealth program should be carried out on an on-going basis and should include the program's governing board. This planning process should include goal setting and the periodic updating of the program's vision and mission statements. There can be additional special issues for multi-organization telemedicine and telehealth programs. For example, authority management can require the use of innovative approaches tailored to the realities of the organizational structures of the participating members. Inter-institutional relations may introduce additional issues when competing health care organizations are utilizing shared resources. Branding issues are preferably addressed during the initial planning of a multi-organizational telemedicine and telehealth program. Ideally, public policy regarding telemedicine and telehealth within a service region will complement the objectives of telemedicine and telehealth programs within that service area.

One small community hospital library's successful outsourcing of document delivery: an ongoing study.

PubMed

Haas, V

2000-01-01

When DOCLINE was implemented in 1985, community hospital librarians were beginning to feel the economic pressures of the changing health care arena. However, staff and resources were often sufficient or plentiful. Now, fifteen years after the creation of DOCLINE, many existing small hospitals either no longer have a librarian, an assistant is managing the library, the librarian is managing one or more libraries of an integrated system, or the number of librarians has been reduced. A system that is heavily staff dependent is no longer feasible. In addition, as the role of the community hospital librarian evolves into one of instructor and patient education liaison, a system that does not permit the librarian to expand such services will be detrimental to the entire library program. Following is a discussion of one small community hospital's decision to outsource document delivery services as a result of staffing changes and the expansion of additional library programs.

Federally funded comprehensive women's health centers: leading innovation in women's healthcare delivery.

PubMed

Bean-Mayberry, Bevanne; Yano, Elizabeth M; Bayliss, Nichole; Navratil, Judith; Weisman, Carol S; Scholle, Sarah Hudson

2007-11-01

Women's healthcare has historically been fragmented, given the artificial separation of reproductive care from general medical care. Aiming to advance new care models for delivery of comprehensive, integrated clinical care for women, two federal agencies-the U.S. Department of Health and Human Services (DHHS) and Department of Veterans Affairs (VA)-launched specialized women's health centers (WHCs). Exemplars of comprehensive service delivery, these originally federally funded centers have served as foundations for innovations in delivering comprehensive care to women in diverse practice settings. Little is known, however, about details of their organization, staffing, practice arrangements, and service availability that might inform adoption of similar models in the community. Using comparable key informant surveys, we collected organizational data from the DHHS National Centers of Excellence (CoE) (n = 13) and the original VA comprehensive WHC's (n = 8). We abstracted supplemental data (e.g., academic affiliation) from the 2001 American Hospital Association (AHA) survey. All DHHS and VA women's health programs served urban areas, and nearly all had academic partnerships. DHHS centers had three times the average caseload as did VA centers. Preventive cancer screening and general reproductive services were uniformly available at all centers, although DHHS centers offered extensive reproductive services on-site more frequently, and VA centers more often had on-site mental healthcare. The DHHS and VA comprehensive WHCs share similar missions and comparable organization, education, and clinical services, demonstrating their commitment to reducing fragmented service delivery. Their common structural components present opportunities for further advancing women's quality of care across other systems of care.

Trends Impacting One Public School Program for Students Who Are Deaf or Hard-of-Hearing

ERIC Educational Resources Information Center

Miller, Kevin J.

2014-01-01

This article reflects on the author's experience supervising a public school program for students who are deaf or hard-of-hearing, specifically addressing national, regional, and local trends affecting it. These trends included teacher efficacy, changes in educational service delivery, advances in technology, the selection of the listening and…

A Bridging Approach to Boost Doctoral Enrollment in a HBCU: An Exploratory Qualitative Study

ERIC Educational Resources Information Center

Birore, Charles M. S.; Wu, Liyun

2017-01-01

A declining enrollment in doctoral social work programs not only affects the sustainability of the programs, but also impacts the knowledge-based economy in the long run. The shortage of doctoral-prepared faculty, interwoven with the current national shortage of social workers, will limit effective service delivery, and generation of knowledge…

Strategies for Community Rehabilitation Programs to Serve Consumers Who Are Deaf, Hard of Hearing, Late Deafened or Deafblind

ERIC Educational Resources Information Center

Faulkner, Gail; Harmon, Marguerite; Johnson, Lynnette; Knopf, Elise; Latz, Rubin; Parnes, Alan; Currie-Richardson, Diane; Sligar, Steven

2004-01-01

This book provides guidance for administrators and service delivery staff of Community Rehabilitation Programs to serve consumers who are deaf, hard of hearing, late deafened or deafblind. This publication follows an outline based on standards from CARF (Commission on Accreditation of Rehabilitation Facilities), the national accrediting agency for…

JTPA Summer Youth Enrichment: A Change Agent Guide. A Technical Assistance and Training Series.

ERIC Educational Resources Information Center

Bruno, A. Lee; Meltzer, Ann S.

This technical assistance guide is intended to aid teachers and trainers in Job Training Partnership Act Service Delivery Area (SDA) summer programs that are components of work force skill development programs for youths. It is aimed especially at SDAs that either are experiencing or anticipating resistance to change from their organizations,…

Head Start Teaching Center: Outcome Evaluation of 3 Years of Participatory Training.

ERIC Educational Resources Information Center

Caruso, D. A.; Horm-Wingerd, D. M.; Golas, J. C.

The New England Head Start Teaching Center (NEHSTC) is one of 14 federally funded programs created to test the efficacy of participatory, hands-on training for enhancing Head Start service delivery. An outcome evaluation of the program was conducted after 3 years of operation. The research design of the evaluation was a nonequivalent comparison…

Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Bridgman, Kate; Onslow, Mark; O'Brian, Susan; Jones, Mark; Block, Susan

2016-01-01

Purpose: Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early…

"SPECDA"-A Comprehensive Approach to the Delivery of Substance Abuse Prevention Services in the New York City School Systems.

ERIC Educational Resources Information Center

Blotner, Roberta; Lilly, Levander

1986-01-01

Evaluates SPECDA (School Program to Educate and Control Drug Abuse) a comprehensive substance abuse prevention program which links drug counselors and police officers in teams to provide drug education. Results indicated significant positive changes in children's knowledge about drugs, attitudes toward drugs, and attitudes toward polic officers…

M-Health, New Prospect for School Health Education through Mobile Technologies at Lebanese School

ERIC Educational Resources Information Center

Jabbour, Khayrazad Kari

2013-01-01

Supporting school health programs to improve the emotionally and physically health status of Lebanese students has never been more important. The use of mobile and wireless technologies to promote school health programs has the potential to transform the school health education and service delivery in Lebanon. This article explores the possibility…

Perceptions of 1987 Master Gardener Participants toward the Use of Satellite Telecommunications for Educational/Extension Delivery.

ERIC Educational Resources Information Center

Eckles, Stephen G.; Miller, W. Wade

The 1987 Master Gardener program was presented at 16 locations in Iowa, where weekday sessions were supplemented with Saturday satellite telecasts. This cooperative extension service program provided special training in horticulture to members of the local community who would then work as volunteers through their local cooperative extension office…

Innovative Service Delivery for Secondary Prevention of PTSD in At-Risk OIF-OEF Service Men and Women

DTIC Science & Technology

2010-04-01

posttraumatic stress disorder ;” “Predictors of patient satisfaction in OIF/OEF veterans receiving behavioral activation/exposure-based treatment for PTSD ...intervention to prevent the functional impairment associated with PTSD and subclinical PTSD in post -deployed OIF/OEF service men and women, and b...month follow up). Programs that reduce traumatic stress symptoms and related functional impairment will have patient, medical system, and military

Improvement in delivery of type 2 diabetes services differs by mode of care: a retrospective longitudinal analysis in the Aboriginal and Torres Strait Islander Primary Health Care setting.

PubMed

Schierhout, Gill; Matthews, Veronica; Connors, Christine; Thompson, Sandra; Kwedza, Ru; Kennedy, Catherine; Bailie, Ross

2016-10-07

Addressing evidence-practice gaps in primary care remains a significant public health challenge and is likely to require action at different levels of the health system. Whilst Continuous Quality Improvement (CQI) is associated with improvements in overall delivery, little is known about delivery of different types of care processes, and their relative improvement during CQI. We used data from over 15,000 clinical audit records of clients with Type 2 diabetes collected as part of a wide-scale CQI program implemented between 2005 and 2014 in 162 Aboriginal and Torres Strait Islander health centres. We abstracted data from clinical records on 15 service items recommended in clinical guidelines and categorised these items into five modes of care on the basis of the mechanism through which care is delivered: laboratory tests; generalist-delivered physical checks; specialist-delivered checks; education/counselling for nutrition and physical activity and education/counselling for high risk substance use. We calculated delivery for each patient for each of mode of care by determining the proportion of recommended services delivered for that mode. We used multilevel regression models to quantify variation attributable to health centre or client level factors and to identify factors associated with greater adherence to clinical guidelines for each mode of care. Clients on average received 43 to 60 % of recommended care in 2005/6. Different modes of care showed different patterns of improvement. Generalist-delivered physical checks (delivered by a non-specialist) showed a steady year on year increase, delivery of laboratory tests showed improvement only in the later years of the study, and delivery of counselling/education interventions showed early improvement which then plateaued. Health centres participating in CQI had increased odds of top quartile service delivery for all modes compared to baseline, but effects differed by mode. Health centre factors explained 20-52 % of the variation across jurisdictions and health centres for different modes of care. Levels of adherence to clinical guidelines and patterns of improvement during participation in a CQI program differed for different modes of care. Policy and funding decisions may have had important effects on the level and nature of improvements achieved.

Interdisciplinary knowledge translation: lessons learned from a mental health: fire service collaboration.

PubMed

Henderson, Joanna L; Mackay, Sherri; Peterson-Badali, Michele

2010-12-01

Collaborative approaches are being increasingly advocated for addressing a variety of health, mental health and social needs for children, youth and families. Factors important for effective knowledge translation of collaborative approaches of service delivery across disciplines, however, have not been rigorously examined. TAPP-C: The Arson Prevention Program for Children is an intervention program for child and adolescent firesetters provided collaboratively by fire service and mental health professionals. The present study examined the adopter, innovation, and dissemination characteristics associated with TAPP-C implementation, protocol adherence and extent of collaboration by 241 community-based fire service professionals from communities across Ontario. Results revealed that dissemination factors are particularly important for understanding program implementation, adherence and cross-discipline collaboration. Moreover, the findings of this study show significant benefits to both within discipline (intra-disciplinary) and across discipline (interdisciplinary) knowledge translation strategies.

Community health workers and mobile technology: a systematic review of the literature.

PubMed

Braun, Rebecca; Catalani, Caricia; Wimbush, Julian; Israelski, Dennis

2013-01-01

In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings. We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services. Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring. Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and rigorous study designs. Programmatic and scientific gaps will need to be addressed by global leaders as they advance the use and assessment of mobile technology tools for community health workers.

Implementation of the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Lee, Nancy C.; Wong, Faye L.; Jamison, Patricia M.; Jones, Sandra F.; Galaska, Louise; Brady, Kevin T.; Wethers, Barbara; Stokes-Townsend, George-Ann

2015-01-01

In 1990, Congress passed the Breast and Cervical Cancer Mortality Prevention Act because of increases in the number of low-income and uninsured women being diagnosed with breast cancer. This act authorized the Centers for Disease Control and Prevention (CDC) to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide high-quality and timely breast and cervical cancer screening and diagnostic services to low-income, uninsured women. The program started in 1991, and, in 1993, Congress amended the act to allow the CDC to fund American Indian and Alaska Native tribes and tribal organizations. By 1996, the program was providing cancer screening across the United States. To ensure appropriate delivery and monitoring of services, the program adopted detailed policies on program management, evidence-based guidelines for clinical services, a systematized clinical data system to track service quality, and key partnerships that expand the program’s reach. The NBCCEDP currently funds 67 programs, including all 50 states, the District of Columbia, 5 US territories, and 11 tribes or tribal organizations. PMID:25099896

Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative

PubMed Central

Krenn, Susan; Cobb, Lisa; Babalola, Stella; Odeku, Mojisola; Kusemiju, Bola

2014-01-01

ABSTRACT Background: The Nigerian Urban Reproductive Health Initiative (NURHI), a 6-year comprehensive family planning program (2009–2015) in 4 cities, intentionally applies communication theories to all program elements, not just the demand generation ones, relying mainly on a theory called ideation—the concept that contraceptive use is influenced by people's beliefs, ideas, and feelings and that changing these ideational factors can change people's behavior. Program Description: The project used multiple communication channels to foster dialogue about family planning, increase social approval for it, and improve accurate knowledge about contraceptives. Mobile service delivery was started in the third year to improve access to clinical methods in slums. Methods: Data from representative baseline (2010–11) and midterm (2012) surveys of women of reproductive age in the project cities were analyzed. We also used propensity score matching to create a statistically equivalent control group of women not exposed to project activities, and we examined service delivery data from NURHI-supported clinics (January 2011–May 2013) to determine the contribution of mobile services to total family planning services. Results: Three years into the initiative, analysis of longitudinal data shows that use of modern contraceptives has increased in each city, varying from 2.3 to 15.5 percentage points, and that the observed increases were predicted by exposure to NURHI activities. Of note is that modern method use increased substantially among the poorest wealth quintiles in project cities, on average, by 8.4 percentage points. The more project activities women were exposed to, the greater their contraceptive use. For example, among women not using a modern method at baseline, contraceptive prevalence among those with no exposure by midterm was 19.1% vs. 43.4% among those with high exposure. Project exposure had a positive dose-response relationship with ideation, as did ideation and contraceptive use. By the end of the observation period, mobile services were contributing nearly 50% of total family planning services provided through NURHI-supported clinics. Propensity score matching found that the increase in contraceptive use in the 4 cities attributable to project exposure was 9.9 percentage points. Intention to use family planning in the next 12 months also increased by 7.5 to 10.2 percentage points across the 4 cities. Conclusion: Demand-led family planning programs, in which demand generation is the driving force behind the design rather than the conventional, service delivery-oriented approach, may be more suitable in places where expressed demand for contraceptives is low. PMID:25611477

Implementing program-wide awareness about recovery in a large mental health and addictions program.

PubMed

McVanel-Viney, Sarah; Younger, Jodi; Doyle, Winnie; Kirkpatrick, Helen

2006-01-01

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.

Multi-objective optimization to evaluate tradeoffs among forest ecosystem services following fire hazard reduction in the Deschutes National Forest, USA

Treesearch

Svetlana A. (Kushch) Schroder; Sandor F. Toth; Robert L. Deal; Gregory J. Ettl

2016-01-01

Forest owners worldwide are increasingly interested in managing forests to provide a broad suite of Ecosystem services, balancing multiple objectives and evaluating management activities in terms of Potential tradeoffs. We describe a multi-objective mathematical programming model to quantify tradeoffs in expected sediment delivery and the preservation of Northern...

Demographic, Clinical, and Geographic Predictors of Placement Disruption among Foster Care Youth Receiving Wraparound Services

ERIC Educational Resources Information Center

Weiner, Dana A.; Leon, Scott C.; Stiehl, Michael J.

2011-01-01

The effective delivery of wraparound depends upon the availability of a wide range of community-based services. This study seeks to determine the impact of proximity to resources on the effectiveness of a wraparound program for stabilizing foster care placements among a sample of youth. We present a methodology for deriving proximity scores for…

Coast Guard Deepwater Acquisition Programs: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-12-23

NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional Research Service,Library of Congress...Northrop Grumman Ship Systems ( NGSS ). ICGS was awarded an indefinite delivery, indefinite quantity (ID/IQ) contract for the Deepwater program that...sustainment is not a Deepwater program but is displayed to align with the FY2009 Consolidated Security, Disaster Assistance, and Continuing Appropriations

Accountable Care Organizations: roles and opportunities for hospitals.

PubMed

Schoenbaum, Stephen C

2011-08-01

Federal health reform has established Medicare Accountable Care Organizations (ACOs) as a new program, and some states and private payers have been independently developing ACO pilot projects. The objective is to hold provider groups accountable for the quality and cost of care to a population. The financial models for providers generally build off of shared savings between the payers and providers or some type of global payment that includes the possibility of partial or full capitation. For ACOs to achieve the same outcomes with lower costs or, better yet, improved outcomes with the same or lower costs, the delivery system will need to become more oriented toward primary care and care coordination than is currently the case. Providers of clinical services, in order to be more effective, efficient, and coordinated, will need to be supported by a variety of shared services, such as off-hours care, easy access to specialties, and information exchanges. These services can be organized by an ACO as a medical neighborhood or community. Hospitals, because they have a management structure, history of developing programs and services, and accessibility 24/7/365, are logical leaders of this enhancement of health care delivery for populations and other providers.

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

Uptake of the MedsCheck annual medication review service in Ontario community pharmacies between 2007 and 2013

PubMed Central

Dolovich, Lisa; Consiglio, Giulia; MacKeigan, Linda; Abrahamyan, Lusine; Pechlivanoglou, Petros; Rac, Valeria E.; Pojskic, Nedzad; Bojarski, Elizabeth A.; Su, Jiandong; Krahn, Murray; Cadarette, Suzanne M.

2016-01-01

Background: MedsCheck Annual (MCA) is an Ontario government-funded medication review service for individuals taking 3 or more prescription medications for chronic conditions. Methods: This cohort study analyzed linked administrative claims data from April 1, 2007, to March 31, 2013. Trends in MCA claims and recipient characteristics were examined. Results: A total of 1,498,440 Ontarians (55% seniors, 55% female) received an MCA. One-third (36%) had 2 or more MCAs within 6 years. Service provision increased over time, with a sharper increase from 2010 onward. Almost half of Ontario pharmacies made at least 1 MCA claim in the first month of the program. Hypertension, respiratory disease, diabetes, psychiatric conditions and arthritis were common comorbidities. Recipients older than 65 years were most commonly dispensed an antihypertensive and/or antihyperlipidemic drug in the prior year and received an average of 11 unique prescription medications. Thirty-eight percent of recipients visited an emergency department or were hospitalized in the year prior to their first MCA. Discussion: Over the first 6 years of the program, approximately 1 in 9 Ontarians received an MCA. There was rapid and widespread uptake of the service. Common chronic conditions were well represented among MCA recipients. Older MCA recipients had less emergency department use compared with population-based estimates. Conclusions: Medication reviews increased over time; however, the number of persons receiving the service more than once was low. Service delivery was generally consistent with program eligibility; however, there are some findings possibly consistent with delivery to less complex patients. PMID:27708675

City of San Antonio, Texas Better Buildings Program

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

Meyer, Liza C.; Hammer, Mary C.

2014-06-30

The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

16 CFR 4.4 - Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

...). Service under this provision is complete upon delivery by the Post Office or upon personal delivery. (3... counsel, service shall be by personal delivery (including delivery by courier) or delivery by first-class... association, to an officer or agent authorized to accept service of process therefor. Personal service...

16 CFR 4.4 - Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

...). Service under this provision is complete upon delivery by the Post Office or upon personal delivery. (3... counsel, service shall be by personal delivery (including delivery by courier) or delivery by first-class... association, to an officer or agent authorized to accept service of process therefor. Personal service...

16 CFR 4.4 - Service.

Code of Federal Regulations, 2010 CFR

2010-01-01

...). Service under this provision is complete upon delivery by the Post Office or upon personal delivery. (3... counsel, service shall be by personal delivery (including delivery by courier) or delivery by first-class... association, to an officer or agent authorized to accept service of process therefor. Personal service...

16 CFR 4.4 - Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

...). Service under this provision is complete upon delivery by the Post Office or upon personal delivery. (3... counsel, service shall be by personal delivery (including delivery by courier) or delivery by first-class... association, to an officer or agent authorized to accept service of process therefor. Personal service...

16 CFR 4.4 - Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

...). Service under this provision is complete upon delivery by the Post Office or upon personal delivery. (3... counsel, service shall be by personal delivery (including delivery by courier) or delivery by first-class... association, to an officer or agent authorized to accept service of process therefor. Personal service...

The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People.

PubMed

Knight, Alice; Havard, Alys; Shakeshaft, Anthony; Maple, Myfanwy; Snijder, Mieke; Shakeshaft, Bernie

2017-02-20

There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. The youth service is a rural based NGO comprised of multiple program components: (i) engagement activities; (ii) case management; (iii) diversionary activities; (iv) personal development; and (v) learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service's existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation, and involvement in crime or with the juvenile justice system. All but one participant experienced at least two co-occurring domains of risk, and the majority of participants (58%) experienced co-occurring risk across four domains. This is the first study to demonstrate that best-evidence measures can feasibly be embedded into the routine data collection processes of a service for high-risk young people. This process allows services to tailor their activities to the most prevalent risks experienced by participants, and monitor these risks over time. Replication of this process in other services would improve the quality of services, facilitate more high quality evaluations of services, and contribute evidence on how to improve outcomes for high-risk young people.

Designing for International Teletraining.

ERIC Educational Resources Information Center

Chute, Alan G.; Shatzer, Linda S.

The ability to bridge together geographically-distant populations for training is made possible through teletraining, a human performance system which integrates telecommunications into the planning, design, and delivery of training programs. Typically, teletraining uses standard telephone lines or digital communication services to provide…

47 CFR 101.803 - Frequencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Service may be assigned frequencies listed in §§ 74.602(a), 78.18(a)(6), and 78.18(a)(7) of this chapter... operations permitted. Use of this spectrum for direct delivery of video programs to the general public or for...

47 CFR 101.803 - Frequencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Service may be assigned frequencies listed in §§ 74.602(a), 78.18(a)(6), and 78.18(a)(7) of this chapter... operations permitted. Use of this spectrum for direct delivery of video programs to the general public or for...

47 CFR 101.803 - Frequencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Service may be assigned frequencies listed in §§ 74.602(a), 78.18(a)(6), and 78.18(a)(7) of this chapter... operations permitted. Use of this spectrum for direct delivery of video programs to the general public or for...

47 CFR 101.803 - Frequencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Service may be assigned frequencies listed in §§ 74.602(a), 78.18(a)(6), and 78.18(a)(7) of this chapter... operations permitted. Use of this spectrum for direct delivery of video programs to the general public or for...

47 CFR 101.803 - Frequencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Service may be assigned frequencies listed in §§ 74.602(a), 78.18(a)(6), and 78.18(a)(7) of this chapter... operations permitted. Use of this spectrum for direct delivery of video programs to the general public or for...

Integrating cervical cancer with HIV healthcare services: A systematic review

PubMed Central

Sigfrid, Louise; Murphy, Georgina; Haldane, Victoria; Chuah, Fiona Leh Hoon; Ong, Suan Ee; Cervero-Liceras, Francisco; Watt, Nicola; Alvaro, Alconada; Otero-Garcia, Laura; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; Mckee, Martin; Piot, Peter; Perel, Pablo

2017-01-01

Background Cervical cancer is a major public health problem. Even though readily preventable, it is the fourth leading cause of death in women globally. Women living with HIV are at increased risk of invasive cervical cancer, highlighting the need for access to screening and treatment for this population. Integration of services has been proposed as an effective way of improving access to cervical cancer screening especially in areas of high HIV prevalence as well as lower resourced settings. This paper presents the results of a systematic review of programs integrating cervical cancer and HIV services globally, including feasibility, acceptability, clinical outcomes and facilitators for service delivery. Methods This is part of a larger systematic review on integration of services for HIV and non-communicable diseases. To be considered for inclusion studies had to report on programs to integrate cervical cancer and HIV services at the level of service delivery. We searched multiple databases including Global Health, Medline and Embase from inception until December 2015. Articles were screened independently by two reviewers for inclusion and data were extracted and assessed for risk of bias. Main results 11,057 records were identified initially. 7,616 articles were screened by title and abstract for inclusion. A total of 21 papers reporting interventions integrating cervical cancer care and HIV services met the criteria for inclusion. All but one study described integration of cervical cancer screening services into existing HIV services. Most programs also offered treatment of minor lesions, a ‘screen-and-treat’ approach, with some also offering treatment of larger lesions within the same visit. Three distinct models of integration were identified. One model described integration within the same clinic through training of existing staff. Another model described integration through co-location of services, with the third model describing programs of integration through complex coordination across the care pathway. The studies suggested that integration of cervical cancer services with HIV services using all models was feasible and acceptable to patients. However, several barriers were reported, including high loss to follow up for further treatment, limited human-resources, and logistical and chain management support. Using visual screening methods can facilitate screening and treatment of minor to larger lesions in a single ‘screen-and-treat’ visit. Complex integration in a single-visit was shown to reduce loss to follow up. The use of existing health infrastructure and funding together with comprehensive staff training and supervision, community engagement and digital technology were some of the many other facilitators for integration reported across models. Conclusions This review shows that integration of cervical cancer screening and treatment with HIV services using different models of service delivery is feasible as well as acceptable to women living with HIV. However, the descriptive nature of most papers and lack of data on the effect on long-term outcomes for HIV or cervical cancer limits the inference on the effectiveness of the integrated programs. There is a need for strengthening of health systems across the care continuum and for high quality studies evaluating the effect of integration on HIV as well as on cervical cancer outcomes. PMID:28732037

Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

PubMed Central

Spindler, Esther; Bitar, Nisreen; Solo, Julie; Menstell, Elizabeth; Shattuck, Dominick

2017-01-01

Health practitioners, researchers, and donors are stumped about Jordan's stalled fertility rate, which has stagnated between 3.7 and 3.5 children per woman from 2002 to 2012, above the national replacement level of 2.1. This stall paralleled United States Agency for International Development (USAID) funding investments in family planning in Jordan, triggering an assessment of USAID family planning programming in Jordan. This article describes the methods, results, and implications of the programmatic assessment. Methods included an extensive desk review of USAID programs in Jordan and 69 interviews with reproductive health stakeholders. We explored reasons for fertility stagnation in Jordan's total fertility rate (TFR) and assessed the effects of USAID programming on family planning outcomes over the same time period. The assessment results suggest that the increased use of less effective methods, in particular withdrawal and condoms, are contributing to Jordan's TFR stall. Jordan's limited method mix, combined with strong sociocultural determinants around reproduction and fertility desires, have contributed to low contraceptive effectiveness in Jordan. Over the same time period, USAID contributions toward increasing family planning access and use, largely focused on service delivery programs, were extensive. Examples of effective initiatives, among others, include task shifting of IUD insertion services to midwives due to a shortage of female physicians. However, key challenges to improved use of family planning services include limited government investments in family planning programs, influential service provider behaviors and biases that limit informed counseling and choice, pervasive strong social norms of family size and fertility, and limited availability of different contraceptive methods. In contexts where sociocultural norms and a limited method mix are the dominant barriers toward improved family planning use, increased national government investments toward synchronized service delivery and social and behavior change activities may be needed to catalyze national-level improvements in family planning outcomes. PMID:29284697

Federal expenditures on maternal and child health in the United States.

PubMed

Kenney, Mary Kay; Kogan, Michael D; Toomer, Stephanie; van Dyck, Peter C

2012-02-01

The goals of this study are to estimate federal maternal and child health (MCH) expenditures and identify their sources. This analysis is intended to provide a broad view of MCH funding appropriations and a basis for discussion of whether funds could be better utilized for the benefit of the population served. Data on federal maternal and child health expenditures for fiscal year (FY) 2006 were derived from examining federal legislation, department/agency budgets, and various web-based program documents posted by federal agencies. Based on selected criteria, we identified programs targeting children under 21 or pregnant/parenting women within the United States. The funding levels of agency programs for maternal and child health activities were determined and the programs briefly summarized. The identifiable funding for maternal and child health programs in FY 2006 approached $57.5 billion dollars. Funding sources for maternal and child health were concentrated within the U.S. Department of Health and Human Services, but spread across several different agencies within the department and in the Departments of Defense, Education, Agriculture, Housing and Urban Development, and the Environmental Protection Agency. Multiple agencies and offices often funded related activities, without evidence of a common underlying strategy. Federal maternal and child health funding mechanisms may lead to a fragmentation in maternal and child health activities. The funding and service delivery apparatus would benefit from an integrative MCH infrastructure approach to pediatric research, service delivery, and data collection/access that incorporates life-course and social/environmental determinants perspectives.

The Mobile Reference Service: a case study of an onsite reference service program at the School of Public Health.

PubMed

Tao, Donghua; McCarthy, Patrick G; Krieger, Mary M; Webb, Annie B

2009-01-01

The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver on-site information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health.

The India Local Initiatives Program: a model for expanding reproductive and child health services.

PubMed

Paxman, John M; Sayeed, Abu; Buxbaum, Ann; Huber, Sallie Craig; Stover, Charles

2005-09-01

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government's reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. The program established health committees in 620 villages, recruited and trained 1,850 community health volunteers, and added 232 sites to extend government services. Using three strategies--demand creation, increased access to services, and local capacity building--the NGOs increased contraceptive-use rates by 78 percent, on average; child immunizations by 67 percent; and antenatal care by 78 percent among the populations served. Community resources--such as local health personnel, community-supplied clinic sites, and community drug funds--added 40 cents to every dollar provided by donors. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services.

The Mobile Reference Service: a case study of an onsite reference service program at the school of public health*

PubMed Central

Tao, Donghua; McCarthy, Patrick G.; Krieger, Mary M.; Webb, Annie B.

2009-01-01

The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver onsite information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health. PMID:19159004

Prenatal nutrition services: a cost analysis.

PubMed

Splett, P L; Caldwell, H M; Holey, E S; Alton, I R

1987-02-01

The scarcity of information about program costs in relation to quality care prompted a cost analysis of prenatal nutrition services in two urban settings. This study examined prenatal nutrition services in terms of total costs, per client costs, per visit costs, and cost per successful outcome. Standard cost-accounting principles were used. Outcome measures, based on written quality assurance criteria, were audited using standard procedures. In the studied programs, nutrition services were delivered for a per client cost of $72 in a health department setting and $121 in a hospital-based prenatal care program. Further analysis illustrates that total and per client costs can be misleading and that costs related to successful outcomes are much higher. The three levels of cost analysis reported provide baseline data for quantifying the costs of providing prenatal nutrition services to healthy pregnant women. Cost information from these cost analysis procedures can be used to guide adjustments in service delivery to assure successful outcomes of nutrition care. Accurate cost and outcome data are necessary prerequisites to cost-effectiveness and cost-benefit studies.

A framework for monitoring social process and outcomes in environmental programs.

PubMed

Chapman, Sarah

2014-12-01

When environmental programs frame their activities as being in the service of human wellbeing, social variables need to be integrated into monitoring and evaluation (M&E) frameworks. This article draws upon ecosystem services theory to develop a framework to guide the M&E of collaborative environmental programs with anticipated social benefits. The framework has six components: program need, program activities, pathway process variables, moderating process variables, outcomes, and program value. Needs are defined in terms of ecosystem services, as well as other human needs that must be addressed to achieve outcomes. The pathway variable relates to the development of natural resource governance capacity in the target community. Moderating processes can be externalities such as the inherent capacity of the natural system to service ecosystem needs, local demand for natural resources, policy or socio-economic drivers. Internal program-specific processes relate to program service delivery, targeting and participant responsiveness. Ecological outcomes are expressed in terms of changes in landscape structure and function, which in turn influence ecosystem service provision. Social benefits derived from the program are expressed in terms of the value of the eco-social service to user-specified goals. The article provides suggestions from the literature for identifying indicators and measures for components and component variables, and concludes with an example of how the framework was used to inform the M&E of an adaptive co-management program in western Kenya. Copyright © 2014 Elsevier Ltd. All rights reserved.

Manage Hydrologic Fluxes Instead of Land Cover in Watershed Services Projects

NASA Astrophysics Data System (ADS)

Brauman, K. A.; Ponette-González, A. G.; Marin-Spiotta, E.; Farley, K. A.; Weathers, K. C.; Young, K. R.; Curran, L. M.

2014-12-01

Payments for Watershed Services (PWS), Water Funds, and other payment schemes intended to increase the delivery of hydrologic ecosystem services have great potential for ensuring water resources for downstream beneficiaries while improving livelihoods for upstream residents. However, it is often ambiguous which land-management options should be promoted to enhance watershed service delivery. In many watershed investment programs, specific land covers are promoted as proxies for water service delivery. This approach is based on assumed relationships between land cover and water service outcomes. When land cover does not sufficiently describe ecosystem characteristics that affect water flow, however, desired water services may not be delivered. The use of land cover proxies is especially problematic for watershed investments in the tropics, where many projects are located, because these proxies rely on generalizations about landscape hydrology established for temperate zones. Based on an extensive review of hydrologic fluxes in the high-elevation tropics, we argue that direct management of hydrologic fluxes is a good design for achieving quantifiable results. We use case studies from sites in the Caribbean and Latin American tropics to illustrate how designers of watershed payment projects can manage hydrologic fluxes. To do so, projects must explicitly articulate the water service of interest based on the specific social setting. Projects must also explicitly account for the particulars of the geographic setting. Finally, outcomes must be assessed relative to water services delivered under an alternative land use or land cover scenario.

High-Skill Training: Grants from H-1B Visa Fees Meet Specific Workforce Needs, But at Varying Skill Levels. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Education, Workforce, and Income Security Issues.

A study examined the skill grant and scholarship grant programs. Findings indicated skill grantees offered training through various service delivery options to people needing skill upgrading; scholarship grantees provided scholarships to low income students for college degree programs in computer science, mathematics, and engineering. The skill…

An Alternative Curriculum Model for Urban Education and Community Affairs Programs in Higher Education. Working Paper No. 103.

ERIC Educational Resources Information Center

Simmons, Ron

This document describes the urban education program at William Paterson College of New Jersey. Urban education is defined as educating people for living and in coping with an urban environment, including politics, crime and drug prevention, and delivery of services to cities. Some problems in urban education are identified as weak…

Assisting Scientific and Technical Research Through Subject Oriented Bibliographies of NTIS Reports.

ERIC Educational Resources Information Center

Schwarzwalder, Robert N., Jr.

A program combining cost-free searching of the National Technical Information Service (NTIS) database and document delivery to faculty members was offered at the Kansas State University Libraries. NTIS report usage was monitored from May 1987, five months prior to the onset of the study, until May 1988, at which time the program was terminated.…

A Well Walked Path to Program Efficacy: The Details Tell the Story

ERIC Educational Resources Information Center

Bruder, Mary Beth

2011-01-01

When the author attended an Individualized Education Program (IEP) meeting for the 3-year-old son of a friend, she met a preschool service delivery team that was struggling to design interventions for a growing population of children being diagnosed with Autism Spectrum Disorder (ASD). It is within the context of this struggle that she was so…

Naval Postgraduate School Fact Book 2004

DTIC Science & Technology

2004-01-01

education to other nations. NPS develops new educational programs, explores different delivery methods and modifies its existing programs to meet the...leadership and the right organizational structure are needed to prepare warriors for the challenges of the future battlespace. To develop the ideas...the rapidly changing needs of the national security. Opportunities for faculty development are available in areas important to the Naval services

A Critical Meta-Analysis of All Evaluations of State-Funded Preschool from 1977 to 1998: Implications for Policy, Service Delivery and Program Evaluation.

ERIC Educational Resources Information Center

Gilliam, Walter S.; Zigler, Edward F.

2000-01-01

Presents a meta-analytic review of evaluations of state-funded preschool programs over 20 years. Identifies several methodological flaws but also suggests that pattern of findings offers modest support for positive impact in improving children's developmental competence, improving later school attendance and performance, and reducing subsequent…

Public finance policy strategies to increase access to preconception care.

PubMed

Johnson, Kay A

2006-09-01

Policy and finance barriers reduce access to preconception care and, reportedly, limit professional practice changes that would improve the availability of needed services. Millions of women of childbearing age (15-44) lack adequate health coverage (i.e., uninsured or underinsured), and others live in medically underserved areas. Service delivery fragmentation and lack of professional guidelines are additional barriers. This paper reviews barriers and opportunities for financing preconception care, based on a review and analysis of state and federal policies. We describe states' experiences with and opportunities to improve health coverage, through public programs such as Medicaid, Medicaid waivers, and the State Children's Health Insurance Program (SCHIP). The potential role of Title V and of community health centers in providing primary and preventive care to women also is discussed. In these and other public health and health coverage programs, opportunities exist to finance preconception care for low-income women. Three major policy directions are discussed. To increase access to preconception care among women of childbearing age, the federal and state governments have opportunities to: (1) improve health care coverage, (2) increase the supply of publicly subsidized health clinics, and (3) direct delivery of preconception screening and interventions in the context of public health programs.

Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics.

PubMed

Erickson, Steven R; Workman, Paul

2014-01-01

To document the availability of selected pharmacy services and out-of-pocket cost of medication throughout a diverse county in Michigan and to assess possible associations between availability of services and price of medication and characteristics of residents of the ZIP codes in which the pharmacies were located. Cross-sectional telephone survey of pharmacies coupled with ZIP code-level census data. 503 pharmacies throughout the 63 ZIP codes of Wayne County, MI. The out-of-pocket cost for a 30 days' supply of levothyroxine 50 mcg and brand-name atorvastatin (Lipitor-Pfizer) 20 mg, availability of discount generic drug programs, home delivery of medications, hours of pharmacy operation, and availability of pharmacy-based immunization services. Census data aggregated at the ZIP code level included race, annual household income, age, and number of residents per pharmacy. The overall results per ZIP code showed that the average cost for levothyroxine was $10.01 ± $2.29 and $140.45 + $14.70 for Lipitor. Per ZIP code, the mean (± SD) percentages of pharmacies offering discount generic drug programs was 66.9% ± 15.0%; home delivery of medications was 44.5% ± 22.7%; and immunization for influenza was 46.7% ± 24.3% of pharmacies. The mean (± SD) hours of operation per pharmacy per ZIP code was 67.0 ± 25.2. ZIP codes with higher household income as well as higher percentage of residents being white had lower levothyroxine price, greater percentage of pharmacies offering discount generic drug programs, more hours of operation per week, and more pharmacy-based immunization services. The cost of Lipitor was not associated with any ZIP code characteristic. Disparities in the cost of generic levothyroxine, the availability of services such as discount generic drug programs, hours of operation, and pharmacy-based immunization services are evident based on race and household income within this diverse metropolitan county.

Prescribed burning

Treesearch

James D. Haywood; Finis Harris

2002-01-01

This presentation on prescribed burning is a cooperative effort of the USDA Forest Service, Southern Research Station and Kisatchie National Forest; Louisiana State University Agricultural Center; and the Joint Fire Science Program. The CD includes three methods of delivery: slides, Power Point presentation, and script only.

75 FR 43178 - Medicare Program; Solicitation for Proposals for the Medicare Imaging Demonstration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

..., medical specialty societies, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, and... societies. The Centers for Medicare & Medicaid Services (CMS) worked with medical specialty societies and...

Planning and Implementing Augmentative Communication Service Delivery, 2: Proceedings of the National Planners Conference on Assistive Device Service Delivery.

ERIC Educational Resources Information Center

Coston, Caroline A., Ed.

The document consists of 30 author contributed chapters concerned with augmentative communication service delivery. Chapter titles and authors are: "Communication Options for Persons Who Cannot Speak: Planning for Service Delivery" (David Beukelman); "Planning Service Delivery Systems" (Roland Hahn II); "Planning Ohio's…

Planning, implementing, and evaluating a program to address the oral health needs of aboriginal children in port augusta, australia.

PubMed

Parker, E J; Misan, G; Shearer, M; Richards, L; Russell, A; Mills, H; Jamieson, L M

2012-01-01

Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children's dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.

NERMLS: The First Year *

PubMed Central

Colby, Charles C.; Bloomquist, Harold; Hodges, T. Mark

1969-01-01

The Countway Library, Boston, was the nation's first Regional Medical Library under the Regional Medical Library Program of the NLM. New England Regional Medical Library Service (NERMLS) began in October 1967 and is the outgrowth of traditional extramural services of the Harvard and Boston Medical Libraries (constituents of the Countway). During the first year over 27,000 requests were received of which 84 percent were filled. Some problems of document delivery (and their solution) are recounted. Other activities were: a limited amount of reference work; distribution of a Serials List; and planning for a region-wide medical library service. Proposals call for consultation and education, regional reference service, and improved document delivery service. Emphasis is placed on the role of the Community Hospital as a center for continuing education and the need to strengthen and assist hospital medical libraries. With the Postgraduate Medical Institute, Boston, NERMLS assisted in the compilation of a small physician-selected medical Core Collection which would serve as a minimum standard collection for community hospital libraries. PMID:5823504

Changes in North Carolina maternal health service use and outcomes among medicaid-enrolled pregnant women during state budget cuts.

PubMed

Cilenti, Dorothy; Kum, Hye-Chung; Wells, Rebecca; Whitmire, J Timothy; Goyal, Ravi K; Hillemeier, Marianne M

2015-01-01

The recent recession has weakened the US health and human service safety net. Questions about implications for mothers and children prompted this study, which tested for changes in maternal service use and outcomes among North Carolina women with deliveries covered through Medicaid before and after a year of significant state budget cuts. Data for Medicaid covered deliveries from April-June 2009 (pre) and from April-June 2010 (post) were derived from birth certificates, Medicaid claims and eligibility files, and WIC (Special Supplemental Food Program for Women, Infants and Children) records. These time periods represent the quarter immediately before as well as the final quarter of a state fiscal year 2010 (July 2009-June 2010) characterized by substantial state budget cuts, including an October 2009 reduction in reimbursement rates for maternity care coordination. We examined how often women received medical care, maternity care coordination, family planning services, and the average numbers of obstetrical encounters, as well as the prevalence of excessive pregnancy weight gain, preterm delivery, and low birth weight. By the end of a year of substantial state budget cuts, women covered through Medicaid had fewer obstetrical visits in all trimesters as well as postpartum (P < .001). Maternal weight gain, preterm delivery, and low birth weight were stable. One key aspect of medical service use decreased for women enrolled in Medicaid by the end of a year of major state health and human services budget cuts. Maternal and infant child health outcomes measured in this study did not change during that year. Future monitoring is warranted to ensure that maternal health service access remains adequate.

The SBIRT program matrix: a conceptual framework for program implementation and evaluation.

PubMed

Del Boca, Frances K; McRee, Bonnie; Vendetti, Janice; Damon, Donna

2017-02-01

Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes. Overview and narrative description of the SBIRT Program Matrix. The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance. The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts. © 2017 Society for the Study of Addiction.

Implementing guidelines: Proposed definitions of neuropsychology services in pediatric oncology.

PubMed

Baum, Katherine T; Powell, Stephanie K; Jacobson, Lisa A; Gragert, Marsha N; Janzen, Laura A; Paltin, Iris; Rey-Casserly, Celiane M; Wilkening, Greta N

2017-08-01

Several organizations have published guidelines for the neuropsychological care of survivors of childhood cancer. However, there is limited consensus in how these guidelines are applied. The model of neuropsychology service delivery is further complicated by the variable terminology used to describe recommended services. In an important first step to translate published guidelines into clinical practice, this paper proposes definitions for specific neuropsychological processes and services, with the goal of facilitating consistency across sites to foster future clinical program development and to clarify clinical practice guidelines. © 2017 Wiley Periodicals, Inc.

Non-communicable diseases and HIV care and treatment: models of integrated service delivery.

PubMed

Duffy, Malia; Ojikutu, Bisola; Andrian, Soa; Sohng, Elaine; Minior, Thomas; Hirschhorn, Lisa R

2017-08-01

Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunodeficiency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. We describe models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identified integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. © 2017 John Wiley & Sons Ltd.

Lessons from the first two years of Project Heartland, Oklahoma's mental health response to the 1995 bombing.

PubMed

Call, J A; Pfefferbaum, B

1999-07-01

On April 19, 1995, a terrorist bombing in Oklahoma City killed 168 people and injured 853 others. The Oklahoma Department of Mental Health and Substance Abuse Services was the lead agency in crafting a community mental health response to reduce impairment of those affected. The Project Heartland program, which opened on May 15, 1995, was the first community mental health program in the U.S. designed to intervene in the short to medium term with survivors of a major terrorist event. The authors describe lessons learned in the areas of planning and service delivery, as well as the types and extent of services provided in the project's first two years.

The association of prenatal nutrition and educational services with low birth weight rates in a Florida program.

PubMed Central

Taren, D L; Graven, S N

1991-01-01

Nutrition services and education, provided as components of normal prenatal care, have a key role in preventing preterm delivery and low birth weight (LBW). To determine the influence of these components on a woman's risk of having a LBW infant, the authors examined groups of patients who were receiving the services. Bivariate analyses were made of 9,024 prenatal charts of single births. Most women received nutrition education, prescriptions for nutrient supplements, screenings for anemia, and dietary assessments. A greater proportion of the women at high risk received the interventions than did women at lower risk. The presence of educational components and assays for anemia were associated with a lower risk of a LBW delivery in the total group and in the high risk groups. PMID:1908594

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

Cultural and linguistic barriers to mental health service access: the deaf consumer's perspective.

PubMed

Steinberg, A G; Sullivan, V J; Loew, R C

1998-07-01

The authors investigated knowledge, attitudes, and beliefs about mental illness and providers held by a group of deaf adults. The American Sign Language interviews of 54 deaf adults were analyzed. Recurrent themes included mistrust of providers, communication difficulty as a primary cause of mental health problems, profound concern with communication in therapy, and widespread ignorance about how to obtain services. Deaf consumers' views need due consideration in service delivery planning. Outreach regarding existing programs is essential.

It Takes Two.

ERIC Educational Resources Information Center

Ballard, Ken

2000-01-01

Discusses planning points when negotiating joint ventures for designing public recreational facilities. The obstacle and impact of money in the negotiations is examined as are handling the definition of operational responsibilities, personnel and maintenance, program and service delivery, and progress of the partnership and facility itself. (GR)

Job Change: A Practitioner's View.

ERIC Educational Resources Information Center

Lenz, Janet G.; Reardon, Robert C.

1990-01-01

Suggests ways that career counselors can use Loughead and Black's "job change thermostat" in working with clients. Program and policy issues include service delivery settings, crisis-oriented versus long-term client needs, individual versus group approaches, staff competence, and availability of resources. (34 references) (SK)