Sample records for area community health

  1. Cohort profile: the Boston Area Community Health (BACH) survey. (United States)

    Piccolo, Rebecca S; Araujo, Andre B; Pearce, Neil; McKinlay, John B


    The Boston Area Community Health (BACH) Survey is a community-based, random sample, epidemiologic cohort of n = 5502 Boston (MA) residents. The baseline BACH Survey (2002-05) was designed to explore the mechanisms conferring increased health risks on minority populations with a particular focus on urologic signs/symptoms and type 2 diabetes. To this end, the cohort was designed to include adequate numbers of US racial/ethnic minorities (Black, Hispanic, White), both men and women, across a broad age of distribution. Follow-up surveys were conducted ∼5 (BACH II, 2008) and 7 (BACH III, 2010) years later, which allows for both within- and between-person comparisons over time. The BACH Survey's measures were designed to cover the following seven broad categories: socio-demographics, health care access/utilization, lifestyles, psychosocial factors, health status, physical measures and biochemical parameters. The breadth of measures has allowed BACH researchers to identify disparities and quantify contributions to social disparities in a number of health conditions including urologic conditions (e.g. nocturia, lower urinary tract symptoms, prostatitis), type 2 diabetes, obesity, bone mineral content and density, and physical function. BACH I data are available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories ( Further inquiries can be made through the New England Research Institutes Inc. website (

  2. [The cultural aspects of the practice of Community Health Agents in rural areas]. (United States)

    Lara, Maristela Oliveira; Brito, Maria José Menezes; Rezende, Lilian Cristina


    The daily practice of Community Health Agents (CHAs) is permeated with educational interventions aimed at preventive care and health promotion. The sociocultural universe of these professionals can affect the dynamics of their practice within the community, particularly in rural areas, where there is evidence that the population expects to obtain information relative to their health and/or disease by means of cultural rites. Based on a case study, we sought to analyze the influence of the cultural practices of the agents working in a rural area in the interior of the state of Minas Gerais. The analysis revealed the presence of a strong connection between the culture and their activities. Religious beliefs and knowledge developed from the fusion of biomedical information and values based on family tradition regarding the health-disease process have a direct effect on their practices. It is emphasized that they have an important role as facilitators in the practice of health care, with a positive effect stemming from the similarity of their life experiences and inherited cultures with those of the clients, thus making it possible to develop effective interventions.

  3. Oral Health in Rural Communities (United States)

    ... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...


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    Ali A.Alemi


    Full Text Available The health status of the rural community under the study is measured in terms of vital statistics, and living conditions in relation to demographic data. The findings reveal that this rural population can be considered a very unhealthy one. For instance, the infant mortality rate is 98.4 per 1000 live births, and 80.0 per cent of the total population were found to be infected by one or more parasitic diseases. Allocation of resources has been recommended to raise the standard of living, in order to bring about a better hygienic environment. Accessibility of health services through expansion of primary health care, and in this sphere the use of health auxiliaries should yet again receive special consideration.

  5. An analysis of topic areas and topic trends in the Community Mental Health Journal from 1965 through 1977. (United States)

    Lounsbury, J W; Roisum, K G; Pokorny, L; Sills, A; Meissen, G J


    A content analysis of all (N = 604) published articles in the Community Mental Health Journal from 1965 through 1977 was performed (a) to provide a cross-sectional view of the community mental health field, and (b) to identify topic trends over time. Sixty-one content categories were used to classify topic areas. Results revealed major and growing emphases on organizing for the delivery and measuring of the effects of mental health service systems. Topics found to be increasing in relative frequency over time included training, measurement and research methodology, and intervention; those decreasing included planning and needs assessment, therapy, and suicide. Topic areas were compared with key characteristics of the field. Topic trends were interpreted in terms of open systems theory.

  6. Perceived ill-health and health seeking behavior in two communities in the nam theun 2 hydroelectric project area in Lao People's Democratic Republic

    Institute of Scientific and Technical Information of China (English)

    Sayasone S; Erlanger TE; Kaul S; Sananikhom P; Tanner M; Utzinger J; Odermatt P


    Objective:To compare perceived ill-health and health seeking behavior between two communities affected by the large Nam Theun 2 hydroelectric project in central Lao People's Democratic Republic (PDR).Methods:Two different affected areas:Nakai plateaubeing remote,sparcely populated and mountainous,and Xe Bang Fai lowland plains,more densely populated and comparatively affluent were included.Data were obtained from two cross-sectional household-based health and socio-economic surveys.Results:We found pronounced differ-ences in the frequency of self-reported fever,cough,headache and myalgia according to location.On the Na-kai plateau,45.1 % of the individuals with ill-health report (recall period:2 weeks)went to a local health volunteer compared to only 7.2 % in the Xe Bang Fai area (P <0.001).In Nakai,there were disproportion-ately more illiterates seeking help from local health volunteers when compared to those who attended at least primary schooling (49.2 % versus 17.5 %,P <0.01).Self-medication with antimalarials was more common in Xe Bang Fai than on Nakai (32.3 % versus 7.0 %,P <0.001).The mean amount of money spent per health consultation was US $1.7 in Nakai and US $7.2 in Xe Bang Fai.Conclusion:The observed differ-ences in self-reported ill-health and health seeking behavior among these two Lao communities need to be con-sidered when implementing setting-specific mitigation measures as part of the public health action plan of the Nam Theun 2 hydroelectric project.

  7. Re-thinking community health work in rural areas: Lessons from existing informal helping frameworks in Uganda

    NARCIS (Netherlands)

    Turinawe, E.B.


    Government of Uganda has introduced many changes in the healthcare delivery in the last two decades. One such change has been the implementation of the decentralized healthcare delivery through community health volunteers (CHWs), known as village health teams (VHTs) in a bid to increase community in

  8. Demographic profile and health conditions of the elderly in a community in an urban area of Southeastern Brazil

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    Telarolli Junior Rodolpho


    Full Text Available Some specific characteristics of the aging of the Brazilian population in different areas, states and communities all over the country, have shown significant variations. Historical series of demographic and health indicators for the population in their sixties and over in Brazil, state of S. Paulo and in the municipal district of Araraquara are listed as follows: level of education and urban population growth rate, income distribution, mortality rates and main causes of death. In 1991 the aged constituled were 7,8% of the Brazilian population and 9,7% in Araraquara community. The elderly population (of 70 years of aged and above as a proportion of the whole, has increased and already stands for 40%. The same trend holds good for both the proportion of aged within the urban population and their level of education wich increased to 90% in 1991. The main causes of death are chronic degenerative diseases which have replaced the infectious illness: firts, the diseases of the circulatory sistem (which account for more than 40% of all deaths and the neoplasms (which let to 15% of the deaths. On the basis of these health and demographic data relating to people of 60 years of age and over, this study suggests some procedures for the improvement of the quality of the assistance given to the target population: a the assistance give to the aged should be improved by providing gerontological training for general physicians and nurses, both of public and private clinics; b the already exixting educational activities for the aged, for health workers and for teachers of secundary education should be further developed; c the number of day-hospitals should be increased for the purpose of avoiding unnecessary confinement so as maintain the low rate of institutionalization in homes for the elderly (0,7% in Araraquara. It is reported that at least 35% of the aged population in this area is entitled to private health assistance, wich brings out the importance of

  9. Community health profile of Windsor, Ontario, Canada: anatomy of a Great Lakes area of concern.


    Gilbertson, M; Brophy, J.


    The rates of mortality, morbidity as hospitalizations, and congenital anomalies in the Windsor Area of Concern ranked among the highest of the 17 Areas of Concern on the Canadian side of the Great Lakes for selected end points that might be related to pollution in this relatively highly industrialized city. Mortality and morbidity rates from all causes were higher than in the rest of the province. Anomalously high rates of diseases included various cancers; endocrine, nutritional, metabolic, ...


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    M.H. Saheb-Zamani


    Full Text Available Twenty to twenty-five years ago, the Community Mental Health Center (CHMC, had scarcely been heard of. Today, it is indeed a movement, and apparently widespread. A total of ten services considered to be necessary to provide adequate mental health services: (1 in patient, (2 out-patient, (3 partial hospitalization, (4 emergency, (5 consultation, (6 diagn1ostic, (7 rehabilitative, (8 precare and aftercare, (9 training, (10 research and evaluation services. This Concept of Community Mental Health would include as many community agents as possible in co-operative efforts. To the average educated layman, and, unfortunately to most mental health practitioners the community mental health care has become synonymous with the provision of mere psycho-therapy. The community mental health center has not succeeded in becoming inductor of catalytic agent in the growth of its patients, nor has it become significantly involved with the community as a scrcla1 system. These are grim facts. But new hope has begun to appear. It is contained in four revolutions now under way – revolutions in understanding, in research, in nu1ternal and child care and in education for mental health.

  11. Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey (United States)

    López, Lenny; Grant, Richard W.; Marceau, Lisa; Piccolo, Rebecca; McKinlay, John B.; Meigs, James B.


    This study assessed the effect of acculturation on type 2 diabetes and whether health literacy may mediate this association. The Boston Area Community Health cohort is a multi-stage stratified random sample of adults from Boston including 744 Latinos. We defined dysglycemia as a HbA1c ≥5.7 %. Multivariable analyses examined the associations between acculturation and health literacy adjusting for demographic and clinical variables. Similar analyses were performed among participants with HbA1c ≥7.0 % to assess the association between acculturation and diabetes control. Among an insured primarily foreign born Spanish speaking Latino population, with a long residence period in the US and good healthcare utilization, higher levels of acculturation were not associated with dysglycemia. Lower levels of acculturation were associated with worse diabetes control. Health literacy level did not modify these associations. Elucidating the components of heterogeneity among Latinos will be essential for understanding the influence of acculturation on diabetes. PMID:26898955

  12. Air Pollution Affects Community Health (United States)

    Shy, Carl M.; Finklea, John F.


    Community Health and Environmental Surveillance System (CHESS), a nationwide program relating community health to environmental quality, is designed to evaluate existing environmental standards, obtain health intelligence for new standards, and document health benefits of air pollution control. (BL)

  13. Nursing care community health

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    Diana Acosta-Salazar


    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  14. Community Bioethics: The Health Decisions Community Council. (United States)

    Gallegos, Tom; Mrgudic, Kate


    Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…

  15. Causative Factors of Social Inequality and its Impact on Community Health: a Neighbourhood Level Study in Midnapore Municipal Area, West Bengal, India (United States)

    Roy, U.


    Health is socio-demographic construct of population. In an urban area social, economic and political systems simultaneously operate within a geographically defined space in which the urban dwellers accommodate and act as key player. As such the physical and social factors virtually affect the community health as a consequence of disparity in accessing health. Health disparities in smaller towns of the developing world have drawn serious attention as they are poorly suffering from the problems of `urban penalty'. This paper deals with statistical clustering of neighbourhoods on the basis of quality of life, social deprivation and multiple suffering quantified as the variables derived from measurable parameters. Neighbourhoods inequality has been mapped as per the score received by each neighbourhood in respect to the above three variables. Principal Component Analysis (PCA) has also been employed for grouping the neighbourhoods in social terms. Then it has been tried to examine relationship between health attainment and social status of the neighbourhoods. The study shows that status of health does not merely depend on socio-demographic and political factors but availability of healthcare facilities, health related behaviour, health perception and awareness have played significant roles. The findings of the study may be helpful for setting planning strategies most important of which would be inclusion of local people in catering health services.

  16. Health Educators and Community Health Workers (United States)

    ... seek to reduce the risk and occurrence of negative health outcomes through research, community education, and health ... at ... Information Network (O*NET). 2015 Median Pay The wage at ...

  17. A comparative study of knowledge regarding emergency care during disaster between community health volunteers working in tsunami-affected and non-affected areas in Aceh Province, Indonesia

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    Anda Kamal


    Full Text Available Purpose: This study aimed to describe and compare the level of knowledge regarding emergency care during disaster between community health volunteers (CHVs working in the tsunami affected and non-affected areas in Aceh Province, Indonesia.Method: 144 CHVs from six districts in Aceh were studied during November 2011 to January 2012 to evaluate their level knowledge regarding emergency care during disaster between CHVs working in tsunami-affected 6-areas and non-tsunami-affected areas. The knowledge was assessed using the Community Health Volunteers’ Knowledge Regarding Emergency Care Questionnaire (CHVK-ECQ with 30 true/false statements. The composite scores of each area and the total score were calculated and transformed to percentage for ease of presentation.Results: Overall, the CHVs’ knowledge in emergency care during disaster in Aceh was at a high level in both groups. However, subjects in non-affected areas had significantly higher mean rank of the overall knowledge than those in the affected areas (p = .02. In the tsunami area, the highest mean score of knowledge was in the disaster triage dimension (M= 80.62%, and the lowest mean score was in the first aid (60.48 %. In contrast, CHVs’ knowledge in the non-tsunami areas had the highest mean score in the first aid (84.52 % and had the lowest mean score in the disaster triage (64. 38 %.Conclusion: Although both groups had high levels of overall knowledge, an education program for improved knowledge in the areas of first aid, team organization, and disaster triage should be emphasized to refresh the CHVs’ knowledge and skills for disaster management.

  18. Baseline determination in social, health, and genetic areas in communities affected by glyphosate aerial spraying on the northeastern Ecuadorian border. (United States)

    Paz-y-Miño, César; Muñoz, María José; Maldonado, Adolfo; Valladares, Carolina; Cumbal, Nadia; Herrera, Catalina; Robles, Paulo; Sánchez, María Eugenia; López-Cortés, Andrés


    The northeastern Ecuadorian border has undergone aerial spraying with an herbicide mix that contains surfactants and adjuvants, executed by the Colombian Government. The purpose of this study was to diagnose social, health, and genetic aspects of the people affected by glyphosate. For this objective to be achieved, 144 people were interviewed, and 521 medical diagnoses and 182 peripheral blood samples were obtained. Genotyping of GSTP1 Ile105Val, GPX-1 Pro198Leu, and XRCC1 Arg399Gln polymorphisms were analyzed, using PCR-RFLP technique. The assessment of chromosomal aberrations was performed, obtaining 182 karyotypes. Malnutrition in children was 3%. Of the total population, 7.7% had children with malformations, and the percentage of abortions was 12.7%. Concerning genotyping, individuals with GSTP1 Val/Val obtained an odds ratio of 4.88 (p < 0.001), and Ile/Val individuals, together with Val/Val individuals, had an odds ratio of 2.6 (p < 0.05). In addition, GPX-1 Leu/Leu individuals presented an odds ratio (OR) of 8.5 (p < 0.05). Regarding karyotyping, the 182 individuals had normal karyotypes. In conclusion, the study population did not present significant chromosomal and DNA alterations. The most important social impact was fear. We recommend future prospective studies to assess the communities.

  19. Traffic density in area of residence is associated with health-related quality of life in women, the community-based Hordaland Health Study. (United States)

    Gundersen, Hilde; Magerøy, Nils; Moen, Bente E; Bråtveit, Magne


    Vehicle traffic is increasing worldwide, and this is a major concern because traffic-related air pollution and noise may influence health. The aim of this study was to evaluate whether health-related quality of life (HRQoL) is associated with vehicle traffic density in area of residence. A total of 16,410 individuals, 40 to 45 years old, were asked to participate in this study (response rate: 55% for men, 66% for women). Using the 12-Item Short Form Health Survey (SF-12) questionnaire, both physical and mental HRQoL were investigated. Multiple linear regression analyses showed that women living in areas with high traffic density had significantly poorer physical HRQoL than women living in areas with moderate or low vehicle traffic density. There were no similar findings among men. Mental HRQoL was not associated with vehicle traffic density in the area of residence, neither for women nor for men. There is an association between high vehicle traffic density in residential area and reduced HRQoL in women.

  20. VLER Health Exchange by Area (United States)

    Department of Veterans Affairs — “Connect Your Docs” through the Virtual Lifetime Electronic Record (VLER) Health Exchange program. This program gives VA and community health care providers secure...

  1. [Childhood leukaemia in a residential area with a high-voltage power line: approach according to the Dutch Community Health Services' guideline 'Cancer Clusters']. (United States)

    Hegger, Carola; Reedijk, Ardine M J


    The new Dutch Community Health Services' (GGD) guideline titled 'Cancer Clusters' describes a phased plan for investigating reported cancer clusters. In each phase, attention is paid to both health and environmental issues and their possible links to one another. Throughout the entire cluster investigation, good risk communication is essential. In accordance with the new guideline, the Rotterdam-Rijnmond Public Health Services investigated the incidence of childhood leukaemia in a residential area as well as the data available on the high-voltage power line located there. More children in this residential area had been diagnosed with leukaemia than expected. However, the children had not been subjected to prolonged exposure to strong magnetic fields emitted from the high-voltage power line. With this type of cluster investigation, it is not possible to establish a causal relationship between childhood leukaemia and high-voltage power lines. However, the research did provide stakeholders insight into the health-and-environment situation and thereby, the opportunity to assess the situation appropriately and to act accordingly, if desired.

  2. Racial ethnic differences in type 2 diabetes treatment patterns and glycaemic control in the Boston Area Community Health Survey



    Objectives Numerous studies continue to report poorer glycaemic control, and a higher incidence of diabetes-related complications among African–Americans and Hispanic–Americans as compared with non-Hispanic Caucasians with type 2 diabetes. We examined racial/ethnic differences in receipt of hypoglycaemic medications and glycaemic control in a highly insured Massachusetts community sample of individuals with type 2 diabetes. Setting Community-based sample from Boston, Massachusetts, USA. Parti...

  3. Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area. (United States)

    Jung, Hee-Won; Jang, Il-Young; Lee, Young Soo; Lee, Chang Ki; Cho, Eun-Il; Kang, Woo Young; Chae, Jeoung Hee; Lee, Eun Ju; Kim, Dae Hyun


    Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.

  4. Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users - A Cross-Sectional Study.

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    Andrew Bonney

    Full Text Available Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities.The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable.The prevalence of overweight or obesity was 79.2% (males and 65.8% (females; increased with age to 74 years; and was higher in rural (74% versus urban areas (71.4% (p<0.001. Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001, obesity (p<0.0001 and overweight or obesity (p<0.0001 in women and obesity (p<0.0001 in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024 and overweight or obesity (p = 0.4896 in males.It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.

  5. Working with women to improve child and community eye health

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    Gopa Kothari


    Full Text Available In the slums and rural areas of India, visual impairment, blindness, and childhood blindness are usually more prevalent.In order to improve the eye health of children and the community in these areas, it is important to understand the influence women and mothers have over children’s eye health and the eye health of the community as a whole.

  6. Local Experiences in Community Health

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    Sébastien Fleuret


    Full Text Available This paper presents the findings of international research with an original approach anchored in health geography, which illustrates the importance of place as a dimension in community health. The aim of the research is to identify the success factors in the processes used to build community health initiatives at the local level. The study is based on interviews encoded and analysed using the framework of the grounded theory. Three main themes—the place, the community and healthcare supply—and two cross-cutting issues referring to 18 explanatory dimensions are identified. These findings are then put to the test in France through an action research approach. Overall, the work suggest avenues to enable the transferability of successful elements of community health initiatives.

  7. Preserving community in health care. (United States)

    Emanuel, E J; Emanuel, L L


    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  8. Designated Health Professional Shortage Areas (United States)

    U.S. Department of Health & Human Services — Health Professional Shortage Areas (HPSAs) Data Download makes data and information concerning Designated HPSAs readily available to our users in a one-stop...


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    Full Text Available BACKGROUND: Children are the wealth of any nation as they constitute one of the important segments of the population. School is important for cognitive, creative and social development of children. The primary school children group is non - earning, depended to family and easily accessible for the health assessment, care and education through teachers, books etc. OBJECTIVES : a to assess the morbidity pattern amongst primary school children b To assess the association between morbidity pattern and socioeconomic status of the school children. METHODOLOGY: A c ommunity based cross sectional study was under taken amongst the primary school children in Boko - Bongaon block of Kamrup district, Assam from August 2012 to July 2013 with the help of a predesigned and pretested proforma, clinical examination, anthropometric measurement and laboratory investigation. Statistical analysis used: Data was analyzed in Microsoft excel and by using chi - square test and proport ions. RESULTS: 228 (57% school children were suffering from one or more morbidities. The leading cause of morbidities were anaemia (70%, under nutrition(31.25%, worm infestation (29%, vitamin (vitamin B complex and vitamin C deficiency disorder (29.75 %, skin disorder (24.25%, dental carries (23.75%, ocular disorder (13% etc. 139 (34.75% of school children were suffering from at least one episode of fever in the last 4 weeks followed by ARI 127 (31.75%. There is strong association between socioeconomic status and morbidities amongst the children and it is highly significant. CONCLUSION: In this study, Prevalence of diseases is found to be clubbed in the lower socioeconomic group. Health education and proper awareness to parents or guardians regarding prevention and treatment of common health problems and to improve personal hygiene of the children is necessary.



    Sandra Fikawati; Ita Yulita


    Dentist and dental nurse as dental health personnel in community health center are spearheads in community dental health service. The effectiveness and efficacy of community dental health service needs updated adequate dental health knowledge and skill. One effort to assure the fulfillment of those needs is by providing community dental health survey training. This training aims at improving the skill and capability of dental health personnel to conduct dental health survey. The training cons...

  11. Public health and health education in faith communities. (United States)

    Chatters, L M; Levin, J S; Ellison, C G


    This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

  12. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: results from the Boston Area Community Health (BACH) Survey. (United States)

    Piccolo, Rebecca S; Duncan, Dustin T; Pearce, Neil; McKinlay, John B


    Racial/ethnic disparities in the prevalence of type 2 diabetes mellitus (T2DM) are well documented and until recently, research has focused almost exclusively on individual-based determinants as potential contributors to these disparities (health behaviors, biological/genetic factors, and individual-level socio-demographics). Research on the role of neighborhood characteristics in relation to racial/ethnic disparities in T2DM is very limited. Therefore, the aim of this research is to identify and estimate the contribution of specific aspects of neighborhoods that may be associated with racial/ethnic disparities in T2DM. Data from the Boston Area Community Health III Survey (N = 2764) was used in this study, which is a community-based random-sample survey of adults in Boston, Massachusetts from three racial/ethnic groups (Black, Hispanic, and White). We applied two-level random intercepts logistic regression to assess the associations between race/ethnicity, neighborhood characteristics (census tract socioeconomic status, racial composition, property and violent crime, open space, geographic proximity to grocery stores, convenience stores, and fast food, and neighborhood disorder) and prevalent T2DM (fasting glucose > 125 mg/dL, HbA1c ≥ 6.5%, or self-report of a T2DM diagnosis). Black and Hispanic participants had 2.89 times and 1.48 times the odds of T2DM as White participants, respectively. Multilevel models indicated a significant between-neighborhood variance estimate of 0.943, providing evidence of neighborhood variation. Individual demographics (race/ethnicity, age and gender) explained 22.3% of the neighborhood variability in T2DM. The addition of neighborhood-level variables to the model had very little effect on the magnitude of the racial/ethnic disparities and on the between-neighborhood variability. For example, census tract poverty explained less than 1% and 6% of the excess odds of T2DM among Blacks and Hispanics and only 1.8% of the neighborhood

  13. Soil-transmitted helminthiases and health behaviors among schoolchildren and community members in a west-central border area of Thailand. (United States)

    Anantaphruti, Malinee T; Waikagul, Jitra; Maipanich, Wanna; Nuamtanong, Supaporn; Pubampen, Somchit


    The prevalence of soil-transmitted helminthic infections and health behaviors related to infections in schoolchildren and villagers of a community (4 hamlets) was studied in Hauy Kayeng subdistrict, Thong Pha Phum district, in the north of Kanchanaburi Province. The intestinal helminth infection rate of the schoolchildren was 15.6%. Hookworm infection was the most prominent (9.8%), followed by Trichuris trichiura (6.2%), and Ascaris lumbricoides (2.2%). The community showed higher prevalence rates and was infected with more types of intestinal helminths than the schoolchildren. Thirty-five point two percent (35.2%) of the residents were infected with soil-transmitted helminths, 30.5% with hookworm, 3.4% with A. lumbricoides and 2.2% with T. trichiura. Almost all hookworm cases (94.3%) were light intensity infections, while only 1.3% were heavy infections. Moreover, the hookworm infection rate in the community was found to be much higher when a stool culture method was used (39.1%). With this technique, 2.3% Strongyloides stercoralis infections were detected in the community population. Examination of the health behavior of the study samples showed that approximately 75% always defecated in a toilet. Schoolchildren who always wore shoes comprised 67%, which was lower than the community, at 85%.

  14. Patient moderator interaction in online health communities. (United States)

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


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

  15. Community perception of quality of (primary health care services in a rural area of Limpopo Province, South Africa: a qualitative study

    Directory of Open Access Journals (Sweden)

    T-AB Mashego


    Full Text Available The aim of the study was to survey perceptions of quality of (primary health care services provided in rural communities in the Limpopo province. Ten focus groups discussions were held with community members chosen by convenience from public places from four villages in the central region of the Limpopo Province. The sample included 42 women and 34 men (76 participants. Results indicated perceived quality discussed within the following categories: (1 conduct of staff (reception, communication, discrimination, care and compassion, respect for privacy, (2 technical care (examination, explanation of treatment, responsiveness, treatment outcomes, (3 health care facility, (4 health care organisation, (5 drugs (availability, explanation, effectiveness, payment, and (6 waiting time. The findings suggest some satisfaction with free basic and preventive health care and social services provided but there is a need to look closely into the interpersonal dimension of the services provided, provision of medication with adequate explanation to patients on the medication given, and on structural aspects, there is need for the government to give support to the clinics to provide adequate services. Improving drug availability, interpersonal skills (including attitudes towards patients and technical care have been identified as the three main priorities for enhancing perceived quality of primary health care and health policy action.

  16. Health education through analogies: preparation of a community for clinical trials of a vaccine against hookworm in an endemic area of Brazil.

    Directory of Open Access Journals (Sweden)

    Maria Flavia Gazzinelli

    Full Text Available BACKGROUND: Obtaining informed consent for clinical trials is especially challenging when working in rural, resource-limited areas, where there are often high levels of illiteracy and lack of experience with clinical research. Such an area, a remote field site in the northeastern part of the state of Minas Gerais, Brazil, is currently being prepared for clinical trials of experimental hookworm vaccines. This study was conducted to assess whether special educational tools can be developed to increase the knowledge and comprehension of potential clinical trial participants and thereby enable them to make truly informed decisions to participate in such research. METHODOLOGY/PRINCIPAL FINDINGS: An informational video was produced to explain the work of the research team and the first planned hookworm vaccine trial, using a pedagogical method based on analogies. Seventy-two adults living in a rural community of Minas Gerais were administered a structured questionnaire that assessed their knowledge of hookworm, of research and of the planned hookworm vaccine trial, as well as their attitudes and perceptions about the researchers and participation in future vaccine trials. The questionnaire was administered before being shown the educational video and two months after and the results compared. After viewing the video, significant improvements in knowledge related to hookworm infection and its health impact were observed: using a composite score combining related questions for which correct answers were assigned a value of 1 and incorrect answers a value of 0, participants had a mean score of 0.76 post-video compared to 0.68 pre-video (p = 0.0001. Similar improvements were seen in understanding the purpose of vaccination and the possible adverse effects of an experimental vaccine. Although 100% of participants expressed a positive opinion of the researchers even before viewing the film and over 90% said that they would participate in a hookworm vaccine

  17. Belledune area health study : summary report

    Energy Technology Data Exchange (ETDEWEB)



    The Belledune area has been home to various industrial activities such as mining, smelting, fertilizer plants, battery-recycling plants, gypsum plants, sawmills, and a coal-fired electricity generating facility. These industries have had various types and quantities of emissions over the past 4 decades that may have impacted on the health of people in the area. This report provided details of the Belledune Health Area Study. The objective of the study was to ensure that the concerns of residents were addressed and that the historical and human health risks associated with past and current industrial activities were quantified. The current health status of residents in the area was examined with reference to environmental exposures, and recommendations for future studies and research based on the results of the study were presented. Two main components were used: the human health risk assessment (HHRA), and community health status assessment (CHSA). Best estimate calculations for residents in the core communities showed that exposures to cadmium, lead and mercury were predicted to be below toxicity reference values. In Belledune itself, child exposures to cadmium and mercury were above the toxicity reference value. Results indicated that the health status pattern for the study area was different from that found in the surrounding areas. There was a statistically significantly elevated incidence of oral, respiratory, and prostate cancer and elevated incidences of kidney and colorectal cancer. There was a higher mortality rate than expected, and there were more deaths than expected due to circulatory disease, cancer and other causes such as accidents and suicides. An expanded survey of blood lead among child residents and pregnant women was recommended. A program was launched to collect data on metal concentrations in fish from the Baie des Chaleurs and additional data on vegetables from the Greater Belledune area. Future research on some of the factors associated

  18. Monks' Health: Holistic Health Care Model by Community Participation

    Directory of Open Access Journals (Sweden)

    Decha Buates


    Full Text Available Problem statement: Monks’ health tended to be a continuous increased problem. They were groups who had limitations to access health services due to their monastic disciplines and their most importance for Buddhist institution. Without urgent solution, their normal way of life would have been affected. Approach: This research aimed to study current conditions and to develop monks’ holistic health care models by community participation in central region of Thailand. The study was a qualitative research conducted in 9 temples; 3 temples in urban area, 3 in semi-urban area and 3 in rural area. Samples were 224 persons; consisted of monks, public health officers from Department of Religious Affairs, local administrative organizations and people; selected by purposive sampling method. Observation form, survey form, interview form, focus group discussion and workshop were used as research tools while data was analyzed by descriptive research. Results: The result founded that in former time culture of monks’ health care was leaned on community, social, culture and tradition. People spoke in style of central Thai language and were in agricultural sector as well as had their belief in merit, sin and elder respect. Relation in communities was in form of generosity and living as similar as relatives. When some monk got sick, they would visit, take care and give foods and medicines. Most of medicines were household remedy and Thai herbal medicine that bought from drug stores in local market or grocery stores in village and monks were sent to hospital in case of severe illness. Temple was a part of community, so they had close relation. Nowadays people increasingly worked in manufactories that caused conflicts and alienations among them. Monks leaned on local markets for receiving foods offering and most of foods were cooked from flour, sugar, coconut milk and fat. These caused three-fourth of monks having chronic disease as diabetes

  19. Rural Community as Context and Teacher for Health Professions Education. (United States)

    Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana; Renouf, Tia


    Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed "community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.

  20. Coalfield health effects: Variation in health across former coalfield areas in England

    Energy Technology Data Exchange (ETDEWEB)

    Riva, M.; Terashima, M.; Curtis, S.; Shucksmith, J.; Carlebach, S. [University of Durham, Durham (United Kingdom)


    Regions affected by deindustrialisation are often characterised by unfavourable local health profiles. This was the situation in coalfield areas in England, where the scale and suddenness of the job losses in the 1980s and 1990s left these communities experiencing difficult socioeconomic conditions, and associated poor health status. Using data from the Health Survey for England, this paper examines whether poorer health outcomes still characterise coalfield areas today. Findings confirm a 'coalfield health effect' related to limiting long-term illness. With regards to self reported general health and mental health outcomes, results are less clear. The population health profile of coalfield communities is not homogeneous, with some coalfield communities faring worse than others, indicating more localised health issues.

  1. Aftercare and Rehabilitation in a Community Mental Health Center (United States)

    Scoles, Pascal; Fine, Eric W.


    The community, state mental hospitals, and a community mental health center work together to provide an environment conducive to the continued well being of chronic mental patients in an area of West Philadelphia, Pennsylvania. The authors describe a program that involves day care centers and the patients' everyday living. (Author)

  2. Towards a Conceptualization of Online Community Health

    DEFF Research Database (Denmark)

    Wagner, David; Richter, Alexander; Trier, Matthias


    elements. In writing this paper, we attempt to foster theory development around new organizational forms by advancing a new and important construct. The paper further provides guidance to the managers of social media and online communities by taking a systematic look at the well-being of their communities.......Along with the increasing popularity of social media and online communities in many business settings, the notion of online community health has become a common means by which community managers judge the condition or state of their communities. It has also been introduced to the literature, yet...... the concept remains underspecified and fragmented. In this paper, we work toward a construct conceptualization of online community health. Through a review of extant literature and dialogue with specialists in the field, we develop a multi-dimensional construct of online community health, consisting of seven...

  3. Considering place in community health nursing. (United States)

    Bender, Amy; Clune, Laurie; Guruge, Sepali


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

  4. Community Mental Health Clinic Cost Reports (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Community Mental Health Center (CMHC). This data was reported on form CMS-2088-92. The data in this...

  5. Personas in online health communities. (United States)

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


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

  6. Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia

    Directory of Open Access Journals (Sweden)

    Liza Nyantekyi


    Conclusions: Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.

  7. Comparison of Family Clinic Community Health Service Model with State-owned Community Health Service Model

    Institute of Scientific and Technical Information of China (English)

    万方荣; 卢祖洵; 张金隆


    Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.

  8. Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service. (United States)

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


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


    Directory of Open Access Journals (Sweden)

    Constantin Ciucurel


    Full Text Available The purpose of this project aimed to apply a sanogenetic intervention on a rural population, from a disadvantaged geographical area. 50 students in Physical Therapy and 4 teachers were involved in assessment and intervention activities for optimization of the individual and collective health status of inhabitants of a village located in the Caras-Severin district, in the Cerna Mountains. The project results consisted in: a database regarding the health of the subjects; a model of therapeutic education and promoting of a healthy lifestyle among inhabitants; creating a network of social interaction among project participants; professional and transversal skills development of students; developing research skills of teachers. The activities referred to: subjects health assessment (medical diagnostic, anthropometric and physiometric measurements; recommending and implementing of programs of kinetic prophylaxis and rehabilitation; conducting activities to provide opportunities for social interaction and support. The project offered also the possibility of optimizing the students training by developing their professional skills of assessment and physiotherapeutic intervention, their transversal skills of teamwork, respect for the principles for professional ethics and self-assessment of needs for professional training and also for developing good inter-institutional relations, designed to facilitate the development of specific research activities, in benefit of both parts.

  10. Team management in community mental health. (United States)

    McGuinness, M


    The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager.

  11. The narrative psychology of community health workers. (United States)

    Murray, Michael; Ziegler, Friederike


    Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work.

  12. Health Information Technology Adoption in California Community Health Centers (United States)

    Kim, Katherine K.; Rudin, Robert S.; Wilson, Machelle D.


    Objectives National and state initiatives to spur adoption of electronic health record (EHR) use and health information exchange (HIE) among providers in rural and underserved communities have been in place for 15 years. Our goal was to systematically assess the impact of these initiatives by quantifying the level of adoption and key factors associated with adoption among community health centers (CHCs) in California. Study Design Cross-sectional statewide survey. Methods We conducted a telephone survey of all California primary care CHCs from August to September 2013. Multiple logistic regressions were fit to test for associations between various practice characteristics and adoption of EHRs, Meaningful Use (MU)–certified EHRs, and HIE. For the multivariable model, we included those variables which were significant at the P = .10 level in the univariate tests. Results We received responses from 194 CHCs (73.5% response rate). Adoption of any EHRs (80.3%) and MU–certified EHRs (94.6% of those with an EHR) was very high. Adoption of HIE is substantial (48.7%) and took place within a few years (mean = 2.61 years; SD = 2.01). More than half (54.7%) of CHCs are able to receive data into the EHR, indicating some level of interoperability. Patient engagement capacity is moderate, with 21.6% offering a personal health record, and 55.2% electronic visit summaries. Rural location and belonging to a multi-site clinic organization both increase the odds of adoption of EHRs, HIE, and electronic visit summary, with odds ratios ranging from 0.63 to 3.28 (all P values <.05). Conclusions Greater adoption of health information technology (IT) in rural areas may be the result of both federal and state investments. As CHCs lack access to capital for investments, continued support of technology infrastructure may be needed for them to further leverage health IT to improve healthcare. PMID:26760431

  13. Health Knowledge Effects: An Integrated Community Health Promotion Platform. (United States)

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu


    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform.

  14. Health literacy of an urban business community. (United States)

    Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M


    The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.



    Argan, Mehpare Tokay; ARGAN, Metin; Idil K. SUHER


    Today, like in all areas, the Internet has had an important effect in the area of health as well. With the development of the Internet many new and different applications have developed and one of the most important of these are probably virtual communities. Virtual communities, which are used as a tool for providing information and word of mouth communication, have become a widely used marketing tool in the area of healthcare services in recent years. A virtual community is a group that does...

  16. Developing Responsive Indicators of Indigenous Community Health (United States)

    Donatuto, Jamie; Campbell, Larry; Gregory, Robin


    How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

  17. The value of using schools as community assets for health. (United States)

    Caan, W; Cassidy, J; Coverdale, G; Ha, M-A; Nicholson, W; Rao, M


    In planning, designing, procuring and ensuring delivery of improved services ('commissioning') for the school age population, the outcomes should be students who are healthy to learn and who learn to be healthy. Intuitively, linking education and health development together within the wider learning environment seems a good start to planning school health. However there has been a shortage of either theoretical models that can span different settings or experimental research that demonstrates improved community health. Is there evidence that the wider learning environment provided in a school is valuable in improving health? An initial scoping exercise identified domains of health where there was a promise of health gain. International literature on school health outcomes using the framework of Asset-Based Community Development (ABCD) has been reviewed. It was found that research on a variety of interventions was relevant to schools as an asset for public health. Effective areas for health gain were identified for local planning and evaluation using this community model. However, none of the studies reviewed was originally designed to test schools as assets and most of the research lacked methodological rigour, especially regarding children in low income countries. The ABCD model could help national governments develop resources for both education and health, but there is a global need to generate better quality evidence. Then people who commission for their local communities can make more effective use of these multifaceted assets to improve health and education outcomes for children.

  18. Extension for Community Health Outcomes-hepatitis C:Small steps carve big footprints in the allocation of scarce resources for hepatitis C virus treatment to remote developing areas

    Institute of Scientific and Technical Information of China (English)

    Veysel; Tahan; Ashraf; Almashhrawi; Ali; M; Kahveci; Rachel; Mutrux; Jamal; A; Ibdah


    Hepatitis C virus(HCV)infection is still a major health problem throughout the world.HCV patients living in rural areas are less fortunate than their counterparts residing in populous urbanized regions.The lack of medical resources and properly trained medical personnel in rural regions make it especially burdensome for HCV patients seeking treatment.Dr.Sanjeev Arora at the University of New Mexico Health Sciences Center took initiative to resolve the issue at hand by developing a model named Project Extension for Community Health Outcomes(ECHO).ECHO connects primary care providers(PCPs),usually family medicine physicians,in local communities with specialists.ECHO providers test the efficacy of treatment given using the ECHO model vs that at academic medical centers.The ECHO model has produced promising results such that the sustained virologic response rates for both types of sites were near-equivalent.Show Me ECHO was adapted from Project ECHO to train PCPs in Missouri and equip them with the tools and skills to properly treat and diagnose HCV in a timely manner.This healthcare model can be implemented for treating other common infections and chronic diseases.Telemedicine is the direction healthcare is headed for the next several decades.It has potential to be applied in developing countries to alleviate agony and despair resulting from limited resources and lack of access to expert medical care.

  19. Mothers' Community Participation and Child Health (United States)

    Nobles, Jenna; Frankenberg, Elizabeth


    We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that…

  20. [Community health workers: promoters of interaction between territories]. (United States)

    da Costa, Samira Lima; de Carvalho, Emílio Nolasco


    This article presents reflections originating from a series of meetings with community health workers over a period of ten years. It identifies the consolidation of two existential territories, which are sometimes closer and at other times more distant from each other, namely the territory of technical knowledge about health and the territory of popular knowledge about health. Starting with the analysis of some quotes from health workers and reflections which tally with the theoretical reference in the area, this paper discusses some of the dilemmas and deadlocks of access and affiliation from the perspective of some of these health workers, as well as the strategies devised on a day-to-day basis from the crossovers that take place between these two territories. It identifies the function of community health workers as frontier agents, at times acting as inventors or motivators of contact zones between the territories, and at other times acting as a representative by one territory inside the other.

  1. Community Health Workers Support Community-based Participatory Research Ethics: (United States)

    Smith, Selina A.; Blumenthal, Daniel S.


    Ethical principles of community-based participatory research (CBPR)— specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability—stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR. PMID:23124502

  2. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources. (United States)

    Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John


    Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.

  3. The community need index. A new tool pinpoints health care disparities in communities throughout the nation. (United States)

    Roth, Richard; Barsi, Eileen


    Catholic Healthcare West, San Francisco (CHW), has developed a national Community Need Index (CNI) in partnership with Solucient, an information products company, to help health care organizations, not-for-profits, and policymakers identify and address barriers to health care access in their communities. The CNI aggregates five socioeconomic indicators long known to contribute to health disparity--income, culture/language, education, housing status, and insurance coverage--and applies them to every zip code in the United States. Each zip code is then given a score ranging from 1.0 (low need) to 5.0 (high need). Residents of communities with the highest CNI scores were shown to be twice as likely to experience preventable hospitalization for manageable conditions--such as ear infections, pneumonia or congestive heart failure--as communities with the lowest CNI scores. The CNI provides compelling evidence for addressing socioeconomic barriers when considering health policy and local health planning. The tool highlights health care disparities between geographic regions and illustrates the acute needs of several notable geographies, including inner city and rural areas.Further, it should enable health care providers, policymakers, and others to allocate resources where they are most needed, using a standardized, quantitative tool. The CNI provides CHW with an important means to strategically allocate resources where it will be most effective in maintaining a healthy community.

  4. Emergency preparedness training of tribal community health representatives. (United States)

    Hites, Lisle S; Granillo, Brenda S; Garrison, Edward R; Cimetta, Adriana D; Serafin, Verena J; Renger, Ralph F; Wakelee, Jessica F; Burgess, Jefferey L


    This study describes the development and evaluation of online Public Health Emergency Preparedness (PHEP) training adapted to the learning styles and needs of tribal Community Health Representatives (CHRs). Working through a university-tribal community college partnership, the Arizona Center for Public Health Preparedness at the University of Arizona and Diné College of the Navajo Nation delivered a blended online and face-to-face public health preparedness certificate program based on core public health emergency preparedness competencies. This program was carefully adapted to meet the environmental and learning needs of the tribal CHRs. The certificate program was subsequently evaluated via a scenario-based decision-making methodology. Significant improvements in five of six competency areas were documented by comparison of pre- and post-certificate training testing. Based on statistical support for this pedagogical approach the cultural adaptations utilized in delivery of the certificate program appear to be effective for PHEP American Indian education.

  5. Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions. (United States)

    Alaimo, Katherine; Beavers, Alyssa W; Crawford, Caroline; Snyder, Elizabeth Hodges; Litt, Jill S


    The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions.

  6. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities (United States)

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee


    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  7. Ethical considerations in community oral health. (United States)

    Naidoo, Sudeshni


    As the public's oral health care needs increase in complexity, there is renewed attention to the ethical dimensions of community oral health decision making and the development of public health ethics in teaching and research in dentistry. Despite their reduction globally, oral diseases persist with a particular distribution pattern that is a reflection of the increasingly widespread inequality in access to community oral health preventive and dental care. This is due to differences in the appropriateness, availability, accessibility, and acceptability of oral health education and the care provided. This article provides an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care to the underserved. The need for a paradigm shift from highly technical and individualistic dental training curricula is discussed, together with the need to instill a holistic approach to ethical and social responsibility in new dental graduates. It concludes with some possible strategies, using the overarching principles of ethics and bioethics that are applicable to practice among vulnerable populations.

  8. Developing community mental health services for children in South Africa. (United States)

    Pillay, A L; Lockhat, M R


    As a result of South Africa's Apartheid history, mental health care for black people, especially in rural areas, has been grossly inadequate and even non-existent in many areas. Children have been severely neglected in this regard. This paper describes an attempt by clinical psychologists to develop a community intervention programme for children with emotional problems. From their hospital base the authors set out, on a monthly basis, to outlying areas up to 250 km away to (1) train primary care nurses and other personnel in the basic techniques of identifying and dealing with uncomplicated psychological problems of childhood, and (2) render consultations to psychologically disturbed children. The paper argues the need to provide primary care workers with mental health skills and thus integrate childhood mental health care into the primary care structure. Such a move could make mental health care accessible to all inhabitants, thus deviating from the policies of the past.

  9. Community Changes Address Common Health Threat

    Centers for Disease Control (CDC) Podcasts


    This podcast helps residents living in multiunit housing, like apartments and condos, understand the threat of secondhand smoke. It also helps residents understand what steps they can take to breathe a little easier if involuntarily exposed to secondhand smoke.  Created: 9/30/2013 by Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 9/30/2013.

  10. Community participation in rural health: a scoping review

    Directory of Open Access Journals (Sweden)

    Kenny Amanda


    Full Text Available Abstract Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for

  11. Community Health Service in Urban China: Rebuilding Health Care Systems in New Ways

    Institute of Scientific and Technical Information of China (English)

    赵志广; 卢祖洵


    IN THE 1970s, the World Health Organization(WHO) put forward a community-oriented healthservice model based on the experience of Europeancountries such as Britain. At present, this model hasbeen adopted as the key strategy to make health ser-vices accessible, affordable and socially acceptableand is an important component of health servicesystem in many countries.1,2In the early 1950s, China set out to establish athree-level primary health care network in urban andrural areas in order to provide health care...

  12. Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities (United States)

    West, Jenny S.; Price, Matthew; Gros, Kirstin Stauffacher; Ruggiero, Kenneth J.


    Objective We examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health. Methods A representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support. A series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples. Results Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants. Conclusions Community support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. PMID:24274123

  13. Community health nursing vision for 2020: shaping the future. (United States)

    Schofield, Ruth; Ganann, Rebecca; Brooks, Sandy; McGugan, Jennifer; Dalla Bona, Kim; Betker, Claire; Dilworth, Katie; Parton, Laurie; Reid-Haughian, Cheryl; Slepkov, Marlene; Watson, Cori


    As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence.

  14. Multiculturalism, Medicine and Health Part V: Community Considerations (United States)

    Masi, R.


    In this article the author examines multicultural health issues from a community perspective, dealing with relationships between cultural communities and health-care systems in terms of: hospitals and health-care institutions, family and social supports, social norms, and community-health programs. PMID:21248882

  15. Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system. (United States)

    Tichy, N M; Taylor, J I


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

  16. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies. (United States)

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A


    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

  17. Peruvian community health promoters: expanding the spaces of health voluntarism. (United States)

    Jenkins, Katy


    This paper emphasises the importance of recognising the global South as a key site for understanding the patterning of geographies of health voluntarism. Feeding into a broader critique of neoliberal health and development policies, the paper explores what a case study of health promoters in a popular settlement in Lima, Peru, can add to our understanding of practices of health voluntarism rooted in distinct places, emphasising the uneven and gendered nature of such voluntary activity. In particular, the paper considers the ways in which urban community spaces are negotiated, inhabited and shaped by volunteer women health workers, arguing that an exploration of these everyday practices provides a more nuanced picture of the role of voluntarism in healthcare provisioning under neoliberal regimes.

  18. Use of Electronic Health Records in Residential Care Communities (United States)

    ... the National Technical Information Service NCHS Use of Electronic Health Records in Residential Care Communities Recommend on ... Facilities Most residential care communities did not use electronic health records in 2010, and use varied by ...

  19. Community health workers adherence to referral guidelines

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy;


    Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs...... artemisinin-based combination therapy (ACT) and recognize symptoms in children that required immediate referral to the nearest health centre. Intervention arm CHWs had additional training on how to conduct an RDT; CHWs in the control arm used a presumptive diagnosis for malaria using clinical signs...

  20. Faith communities and their assets for health promotion: the views from health professionals and faith leaders in Dundee, in Scotland. (United States)

    Fagan, Donna M; Kiger, Alice; van Teijlingen, Edwin


    Within the European Union, as well as in Canada and the United States (US), health promoters employ a number of strategies to encourage community-based health improvements. This involves the creation of innovative health promotion partnerships to support and enable people to choose and engage in healthy living practices. Compared to the US, in other Western countries, such as the United Kingdom, faith communities have largely been ignored in health promotion partnerships. This study established existing evidence about health promotion in faith communities in Scotland by examining the perceptions and attitudes concerning health promotion among faith leaders and health promotion professionals. We conducted 33 semi-structured interviews with health promotion professionals (n = 9) and representatives of Christian and non-Christian faith communities (n = 24). The majority of participants expressed an interest in the concept of health promotion in a faith community and could readily envision its application in their area of work. Both groups identified multiple physical assets, as well as social supports within faith communities that could be directed towards healthy living activities. Faith groups and church organisations may constitute potential partners and new settings to increase community capacity for health promotion. Further research and funding for demonstration projects may be particularly helpful to provide evidence of the strengths and limitations of faith-based health promotion in Scotland, which in turn could inform health promotion practice and policy.

  1. Community Health Nursing through a Global Lens. (United States)

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia


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

  2. Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo. (United States)

    Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal


    In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

  3. Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

    Directory of Open Access Journals (Sweden)

    Vivi Maketa

    Full Text Available In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health

  4. Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey


    Carty, Denise C.; Kruger, Daniel J.; Turner, Tonya M.; Campbell, Bettina; DeLoney, E. Hill; Lewis, E. Yvonne


    Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and ...

  5. The Health of the School Nurse Community: A Framework (United States)

    Christeson, Elisabeth P.


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

  6. Community College Student Mental Health: A Comparative Analysis (United States)

    Katz, Daniel Seth; Davison, Karen


    This study explores community college student mental health by comparing the responses of California community college and traditional university students on the American College Health Association-National College Health Assessment II (ACHA-NCHA II). Using MANOVA, we compared community college and traditional university students, examining…

  7. Community mental health in India: A rethink

    Directory of Open Access Journals (Sweden)

    Aynkran Jothy R


    Full Text Available Abstract Background Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF, an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes. Methods One hundred and eighty five patients with chronic mental illness were followed up and their present treatment status determined using a modified version of the Psychiatric and Personal History Schedule (PPHS. The resources created earlier were assessed and qualitative information was gathered during interviews with patient and families and other stakeholders to identify the reasons behind the sustenance or failure of these initiatives. Results Of the 185 patients followed up, 15% had continued treatment, 35% had stopped treatment, 21% had died, 12% had wandered away from home and 17% were untraceable. Of the patients who had discontinued treatment 25% were asymptomatic while 75% were acutely psychotic. The referral service was used by only 15% of the patients and mental health services provided by the PHC stopped within a year. The Citizen's group was functional for only a year and apart from chicken rearing, all other self-employment schemes were discontinued within a period of 6 months to 3 years. There were multiple factors contributing to the failure, the primary reasons being the

  8. The Role of Nurses in Community Awareness and Preventive Health

    Directory of Open Access Journals (Sweden)

    Marjaneh M. Fooladi


    Full Text Available With access to multimedia through social networks at global level, one wonders why some of the preventive healthcare services such as children and adult immunizations, annual screening for men and women, prenatal and dental care for childbearing women and adolescents are not provided at a 100% rate. Community awareness is a crucial aspect of preventative healthcare and perhaps those responsible for implementing the national health initiatives seek to realize other key factors influencing community health. In a study of 190 community health nurses caring for blacks, Puerto Ricans and Southeast Asians, the confidence scores for cultural self-efficacy was high when nurses cared for blacks and they were low when they cared for Asians and Latinos. The lowest scores belonged to items related to knowledge of health beliefs and practices regarding respect, authority and modesty within each culture. Scores were higher when interpreters were used correctly to convey meaningful messages. Researchers concluded that nurses lacked confidence when caring for culturally diverse patients and found weaknesses across the nursing curriculum preparing nurses to care for various demographic groups.1 In most countries, including Iran, governmental agencies have the budget and the man- power to apply preplanned initiatives and provide community-based preventive healthcare services to address the majority of the preventable health related issues through satellite clinics, health department and outpatient facilities. Meanwhile, private sectors in metropolitan cities offer cure-based services to urban and suburban communities. Remote and rural areas should be the focus of primary care and preventive health services, because access to multimedia is limited, healthcare providers refuse to work in outreach areas, and unpaved roads are barriers to easy access to the locals and outsiders. To implement an effective community-based preventive program, recognition of resiliency

  9. Promoting health within the community: community therapy as strategy

    Directory of Open Access Journals (Sweden)

    Martha Fuentes R


    Full Text Available Objective: to identify, by assessing the records of community therapy meetings, the everyday problems that affect communities in order to understand and map the pain and suffering expressed by the participants. Methodology: the records created by the therapists after each meeting were used for data collection. The following two topics were chosen for analysis purposes: the problems that were presented and the ones that were chosen. Likewise, analysis categories were identified based on the frequency with which they were mentioned by the participants. The records of 774 meetings were analyzed. Such meetings took place from August, 2006 to December, 2008. An average of 9 to 20 people attended each meeting. Results: openness, freedom, warmth, and respect were characteristics of these meetings. The most common problems were: domestic violence, sexual abuse, divorce, discrimination, feelings of guilt, abandonment, rage, fear, negligence, problems with children, partners, co-workers or neighbors, losing one’s job, one’s loved ones or one’s material possessions, drug addiction, alcoholism, smoking, etc. Conclusions: community therapy has led not only to identify the people who really are in need of treatment, but also contributed to reduce the demand for the municipality’s health services. Having people meet without judging them by what they say, feel or think makes it easier for them to cope with their suffering and fears. It also creates social support networks, develops better attitudes of solidarity, responsibility and affectiveness, empowers the people and the community, and makes it easier to find better ways of overcoming problems. At the same time, it makes it possible to learn how people live and cope with their daily problems, thus allowing them to reframe these problems, and enabling the development of more effective care.

  10. Enabling methods for community health mapping in developing countries

    Directory of Open Access Journals (Sweden)

    Jacobsen Kathryn H


    Full Text Available Abstract Background Spatial epidemiology is useful but difficult to apply in developing countries due to the low availability of digitized maps and address systems, accurate population distributions, and computational tools. A community-based mapping approach was used to demonstrate that participatory geographic information system (PGIS techniques can provide information helpful for health and community development. Results The PGIS process allowed for the rapid determination of sectional (neighborhood boundaries within the city of Bo, Sierra Leone. When combined with data about hospital laboratory visits, a catchment area for one hospital in Bo could be established. A survey of households from within the catchment area determined that the average population per household (about 6 individuals was similar to that found in the 2004 census. However, we also found that the average house was inhabited by more than one household, for an average of 17.5 inhabitants per residential building, which is critical information to know when estimating population size using remote imagery that can detect and enumerate buildings. Conclusions The methods developed in this paper serve as a model for the involvement of communities in the generation of municipal maps and their application to community and health concerns.

  11. 42 CFR 136a.15 - Health Service Delivery Areas. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....

  12. Adolescent health-risk behavior and community disorder.

    Directory of Open Access Journals (Sweden)

    Sarah E Wiehe

    Full Text Available BACKGROUND: Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors. OBJECTIVE: Assess whether exposure to contexts associated with crime (as a marker of community disorder correlates with self-reported health-related behaviors among adolescent girls. METHODS: Girls (N = 52, aged 14-17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points. Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not. RESULTS: Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04 and sexual intercourse or not (p 0.01. Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively. Exposure also varied by school/non-school day as well as time of day. CONCLUSIONS: Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health.

  13. Exploring Social Quality and Community Health Outcomes: An Ecological Model. (United States)

    Jung, Minsoo


    Quality of life is widely used as a measure of individual well-being in developed countries. Social quality (SQ), however, describes how favorable the socioenvironmental components are that impact the life chance of an individual. Despite the associations between SQ, including institutional capacity and citizen capacity, and other community indicators, the impact of SQ on community health status has not been fully examined. This study investigated the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea. Under the principles of conceptual suitability, clarity, reliability, consistency, changeability, and comparability, a total of 81 SQ indicators were collected, and 19 indicators of the 81 indicators were selected. The 19 indicators were transformed by the imputation of missing values, standardization, and geographic information system transformation. It was found that the health outcome of local government was superior as social welfare, political participation, and education were higher. According to the result of the regression analysis based on the regional type, social welfare had the most influence on the health level of local government in both metropolises and small-/medium-sized cities. In addition, education and political participation had a positive effect on the health indicator of local metropolis government. However, SQ indicators did not have any meaningful influence at the county level. Therefore, small- and medium-sized cities need to promote the collective health of the local government through improving social welfare, and metropolises need to consider the complex relationship among other indicators while increasing the level of social welfare and education. Meanwhile, counties need to develop health indicators that reflect aged population characteristics and social environment of rural areas

  14. Community Forestry and Sustainable Development in Rural Area

    Institute of Scientific and Technical Information of China (English)


    After analysis on the current situation of international forestry, this paper proposes that integration, coordination and sustainable development will be the general developing trend of forest in China, and commercial forest, ecological forest and community forest should be organically combined with integrative development and sustainable development in rural areas. This paper focuses especially on clarifying the importance of community forest to the social development or rural areas, and emphasizes tha...

  15. Community matters - why outbreak responses need to integrate health promotion. (United States)

    Kickbusch, Ilona; Reddy, K Srikanth


    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

  16. Trust the process: community health psychology after Occupy. (United States)

    Cornish, Flora; Montenegro, Cristian; van Reisen, Kirsten; Zaka, Flavia; Sevitt, James


    This article argues that community health psychology's core strategy of 'community mobilisation' is in need of renewal and proposes a new way of conceptualising community health action. Taking the Occupy movement as an example, we critique modernist understandings of community mobilisation, which are based on instrumental action in the service of a predetermined goal. Aiming to re-invigorate the 'process' tradition of community health psychology, we explore possibilities of an open-ended, anti-hierarchical and inclusive mode of community action, which we label 'trusting the process'. The gains to be made are unpredictable, but we suggest that the risk is worth taking.

  17. Developing Interactive Video Resource Materials for Community Dental Health. (United States)

    Bartoli, Claire; And Others


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

  18. Using an academic-community partnership model and blended learning to advance community health nursing pedagogy. (United States)

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


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

  19. [Community participation. Some perspectives on professional involvement in health programs]. (United States)

    Pérez Mendoza, S; Ascanio, S V


    Action Community regarding health is but part of a long-term project started out back in the 1960. As far as Latin America was concerned the so-called experience did not work out; notwithstanding, it has become an Attention-Getter among the countries of the area once again. How so? Because of the Primary-Approach. Understood as an approach based on the global development of society, self-involvement lies at the cornerstone of the whole process. The health section gives full measure of the primary-approach theoretical framework and propose alternatives to get it of the ground. Professionals from the health section aim at "self-involvement" as activity performed willingly. Besides as it were, it should be supervised by experts. Nowadays the venezuelan government promotes action community claiming it will endorse the Primary-Approach on health granted the national health system bill is approved. Amid such context dentistry most meet the challenge of upcoming changes, so must fellow-dentists who, in the end, will dominate center stage. The process must narrow down to actions with will stem from its own dynamics along the way. Needless to say, these actions can not be easily foreseen, let alone do they guarantee success.

  20. Community health workers adherence to referral guidelines

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy


    Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs) and trea......Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs......) and treatment guidelines, there is limited evidence whether CHWs adhere to the referral guidelines and refer severely ill children for further management. In southwest Uganda, this study examined whether CHWs referred children according to training guidelines and described factors associated with adherence...... to the referral guideline. Methods A secondary analysis was undertaken of data collected during two cluster-randomized trials conducted between January 2010 and July 2011, one in a moderate-to-high malaria transmission setting and the other in a low malaria transmission setting. All CHWs were trained to prescribe...

  1. Drought, drying and climate change: emerging health issues for ageing Australians in rural areas. (United States)

    Horton, Graeme; Hanna, Liz; Kelly, Brian


    Older Australians living in rural areas have long faced significant challenges in maintaining health. Their circumstances are shaped by the occupations, lifestyles, environments and remoteness which characterise the diversity of rural communities. Many rural regions face threats to future sustainability and greater proportions of the aged reside in these areas. The emerging changes in Australia's climate over the past decade may be considered indicative of future trends, and herald amplification of these familiar challenges for rural communities. Such climate changes are likely to exacerbate existing health risks and compromise community infrastructure in some instances. This paper discusses climate change-related health risks facing older people in rural areas, with an emphasis on the impact of heat, drought and drying on rural and remote regions. Adaptive health sector responses are identified to promote mitigation of this substantial emerging need as individuals and their communities experience the projected impact of climate change.

  2. Australian rural, remote and urban community nurses' health promotion role and function. (United States)

    Roden, Janet; Jarvis, Lynda; Campbell-Crofts, Sandra; Whitehead, Dean


    Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

  3. On the future of local communities in rural areas

    Directory of Open Access Journals (Sweden)

    Malešević Krstan


    Full Text Available When discussing the future of rural areas for rural sociology (which aims at developing a holistic approach, the most important issue is certainly the question of fate of local communities in rural areas. Reviewing the enormous literature on countryside and agriculture, one can notice an overwhelming dominance of articles that focus on the agrarian and economic policy, often written fairly in the form of agro-economic reductionism. The totality of human life in rural communities is often lost in the fragmentary analysis of individual scientific disciplines. That is why there is a lack of knowledge on the meaning and content of (new rurality, rural relationships, rural values, rural communities, rural ways of life and on integral rural development in conceptual-theoretical as well as in practical-empirical sense. This problem, understandably, affects different aspects of the complex phenomenon of "rurality" in our situation. However, regardless of the evident insufficiency of synthetic knowledge about our countryside as a social community, it is clearly evident that rural areas are in deep crisis. Local communities in the majority of our rural areas are completely marginalised. Great number of these communities are in the process of disintegration and disappearance. They have lost a "spirit of time" and identity and have not acquired a new one. Furthermore, in some rural areas local communities have literally vanished. In other words, it is difficult to find in our society any active rural communities with a clear future prospects. That is why the crucial question for social theory as well as for social practice is: Which are the economic, demographic, technological and especially socio-cultural prerequisites of renewal and development of local communities in the near future? Without their revitalisation there is no development of rural areas and vice versa. In the focus of this renewal there should be an adequate spatial, functional, organic and

  4. Making Things Happen: Community Health Nursing and the Policy Arena. (United States)

    Williams, Carolyn A.


    It is important that nurses, particularly those who consider themselves community health nursing specialists, assign a high priority to participation in the formation of health policy and broader public policy. To put subsequent remarks about policy into perspective, it is useful to consider the case for seeing community health nursing as…

  5. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing. (United States)

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.


    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  6. Using Community Health Assessment to Teach and Explore Health Status Disparities (United States)

    Sullivan, Marianne; Levine, Jack


    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  7. Community-Based Nursing versus Community Health Nursing: What Does It All Mean? (United States)

    Zotti, Marianne E.; And Others


    Offers practice models for community-based nursing and community health nursing that demonstrate the different roles, philosophies, and activities of the two approaches. Points to curriculum changes that are needed to prepare students to practice in an increasingly community-oriented health care industry. (Author)

  8. [Historical changes in community concepts and the effect of such on community health nursing praxis]. (United States)

    Yeh, Lily; Chen, Yi-Hsing


    In the 21st century, many healthcare programs are delivered in community settings. As such, successfully recruiting target members of the community to participate in programs represents a key challenge for the nursing profession. Although the "community" is not a new concept, its meaning has changed over the past century or more of public healthcare, which has had a profound effect on community health nursing praxis. This article describes changes in community concepts through history in order to define the significance of community participation in today's community health nursing practice.

  9. Promotores de salud and community health workers: an annotated bibliography. (United States)

    WestRasmus, Emma K; Pineda-Reyes, Fernando; Tamez, Montelle; Westfall, John M


    For underserved and disenfranchised communities in the United States, affordable, effective health care can be nearly inaccessible, which often leads to the exclusion of these communities from relevant medical information and care. Barriers to care are especially salient in minority communities, where language, traditions and customs, socioeconomics, and access to education can serve as additional roadblocks to accessing health care information and services. These factors have contributed to a national health disparity crisis that unnecessarily places some communities in a vulnerable position without adequate prevention and treatment opportunities. One solution to the exclusion some communities face in the health care system may be the promotores de salud (PdS)/community health worker (CHW), an approach to culturally competent health care delivery whose popularity in the mainstream health care system has been steadily growing in recent decades. Known by a wide variety of names and broad in the spectrum of health issues they address, the PdS/CHW serves as cultural brokers between their own community and the formal health care system and can play a crucial role in promoting health and wellness within their community. This annotated bibliography was created to educate the reader about the history, definition, key features, utility, outcomes, and broad potential of the CHW approach in a variety of populations. Intended to serve as a reference point to a vast body of information on the CHW/PdS approach, this document is a resource for those wishing to effect change in the disparities within the health care system, and to improve the access to, quality, and cost of health care for underserved patients and their communities. Promotores de Salud is a Spanish term that translates to Health Promoter. A female health worker may be referred to as a Promotora, a male as a Promotor, and the plural of both is Promotores. For the purposes of this bibliography, the terms community

  10. Growing urban health: community gardening in South-East Toronto. (United States)

    Wakefield, Sarah; Yeudall, Fiona; Taron, Carolin; Reynolds, Jennifer; Skinner, Ana


    This article describes results from an investigation of the health impacts of community gardening, using Toronto, Ontario as a case study. According to community members and local service organizations, these gardens have a number of positive health benefits. However, few studies have explicitly focused on the health impacts of community gardens, and many of those did not ask community gardeners directly about their experiences in community gardening. This article sets out to fill this gap by describing the results of a community-based research project that collected data on the perceived health impacts of community gardening through participant observation, focus groups and in-depth interviews. Results suggest that community gardens were perceived by gardeners to provide numerous health benefits, including improved access to food, improved nutrition, increased physical activity and improved mental health. Community gardens were also seen to promote social health and community cohesion. These benefits were set against a backdrop of insecure land tenure and access, bureaucratic resistance, concerns about soil contamination and a lack of awareness and understanding by community members and decision-makers. Results also highlight the need for ongoing resources to support gardens in these many roles.

  11. Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

    Directory of Open Access Journals (Sweden)

    Harshal Ramesh Salve


    Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

  12. Area health education centers and health science library services. (United States)

    West, R T; Howard, F H


    A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.

  13. Promoting community based approaches to social infrastructure provision in urban areas in Nigeria. (United States)

    Uduku, N O


    Inadequate social infrastructure provision--in terms of education, health care facilities, and water and sanitation--has become a critical issue in Nigeria's urban areas. The decline of the Nigerian economy and the introduction of economic structural adjustment have curtailed drastically government spending on these services. Recommended is a return to the regional community-based approaches that prevailed in earlier periods. In precolonial Nigeria, the community help ethic ensured that all societies had adequate social infrastructure. With colonization and the emergence of an urban cash economy, the government took control of service provision in urban areas; in rural areas, neglected by government, self-help efforts continued to flourish. The trend in recent decades has been toward the privatization of urban services, deregulation, and growing inequities between affluent urban dwellers and the urban and rural poor. The recommended localization strategy would involve the creation of regional bodies to provide public utilities and regulate social infrastructure provision. Responsibility for the organization and provision of these services would rest with democratically elected community associations in rural areas and municipal councils in urban areas. The needs of poor communities could be funded by cross-subsidizing utility costs among affluent communities. Such a strategy, although unlikely to be supported by government and urban elites, would revitalize the community responsibility ethos that was lost in the urbanization process.

  14. Moving health promotion communities online: a review of the literature. (United States)

    Sunderland, Naomi; Beekhuyzen, Jenine; Kendall, Elizabeth; Wolski, Malcom


    There is a need to enhance the effectiveness and reach of complex health promotion initiatives by providing opportunities for diverse health promotion practitioners and others to interact in online settings. This paper reviews the existing literature on how to take health promotion communities and networks into online settings. A scoping review of relevant bodies of literature and empirical evidence was undertaken to provide an interpretive synthesis of existing knowledge on the topic. Sixteen studies were identified between 1986 and 2007. Relatively little research has been conducted on the process of taking existing offline communities and networks into online settings. However, more research has focused on offline (i.e. not mediated via computer networks); 'virtual' (purely online with no offline interpersonal contact); and 'multiplex' communities (i.e. those that interact across both online and offline settings). Results are summarised under three themes: characteristics of communities in online and offline settings; issues in moving offline communities online, and designing online communities to match community needs. Existing health promotion initiatives can benefit from online platforms that promote community building and knowledge sharing. Online e-health promotion settings and communities can successfully integrate with existing offline settings and communities to form 'multiplex' communities (i.e. communities that operate fluently across both online and offline settings).

  15. Northside Partnership "Healthy Community" Pilot Area Walkability Audit


    O'Connor, David; Borscheid, Matthias; Reid, Odran; ni Lochlainn, Meadhbh


    Poor health has been identified as an issue for people who live in areas affected by structural disadvantage and social exclusion. One area in the North East of Dublin City has been identified for the development of a project addressing health inequality and promoting a “Healthy Community” by Northside Partnership, a local development company established in 1991 to address social exclusion. The Partnership has been assisted in the development of the programme by a wide range of statutory and ...

  16. Community based needs assessment in an urban area; A participatory action research project

    Directory of Open Access Journals (Sweden)

    Ahari Saeid


    Full Text Available Abstract Background Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment. Methods The method of participatory action research (PAR was used. The study was carried out in an area of high socio-economic deprivation in Ardabil, a city in the northwest of Iran, which is currently served by a branch of the Social Development Center (SDC. The steering committee of the project was formed by some university faculty members, health officials and delegates form Farhikhteh non-governmental organization and representatives from twelve blocks or districts of the community. Then, the representatives were trained and then conducted focus groups in their block. The focus group findings informed the development of the questionnaire. About six hundred households were surveyed and study questionnaires were completed either during face-to-face interviews by the research team (in case of illiteracy or via self-completion. The primary question for the residents was: 'what is the most important health problem in your community? Each health problem identified by the community was weighted based on the frequency it was selected on the survey, and steering committee perception of the problem's seriousness, urgency, solvability, and financial load. Results The main problems of the area appeared to be the asphalt problem, lack of easy access to medical centers, addiction among relatives and unemployment of youth. High participation rates of community members in the steering committee and survey suggest that the PAR approach was greatly appreciated by the community and that problems identified through this research truly reflect community opinion

  17. Lantern parades in the development of arts in community health. (United States)

    White, Mike; Robson, Mary


    This paper describes the development of two annual lantern parades as case examples of arts in community health, which the authors define as a distinct area of activity operating mainly outside of acute healthcare settings, characterised by the use of participatory arts to promote health. The parades took place in Gateshead 1994-2006 and later in Stockton-on-Tees from 2009 to the present, and the paper reflects on the factors that made for the success of the Gateshead parade and also the problems that led to its demise. It then describes and assesses the Stockton parade, and the benefits and challenges of a workshop ethos of 'positive regard' with reference to interview data gathered from adult volunteers and school staff. It considers the potential of this annual 'tradition' to shape communal memories that identify with place, and it sets out its aspirations for future programme and research.

  18. Community mental health nurses' perspectives of recovery-oriented practice. (United States)

    Gale, J; Marshall-Lucette, S


    Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery.

  19. A survey of community gardens in upstate New York: implications for health promotion and community development. (United States)

    Armstrong, D


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

  20. Developing Community Health Conditions for Happiness, Phase 1

    Directory of Open Access Journals (Sweden)

    Chalard Chantarasombat


    Full Text Available Problem statement: Complete health of physical, social and intellectual development is an appropriate plan of human development and raises the quality of life in communities. If the development plan is integrated into the local community it will create peace and generosity. Good health is also fundamental to sustainable development which will create a peaceful society where community members are happy and content. Approach: The purpose of this research in Phase 1, is to (1 Identify leaders in communities at village and sub-district level to drive the ongoing research study and development to achieve good community health conditions in all aspects and dimensions. (2 To have the participants and researchers identify the key elements and indicators of health issues that communities feel are most important to their way of life. Results: Village communities were selected by cluster sampling from the provinces of Roi-Et and Maha Sarakham. The developed model for developing community health for living happily in communities is an appropriate and practical method that can be utilized in other communities. Conclusion: The model is in accordance with Participatory Action Research (PAR and the procedures are flexible and the development plans which are the results of Phase 1 can be extended to other communities and backgrounds.

  1. Community financed and operated health services: the case of the Ajo-Lukeville Health Service District. (United States)

    Lopes, P M; Nichols, A W


    The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.

  2. Emergence of Virtual Communities as Means of Communication: A Case Study on Virtual Health Care Communities (United States)

    Argan, Mehpare Tokay; Argan, Metin; Suher, Idil K.


    Like in all areas, virtual communities make their presence felt in the area of healthcare too. Virtual communities play an important role in healthcare in terms of gathering information on healthcare, sharing of personal interests and providing social support. Virtual communities provide a way for a group of peers to communicate with each other.…

  3. The restructuring of the health resources devoted to the environmental health in the Community of Madrid

    Directory of Open Access Journals (Sweden)

    J. M. Ordóñez Iriarte


    Full Text Available The Environmental Health, in its broadest sense, wich includes what is administratively meant Environmental Health and Food Hygiene, was traditionally performed by the Titular Chemists, Dictors and Veterinary Surgeons who perforrmed their duties within the limits of the Partidos (Areas or districts within the jurisdiction of a Court. Upon this structures, created in 1953, different technical and political events have been influencing for years, making their restructuring necessary in order to be able to answer the whole of the problems that worry the Public Health.This work tries to describe the model of Chemist and Veterinary Services restructuring carried out within the Community of Madrid, to analyze this model, and to propose a model of restructuring of this Services that can be a paradigm for thouse Communities that have not undertaken the same process yet.The methodology we have used is the analysis of the situation before and after the Chemist and Veterinary Services restructuring carried out by means of two different Orders of the Community of Madrid.“Partido” structures have become obsolete, so the restructuring of resources is a necessity. The approach of this restructuring must be done far from any corporativist tamptation and considerating the possibility of incorporating other professionals different from the traditional ones in view of the increasing complexity of the problems of Environmental Health.

  4. A Community Health Approach to Asthma in the Schools (United States)

    Weiss-Randall, Debra


    Asthma is a leading cause of school absenteeism in the United States, especially in poor and minority communities, where prevalence and hospitalization rates are significantly higher than average. A community health approach can help poorer school districts hire full-time nurses and access other health resources.

  5. The Community Mental Health Center as a Matrix Organization. (United States)

    White, Stephen L.


    This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

  6. Community Health Nursing Curriculum. Components in Baccalaureate Nursing Education. (United States)

    Catell, Grace Manion

    Community health nursing curriculum components in a sample of baccalaureate nursing programs were investigated. Questionnaires were sent to a sample of 12 National League of Nursing (NLN) accredited, generic, baccalaureate nursing programs representative of the four NLN regions in the United States. Community health nursing content in theory…

  7. Service Learning and Community Health Nursing: A Natural Fit. (United States)

    Miller, Marilyn P.; Swanson, Elizabeth


    Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…

  8. The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2007. The National Survey of Children's Health (United States)

    US Department of Health and Human Services, 2011


    The National Survey of Children's Health (NSCH) provides a unique resource with which to analyze the health status, health care use, activities, and family and community environments experienced by children in rural and urban areas. The NSCH was designed to measure the health and well-being of children from birth through age 17 in the United…

  9. Implementation research on community health workers’ provision of maternal and child health services in rural Liberia (United States)

    Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J


    Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511

  10. Community involvement in health services at Namayumba and Bobi health centres: A case study

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    Jane F. Namatovu


    Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.

  11. Vegetation communities associated with the 100-Area and 200-Area facilities on the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Stegen, J.A.


    The Hanford Site, Benton County, Washington, lies within the broad semi-arid shrub-steppe vegetation zone of the Columbia Basin. Thirteen different habitat types on the Hanford Site have been mapped in Habitat Types on the Hanford Site: Wildlife and Plant Species of Concern (Downs et al. 1993). In a broad sense, this classification is correct. On a smaller scale, however, finer delineations are possible. This study was conducted to determine the plant communities and estimate vegetation cover in and directly adjacent to the 100 and 200 Areas, primarily in relation to waste sites, as part of a comprehensive ecological study for the Compensation Environmental Response, Compensation, and Liability Act (CERCLA) characterization of the 100 and 200 Areas. During the summer of 1993, field surveys were conducted and a map of vegetation communities in each area, including dominant species associations, was produced. The field surveys consisted of qualitative community delineations. The community delineations described were made by field reconnaissance and are qualitative in nature. The delineations were made by visually determining the dominant plant species or vegetation types and were based on the species most apparent at the time of inspection. Additionally, 38 transects were run in these plant communities to try to obtain a more accurate representation of the community. Because habitat disturbances from construction/operations activities continue to occur in these areas, users of this information should be cautious in applying these maps without a current ground survey. This work will complement large-scale habitat maps of the Hanford Site.

  12. [Health for all--the development of community health nursing and public health nursing from the perspective of education]. (United States)

    Lin, Pay-Fan


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

  13. [Methodology for health assets mapping in a community]. (United States)

    Botello, Blanca; Palacio, Sergio; García, Mercedes; Margolles, Mario; Fernández, Federico; Hernán, Mariano; Nieto, Javier; Cofiño, Rafael


    Within the development of a regional strategy for community health engagement in Asturias (Spain), and connected to the Health Observatory, we carried out a methodology to initiate the mapping of health assets at a local level. This methodology begins with a description of the most formal resources and of the pre-existing community activities, together with a characterization of the most informal, personal and symbolic health resources. We introduce our tools, grouped for the development of mapping, and explain their connection with the theoretical models of salutogenesis, asset model and community development.

  14. Selecting alternative strategies for community health education in guineaworm control. (United States)

    Brieger, W R; Ramakrishna, J; Akpovi, S U; Adeniyi, J D


    Community health education strategies in guineaworm control can be applied at several intervention levels. Community development mobilizes local resources to provide safe water supplies such as wells. Mass education in schools and communities can teach personal protection measures such as filtering water. Training of volunteer community health workers produces front line staff, who by being culturally in tune with the community can demonstrate and promote the use of appropriate prevention and treatment measures. Advocacy assists community members to express their needs to government and ministry decision makers. All of these strategies have been applied in a community health education/primary health care program in Idere, Ibarapa District, Oyo State. Community development for well construction was found to be a long-term strategy that first must overcome problems of village organization and resource location. Mass education, to be effective, must have a simple and acceptable technology to promote. Trained village health workers must overcome traditional beliefs that inhibit use of preventive and treatment measures. Advocacy requires basic political education of community leaders. A variety of health education strategies is needed to address short- and long-term priorities as well as to overcome the different barriers to guineaworm control.

  15. Service planning in the Victorian community health sector. (United States)

    Roussy, Véronique; Livingstone, Charles


    Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.

  16. Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review

    Directory of Open Access Journals (Sweden)

    Asha S. George


    Full Text Available Abstract Background Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs. Methods We searched for journal articles published between 2000 and 2012 related to the concepts of “community”, “capability/participation”, “health systems research” and “LMIC.” We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. Results When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community


    Directory of Open Access Journals (Sweden)

    Karina Battes


    Full Text Available The present paper represents a preliminary study of periphyton and zoobenthos community from the Someşul Cald catchment area. Zoobenthos was sampled seasonally during 2000. Benthic community structure was similar at the five sampling sites. Thus, mayflies and chironomids recorded high numerical percentage abundances and densities. Oligochaetes, water mites and caddisflies were identified to species level. 38 Oligochaeta, 28 water mite and 12 caddis fly species were found in the sampling period. The samplings collected in the year 2001 included 80 algal species belonging to 5 phyla. Diatoms (Bacillariophyta dominated both qualitatively and quantitatively at all sampling sites.

  18. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru

    Directory of Open Access Journals (Sweden)

    Zumaran Adriana


    Full Text Available Abstract Objective To describe the profile of community health workers – health promoters, traditional birth attendants and traditional healers – in rural Quechua communities from Ayacucho, Peru. Methods Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. Results The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. Conclusion It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

  19. The fear of crime and area differences in health. (United States)

    Chandola, T


    A number of studies have shown that major health inequalities exist between different areas within the UK. However, there has been some debate about the mechanisms underlying area differences in health. One of the mechanisms which could explain area differences in health is the fear of crime in the local area or neighbourhood. This study examines data from the 1996 British Crime Survey (N=16,090). The fear of crime was found to be associated with self-rated health even after adjusting for health behaviours and a number of individual and household level socio-economic factors. Area differences in self-rated health were reduced to non-significance after health behaviours, socio-economic factors and the fear of crime were adjusted for in the regression model. There is some evidence that fear of crime is associated with health and it may have an important role in explaining area differences in health.

  20. Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California (United States)

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel


    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

  1. The voluntary community health movement in India: a strengths, weaknesses, opportunities, and threats (SWOT) analysis. (United States)

    Sharma, M; Bhatia, G


    There has been a prolific growth of voluntary organizations in India since independence in 1947. One of the major areas of this growth has been in the field of community health. The purpose of this article is to historically trace the voluntary movement in community health in India, analyze the current status, and predict future trends of voluntary efforts. A review of the literature in the form of a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was the method of this study. Some of the key trends which emerged as the priority areas for progress and for strengthening voluntary organizations in the future were enhancing linkages between health and development; building upon collective force; greater utilization of participatory training; establishing egalitarian and effectual linkages for decision making at the international level; developing self-reliant community-based models; and the need for attaining holistic empowerment at individual, organizational, and community levels through "duty consciousness" as opposed to merely asking for rights.

  2. Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers? (United States)

    Mockshell, Jonathan; Ilukor, John; Birner, Regina


    The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.

  3. Using Community Health Workers in Community-Based Growth Promotion: What Stakeholders Think (United States)

    Afulani, Patience A.; Awoonor-Williams, John K.; Opoku, Ernest C.; Asunka, Joseph


    The Nutrition and Malaria Control for Child Survival Project is a community-based growth promotion project that utilizes Community Health Workers (CHWs), referred to as Community Child Growth Promoters (CCGPs), as the principal change agents. The purpose of this study was to identify perceptions of key stakeholders about the project and the role…

  4. Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community (United States)

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


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

  5. Capacity building for health through community based participatory nutrition intervention research in rural communities (United States)

    Building community capacity for health promotion in small rural communities is essential if health promotion research is to yield sustainable outcomes. Since its inception, capacity-building has been a stated goal of the Delta Nutrition Intervention Research initiative, a tri-state collaboration in ...

  6. Marine protected areas increase resilience among coral reef communities. (United States)

    Mellin, Camille; Aaron MacNeil, M; Cheal, Alistair J; Emslie, Michael J; Julian Caley, M


    With marine biodiversity declining globally at accelerating rates, maximising the effectiveness of conservation has become a key goal for local, national and international regulators. Marine protected areas (MPAs) have been widely advocated for conserving and managing marine biodiversity yet, despite extensive research, their benefits for conserving non-target species and wider ecosystem functions remain unclear. Here, we demonstrate that MPAs can increase the resilience of coral reef communities to natural disturbances, including coral bleaching, coral diseases, Acanthaster planci outbreaks and storms. Using a 20-year time series from Australia's Great Barrier Reef, we show that within MPAs, (1) reef community composition was 21-38% more stable; (2) the magnitude of disturbance impacts was 30% lower and (3) subsequent recovery was 20% faster that in adjacent unprotected habitats. Our results demonstrate that MPAs can increase the resilience of marine communities to natural disturbance possibly through herbivory, trophic cascades and portfolio effects.

  7. Perceptions of the community on the pricing of community mental health services. (United States)

    Ogden, J R; Ogden, D T


    In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

  8. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health. (United States)

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina


    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  9. Neighborhood adversity, child health, and the role for community development. (United States)

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


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

  10. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Aagaard, Jørgen


    Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi-experime......Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi...... in use of supportive housing make the effects of ACT on overall costs more ambiguous. At worst, however, overall costs did not increase. Given the generally acknowledged clinical benefits of ACT over standard outpatient care, the results support further dissemination of ACT in Denmark....

  11. Sexual and Reproductive Health Behaviors of California Community College Students (United States)

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp


    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  12. Community Health Workers and Their Value to Social Work (United States)

    Spencer, Michael S.; Gunter, Kathryn E.; Palmisano, Gloria


    Community health workers (CHWs) play a vital and unique role in linking diverse and underserved populations to health and social service systems. Despite their effectiveness, as documented by empirical studies across various disciplines including public health, nursing, and biomedicine, the value and potential role of CHWs in the social work…

  13. Actions States and Communities Can Take to Address Cognitive Health

    Centers for Disease Control (CDC) Podcasts


    In this podcast, CDC’s Dr. Lynda Anderson highlights the important roles that states and communities can play in addressing cognitive health as part of overall health.  Created: 6/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/9/2014.

  14. A role for community health promoters in tuberculosis control in the state of Chiapas, Mexico. (United States)

    Herce, Michael E; Chapman, Jacob A; Castro, Arachu; García-Salyano, Gabriel; Khoshnood, Kaveh


    We conducted a qualitative study employing structured interviews with 38 community health workers, known as health promoters, from twelve rural municipalities of Chiapas, Mexico in order to characterize their work and identify aspects of their services that would be applicable to community-based tuberculosis (TB) control programs. Health promoters self-identify as being of Mayan Indian ethnicity. Most are bilingual, speaking Spanish and one of four indigenous Mayan languages native to Chiapas. They volunteer 11 h each week to conduct clinical and public health work in their communities. Over half (53%) work with a botiquín, a medicine cabinet stocked with essential medicines. Fifty-three percent identify TB as a major problem affecting the health of their communities, with one-fifth (21%) of promoters reporting experience caring for patients with known or suspected TB and 29% having attended to patients with hemoptysis. One-third of health promoters have access to antibiotics (32%) and one-half have experience with their administration; 55% complement their biomedical treatments with traditional Mayan medicinal plant therapies in caring for their patients. We describe how health promoters employ both traditional and allopathic medicine to treat the symptoms and diseases they encounter most frequently which include fever, diarrhea, and parasitic infections. We contend that given the complex sociopolitical climate in Chiapas and the state's unwavering TB epidemic and paucity of health care infrastructure in rural areas, efforts to implement comprehensive, community-based TB control would benefit from employing the services of health promoters.

  15. Area Environment and Health in the Netherlands

    NARCIS (Netherlands)

    C. van Hooijdonk (Carolien)


    markdownabstract__Abstract__ Geographical differences in health are becoming an increasingly important theme in the field of public health. Studies focusing on health differences between countries, or regions within countries, or even at a smaller geographical scale, provide evidence for geographic

  16. Health And Social Status Of Senior Citizens In Rural Areas

    Directory of Open Access Journals (Sweden)

    Sunder Lal


    Full Text Available Research Problem: What is the quality of life of the elderly people, as also the available support system, in rural areas?    ■Objectives:i             To determine the demographic profile of eld­erlyii            To assess the socio-economic, nutritional, health, morbidity and dependency status, and health care utilization.Study Design: Population based cross sectional study.Setting:        Community        Development   Block     -LakhanmajraParticipants: Persons above the age of 65 years.Sample Size: 809 elderly above the age of 65 years.Study Variables: Demographic profile, Literacy, Oc­cupation, Health, Nutrition, Mobility, Dependency, Substance abuse, Support system.Statistical Analysis: By simple proportions.Result: In this study, majority ofthe elderly were self reliant and mobile, being an asset to the family and led socially useful and productive lives. Their pre­dominant problems were visual impairment, joint pains, respiratory diseases and hearing impairment. Joint family and government pension was the major support system to the elderly. However, there is an imperative need to organize education, training and special service programmes for the elderly at the village level.

  17. Participatory Democracy, Community Organizing and the Community Assessment of Freeway Exposure and Health (CAFEH) Partnership (United States)

    Sprague Martinez, Linda; Reisner, Ellin; Campbell, Maria; Brugge, Doug


    Background: Conflicting interests, power imbalance and relationships characterized by distrust are just a few of the many challenges community–academic research partnerships face. In addition, the time it takes to build relationships is often overlooked, which further complicates matters and can leave well-intentioned individuals re-creating oppressive conditions through inauthentic partnerships. This paper presents a novel approach of using meeting minutes to explore partnership dynamics. The Community Assessment of Freeway Exposure and Health (CAFEH) partnership is used as an illustrative case study to identify how community academic partnerships overcome the challenges associated with community-based participatory research (CBPR). CAFEH is a study of ultrafine particle exposure (UFP) near highways in the Boston, MA area. Methods: Qualitative analysis was applied to meeting minutes and process evaluation reports from the first three years of the CAFEH study (n = 73 files). In addition, a group meeting was held with project partners in order to contextualize the findings from the document analysis. Results: The three most commonly referenced challenges included language barriers, the overall project structure and budgetary constraints. Meanwhile, a heavy emphasis on process and an approach steeped in participatory democracy facilitated CAFEH’s ability to overcome these challenges, as well as sustain and augment strong partnership ties. Conclusions: This experience suggests that leadership that incorporates an organizing approach and a transformational style facilitates CBPR processes and helps teams surmount challenges. PMID:28165418

  18. Does sustained participation in an online health community affect sentiment? (United States)

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie


    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members' behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members.

  19. Using Social Network Analysis as a Method to Assess and Strengthen Participation in Health Promotion Programs in Vulnerable Areas

    DEFF Research Database (Denmark)

    Hindhede, Anette Lykke; Aagaard-Hansen, Jens


    This paper provides an example of the application of Social Network Analysis (SNA) method to assess community participation thereby strengthening planning and implementation of health promotion programming. Community health promotion often takes the form of services that reach out to or are locat...... of interpersonal ties among people who know one another well as well as more tenuous relationships in networks can be used by community development workers to foster greater cohesion and cooperation within an area....

  20. Using social network analysis as a method to assess and strengthen participation in health promotion programs in vulnerable areas

    DEFF Research Database (Denmark)

    Hindhede, Anette Lykke; Aagaard-Hansen, Jens


    This paper provides an example of the application of Social Network Analysis (SNA) method to assess community participation thereby strengthening planning and implementation of health promotion programming. Community health promotion often takes the form of services that reach out to or are locat...... of interpersonal ties among people who know one another well as well as more tenuous relationships in networks can be used by community development workers to foster greater cohesion and cooperation within an area....

  1. Preparation for Community Health Nursing: Issues and Problems. (United States)

    And Others; White, Caroline


    Highlights of a survey of community health nursing agencies and faculty suggest the need for better planning and collaboration between service and education in preparing students for this field. Survey data tables are included. (CT)

  2. Water harvesting techniques for small communities in arid areas. (United States)

    Yuen, E; Anda, M; Mathew, K; Ho, G


    Limited water resources exist in numerous remote indigenous settlements around Australia. Indigenous people in these communities are still living in rudimentary conditions while their urban counterparts have full amenities, large scale water supplies and behavioral practices which may not be appropriate for an arid continent but are supported by extensive infrastructure in higher rainfall coastal areas. As remote indigenous communities continue to develop, their water use will increase, and in some cases, costly solutions may have to be implemented to augment supplies. Water harvesting techniques have been applied in settlements on a small scale for domestic and municipal purposes, and in the large, broadacre farm setting for productive use of the water. The techniques discussed include swales, infiltration basins, infiltration trenches and "sand dam" basins. This paper reviews the applications of water harvesting relevant to small communities for land rehabilitation, landscaping and flood control. Landscaping is important in these communities as it provides shelter from the sun and wind, reduces soil erosion and hence reduced airborne dust, and in some cases provides food and nutrition. Case studies of water harvesting systems applied in the Pilbara Region, Western Australia for landscaping around single dwellings in Jigalong and Cheeditha, in a permaculture garden in Wittenoon and at a college and carpark in Karratha are described.

  3. Functionalism and holism: community nurses' perceptions of health. (United States)

    Long, A; Baxter, R


    This paper reports the results of a study that was designed to explore and examine the perceptions of two groups of newly qualified community nurses about the factors they considered to be embedded within the concepts of health, health-enhancing behaviours at individual, family and community levels and their 'innermost self'. The research was exploratory in nature, and included two sample groups: group 1 comprised 16 newly qualified health visitors; group 2 comprised 16 newly qualified community mental health nurses. Purposive sampling was used and data were collected using semi-structured interviews. The group of health visitors perceived health in terms of physical fitness and functional states. At a global level they perceived the need to provide education on health matters. They gave generously to 'charities' and perceived the 'inner self' as 'that part that matters'. The group of community mental health nurses perceived health in terms of holism and being states. Their concept of health was related to listening to each individual's perception of what is 'right' and 'health-enhancing' for them. At a global level they considered the protection of the ozone layer and the promotion of a just and equitable society which focused on the reduction of poverty, to be key health-enhancing activities. They perceived their 'innermost self' to be 'that part of me that makes life worth living', and the soul. The findings have implications for developing new and creative approaches for teaching the holistic concept of health and healing. Educational activities could be designed which strive to ensure that nurses themselves have safe and health embracing opportunities for exploring all the elements that are embedded within the topic of health. Their role in facilitating holistic health promoting activities for all clients also needs to be addressed.

  4. Capacity building for health through community-based participatory nutrition intervention research in rural communities. (United States)

    Downey, Laura H; Castellanos, Diana Cuy; Yadrick, Kathy; Threadgill, Paula; Kennedy, Betty; Strickland, Earline; Prewitt, T Elaine; Bogle, Margaret


    Since its inception, capacity building has been a stated goal of the Delta Nutrition Intervention Research Initiative, a tri-state collaboration in the Lower Mississippi Delta to address high rates of chronic disease. Textual analysis of project documents identifies and describes strategies carried out to foster capacity building. Strategies to build community capacity include fostering participation, cultivating leadership opportunities, training community members as co-researchers, securing community resources, and implementing the intervention together. Incorporating capacity-building approaches in health promotion and nutrition-intervention programming in rural communities provides a means to enhance potential for sustainability of health outcomes and developed effectiveness.

  5. The Wellness Mobile: Bringing Preventative Health Services to Rural Communities. (United States)

    Nilson, Ralph; And Others


    The Wellness Mobile transports medical supplies, equipment, informational materials, and staff to rural Saskatchewan communities to assist them in developing wellness programs that stress disease prevention. Staff from the Wellness Mobile offer health-risk screening and appraisal to community members and work with local practitioners and schools…

  6. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative. (United States)

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Borton, J Elaine; Wright, Merrick; Chase, Charlie; Lindley, Corina


    Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization.

  7. Community mental health care worldwide: current status and further developments. (United States)

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire


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

  8. Preparing the U.S. health community for climate change. (United States)

    Jackson, Richard; Shields, Kyra Naumoff


    In society's effort to address and prepare for climate change, the health community itself must ensure that it is prepared. Health personnel will require flexible and iterative action plans to address climate change at the individual, hospital, local health department, state, and national levels. This requires that health workers analyze the impact of climate change with a view to human health, and then formulate robust policy and demonstrate authentic leadership. In this review, we summarize the status of the health community's preparation for climate change and provide specific recommendations for action at each level. Although preparation status and recommendations vary, our observation is that it is not enough for public health and medical care agencies and departments to develop policies and advocate change. They have a direct responsibility to demonstrate substantive leadership.

  9. Setting health priorities in a community: a case example

    Directory of Open Access Journals (Sweden)

    Fábio Alexandre Melo do Rego Sousa

    Full Text Available ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1 grouping by level of similarity, (2 classification according to epidemiological criteria, (3 ordering by experts, and (4 application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence. The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community.

  10. Setting health priorities in a community: a case example (United States)

    Sousa, Fábio Alexandre Melo do Rego; Goulart, Maria José Garcia; Braga, Antonieta Manuela dos Santos; Medeiros, Clara Maria Oliveira; Rego, Débora Cristina Martins; Vieira, Flávio Garcia; Pereira, Helder José Alves da Rocha; Tavares, Helena Margarida Correia Vicente; Loura, Marta Maria Puim


    ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1) grouping by level of similarity, (2) classification according to epidemiological criteria, (3) ordering by experts, and (4) application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence). The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community. PMID:28273229

  11. Investigating the myth of the "model minority": a participatory community health assessment of Chinese and Vietnamese adults. (United States)

    Tendulkar, Shalini Ahuja; Hamilton, Renée Cammarata; Chu, Chieh; Arsenault, Lisa; Duffy, Kevin; Huynh, Van; Hung, Mei; Lee, Eric; Jane, Shwuling; Friedman, Elisa


    Despite the persistent belief that Asians are the "model minority" there is accumulating evidence of health concerns within Asian subgroups. In this study, we implemented a cross-sectional participatory community health assessment in an urban city in Massachusetts, to understand differences and similarities in demographics, health and healthcare access in Chinese and Vietnamese adults. We gathered qualitative data from community stakeholders to inform the development of a community health assessment tool. The tool elicited information on healthcare access, health status, behavioral health and chronic disease history and treatment. Healthcare access issues and poor health status, particularly among Chinese participants and mental health symptomotology in both groups were areas of concern. These findings revealed important health concerns in two Asian ethnic groups. Studies are needed to better understand these concerns and inform programs and policies to improve health outcomes in these Asian ethnic groups.

  12. Mental health nurses' contributions to community mental health care: An Australian study. (United States)

    Heslop, Brett; Wynaden, Dianne; Tohotoa, Jenny; Heslop, Karen


    Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses' experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.

  13. Considerations for community-based mHealth initiatives: insights from three Beacon Communities. (United States)

    Abebe, Nebeyou A; Capozza, Korey L; Des Jardins, Terrisca R; Kulick, David A; Rein, Alison L; Schachter, Abigail A; Turske, Scott A


    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs.

  14. Community, service, and policy strategies to improve health care access in the changing urban environment. (United States)

    Andrulis, D P


    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs.

  15. Toward a Model of Psychological Health Empowerment: Implications for Health Care in Multicultural Communities. (United States)

    Menon, Sanjay T.


    The context for health empowerment includes individuals, health providers, and the regulatory environment. Psychological health empowerment consists of perceived control, perceived competence, and goal internalization. In multicultural communities, barriers to empowerment include locus of control, access to health care, and language and cultural…

  16. Community Dental Health Promotion for Children: Integrating Applied Behavior Analysis and Public Health. (United States)

    Kramer, Kathryn D.; Geller, E. Scott


    The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…

  17. Home visits by Family Health Strategy nurses and community health agents

    Directory of Open Access Journals (Sweden)

    Luciana Valadão Alves Kebian


    Full Text Available The objective of this article was to describe the practice of nurses and community health agents within the context of the Family Health Strategy home visits. This is a descriptive study with a qualitative approach. Data collection was performed between January and March of 2010, through semi-structured interviews with eight nurses and seven community health agents from two family health units in the city of Rio de Janeiro. Data were submitted to content analysis. Low interaction was observed between nurses and community health agents in the home visits. Work overload and violence are the main hindrances identified for performing home visits. It was found that the home visit planning was unsystematic. Permanent education should be intensified with the purpose to discuss, following a problem-posing approach, the roles and attributions of each team member in the home visit, as well as the systematization of this activity. Descriptors: Family Health; Nursing; Community Health Workers; Home Visit.

  18. Sense of Community among Chinese Older Adults in the Greater Chicago Area: Findings from the PINE Study

    Directory of Open Access Journals (Sweden)

    Xinqi Dong


    Full Text Available Background: Sense of community is a concept that has significant implications cross multiple disciplines, particularly in public health practice. However, there exists a knowledge gap in utilizing the sense of community in investigating the health of older immigrant populations. Objective: This study aimed to explore the perception of the sense of community among community-dwelling U.S. Chinese older adults. Methods: Data were from the PINE study, a population-based survey of U.S. Chinese older adults aged 60 years and above in the greater Chicago area. We administered the Sense of Community Index to measure the levels of sense of community. Socio-demographic information was also collected. Results: Our results suggest that Chinese older adults in this study sample reported a strong sense of community. In total, 86.7% of the participants reported satisfaction with the current neighborhood, and 78.4% expressed their desire to continue living in the community as long as possible. In addition, older age (r =0.11, having higher levels of income (r =0.08, being female (r =0.08, being unmarried (r =-0.06, living with fewer people (r =-0.22, having more children (r =0.11, having been in the U.S. for more years (r =0.12, longer residency in the community (r =0.15, higher overall health status (r =0.18, better quality of life (r =0.23, and improved health status in the past year (r =0.11 were significantly correlated with the higher levels of the sense of the community. Conclusions: The study investigation provided the basis for generating empirical knowledge for understanding the sense of community among U.S. Chinese older adults. Future research is needed to delineate the mechanisms underlying sense of community and health in the increasingly diverse aging population.

  19. Health Issues in the Latino Community. (United States)

    Aguirre-Molina, Marilyn, Ed.; Molina, Carlos W., Ed.; Zambrana, Ruth Enid, Ed.

    This collection of papers includes 6 parts. Part 1, "Latino Populations in the United States," includes: (1) "Latino Health Policy: Beyond Demographic Determinism" (Angelo Falcon, Marilyn Aguirre-Molina, and Carlos W. Molina); (2) "Latino Health Status" (Olivia Carter-Pokras and Ruth Enid Zambrana); and (3)…

  20. Residual Barriers for Utilization of Maternal and Child Health Services: Community Perceptions From Rural Pakistan. (United States)

    Memon, Zahid; Zaidi, Shehla; Riaz, Atif


    Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers.

  1. Health Literacy and Happiness: A Community-Based Study (United States)

    Angner, Erik; Miller, Michael J.; Ray, Midge N.; Saag, Kenneth G.; Allison, Jeroan J.


    The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: "How confident are you in filling out medical forms by yourself?" Happiness was measured using an adapted…

  2. "Razoo Health:" A Community-Based Nursing Education Initiative. (United States)

    Kraus, Marjorie B.; Morgan, Connie M.; Matteson, Peggy S.


    In New Orleans, nursing faculty and students partnered with inner-city schools and churches to mobilize neighborhood assets and improve health care. Students learned community assessment skills and worked with empowered citizens who reclaimed their health resources. (Contains 28 references.) (SK)

  3. Exploring Community Health through the Sustainable Livelihoods Framework (United States)

    Barnidge, Ellen K.; Baker, Elizabeth A.; Motton, Freda; Fitzgerald, Teresa; Rose, Frank


    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The…

  4. Papago Indian Modernization: A Community Scale for Health Research (United States)

    Patrick, Ralph; Tyroler, H. A.


    An index of the modernization of Papago communities was developed to test whether social and cultural processes are involved in the determination of human health and whether rapid social change affects health. An earlier version of this paper was presented at the annual meeting of the American Anthropological Association, Detroit, 1964. (FF)

  5. The Impact of Economic Stress on Community Mental Health Services. (United States)

    Hagan, Brian J.; And Others


    Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)

  6. An Informatics Approach to Establishing a Sustainable Public Health Community (United States)

    Kriseman, Jeffrey Michael


    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  7. Community mobilisation and health management committee strengthening to increase birth attendance by trained health workers in rural Makwanpur, Nepal: study protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Manandhar Dharma


    Full Text Available Abstract Background Birth attendance by trained health workers is low in rural Nepal. Local participation in improving health services and increased interaction between health systems and communities may stimulate demand for health services. Significant increases in birth attendance by trained health workers may be affected through community mobilisation by local women's groups and health management committee strengthening. We will test the effect of community mobilisation through women's groups, and health management committee strengthening, on institutional deliveries and home deliveries attended by trained health workers in Makwanpur District. Design Cluster randomised controlled trial involving 43 village development committee clusters. 21 clusters will receive the intervention and 22 clusters will serve as control areas. In intervention areas, Female Community Health Volunteers are supported in convening monthly women's groups. The groups work through an action research cycle in which they consider barriers to institutional delivery, plan and implement strategies to address these barriers with their communities, and evaluate their progress. Health management committees participate in three-day workshops that use appreciative inquiry methods to explore and plan ways to improve maternal and newborn health services. Follow-up meetings are conducted every three months to review progress. Primary outcomes are institutional deliveries and home deliveries conducted by trained health workers. Secondary outcome measures include uptake of antenatal and postnatal care, neonatal mortality and stillbirth rates, and maternal morbidity. Trial registration number ISRCTN99834806

  8. The evolution of the Fenway Community Health model. (United States)

    Mayer, K; Appelbaum, J; Rogers, T; Lo, W; Bradford, J; Boswell, S


    Fenway Community Health was founded by community activists in 1971 in the Fenway neighborhood of Boston, Mass, and within a decade had rapidly expanded its medical services for gay men in response to the AIDS epidemic. Increased expertise and cultural competence in lesbian, gay, bisexual, and transgender (LGBT) care led to expansion of medical services to address broader community concerns, ranging from substance use to parenting issues to domestic and homophobic violence, as well as specialized programs for lesbians, bisexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recorded 5000 patient care visits; in 2000, Fenway's clinical departments recorded 50,850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff people responsible for clinical programs, community education, research, administration, planning, and development. Over the past few years, Fenway's annual budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGBT health issues for other health providers and has developed programs to educate the general community about specific LGBT health concerns. This health center may provide a model of comprehensive LGBT health services that have a local impact.

  9. DEA-based Evaluation of Fund Utilization Efficiency of Basic Public Health Services in the Communities of Binhai New Area of Tianjin%基于数据包络分析的天津市滨海新区社区基本公共卫生服务资金利用效率评价

    Institute of Scientific and Technical Information of China (English)

    杨椿; 王军爽


    Objective To evaluate the fund utilization efficiency of basic public health services in the communities of Binhai New Area of Tianjin and to find out the problems in order to provide references for policy making. Methods In 2013,we enrolled all 14 community health service centers in Binhai New Area,including 6 centers( A、B、C、D、E、F)in Tanggu,4 centers( G、H、I、J)in Hangu and 4 centers( K、L、M、N)in Dagang. We examined a series of indicators,among which 2 were input indicators, including community basic public health service expenditure and national basic public health service subsidy,and 6 were output indicators,including the number of residents with health records,children aged 0 to 6 under health management,pregnant and lying - in women under health management, elderly people aged more than 65 under health management,people under hypertension management and people under diabetes management. The fund utilization efficiency of community basic public health services was evaluated using DEAP 2. 1 software package. Results The average overall efficiency, pure technical efficiency,and scale efficiency of the 14 community health service centers were 0. 746,0. 934 and 0. 805. Among the 14 community health service centers,6 centers showed effectiveness in DEA with constant returns to scale,and 8 centers showed ineffectiveness in DEA with progressive decrease in scale. Conclusion The fund utilization efficiency of basic public health services in the communities of Binhai New area of Tianjin needs further improvement. Scientific management theory should be used to promote service function,innovative fund input mechanism should be adopted to increase fund utilization efficiency, the pattern of health care should be well designed in order to make the best use of health resources,and the evaluation system of basic public health service should be promoted to increase the efficiency of health services.%目的:评价天津市滨海新区社区基本公共卫

  10. Using public health and community partnerships to reduce density of alcohol outlets. (United States)

    Jernigan, David H; Sparks, Michael; Yang, Evelyn; Schwartz, Randy


    Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets - the number of physical locations in which alcoholic beverages are available for purchase either per area or per population - through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms. We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska. Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.

  11. Empowering Minority Communities with Health Information - WSSU

    Energy Technology Data Exchange (ETDEWEB)

    McMurray, L. and W. Templin-Branner


    Environmental health focus with training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine HBCU ACCESS Project at Winston-Salem State University, NC on November 10, 2010.

  12. Community intervention in higher education of environmental health


    Cidália Guia; Raquel Rodrigues dos Santos; Rogério da Silva Nunes


    Currently, in the Bologna context, university teaching methods focus on the student and on a learning experience based on practical methods. Under the guidance of teachers, students in the second year of the first Environmental Health Course at the Polytechnic Institute of Beja have designed and developed the following nine community intervention projects relating to environmental health: dangerous products (mercury); habitability and geriatrics; health education and the environment; drinking...

  13. Psychological and socioeconomic health of community-dwelling older adults. (United States)

    Chen, Kuei-Min; Lin, Mei-Hui; Wang, Yueh-Chin; Li, Chun-Huw; Huang, Hsin-Ting


    Different dimensions of health are intertwined. The purposes of this study were: (1) to investigate the psychological and socioeconomic health status of community-dwelling older adults in Taiwan, and (2) to compare the psychological and socioeconomic health differences among people of different age groups, gender, marital status, and exercise habits. Using stratified random sampling, 384 Taiwanese community-dwelling older adults were recruited for this survey research. Based on the Health Model of Older Adults, seven constructs were measured: (1) psychological health: sleep quality, emotional health, cognitive functioning, and health promotion behaviors; (2) socioeconomic health: social engagement, social support, and financial status. Results showed that most participants were in a good state of psychological and socioeconomic health, except that 38.02% of them suffered from sleep disruptions, and the majority of them were not involved in any social group, nor engaged in any volunteer work. Young-old older adults had better psychological and socioeconomic health than middle-old and old-old older adults. Male older adults had better psychological health than female older adults; however, they had less social engagement and social support than female older adults. Married older adults and exercisers performed better in most of the psychological and socioeconomic health indicators than single/widowed older adults and non-exercisers.

  14. Community participation for transformative action on women's, children's and adolescents' health. (United States)

    Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda


    The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.

  15. Evaluation of the effectiveness of a community health worker training course in India

    Directory of Open Access Journals (Sweden)

    Nicole Butcher


    Full Text Available Community health workers (CHWs have long played a key role in delivering healthcare in rural and remote populations, through primary care, prevention, and education. Numerous mechanisms of training and supporting CHWs have been implemented, and the World Health Organization (WHO has outlined recommendations for the programmatic and financial aspects of CHW programs. This study evaluated the outcomes of a CHW training program in India whereby community development workers from faith-based organisations have been trained since 2011 to extend health promotion, education, and basic services to rural, remote, and poor communities across the country. Triangulation of quantitative and qualitative data and course information was conducted, and analysis pointed to the effectiveness of the trainees in their respective work locations. Outcomes were noted in these areas: health promotion (trainees had gained skills and confidence to implement health promotion interventions; first aid and primary care (graduates were treating common conditions in the community; beneficiary diversity (rural and poor beneficiaries were frequently cited as well as trainees and their families; and, spiritual health (the nurture of person was an important part of conducting CHW activities. The consistency of the data across these areas suggests that the training course is effective in its delivery, its contribution to the expansion of healthcare coverage, and its potential for impact across India.


    Institute of Scientific and Technical Information of China (English)

    尹志勤; 陈丽莉; 涂海霞; 陈军; 陈朝霞


    [目的]探讨温州市农村空巢老人日常生活能力状况、社区卫生服务意愿及影响因素.[方法]采取分层随机整群抽样的方法获取样本.用ADL量表、社区卫生服0务意愿调查表对1 107名空巢老人进行调查.[结果]空巢老人的ADL完好率为69.3%;不同性别的老人ADL各项目下降的比例不同;年龄、文化程度、经济收入、慢性病是影响ADL的主要因素.78.5%的空巢老人有接受社区卫生服务意愿,对定期体检的需求最高;其以往职业、经济收入、行走能力对其社区卫生服务意愿有重要的影响.[结论]加大对高龄老人的护理照顾投入、搞好慢性病的防治、加强健康教育、保证老人的基本经济收入仍是今后农村社区卫生工作不可忽视的问题.应针对农村空巢老人的不同特点,开展老人需要且愿意接受的社区卫生服务.%[Objective] To explore level of daily ability of empty nest elderly in rural areas in Wenzhou, their willingness to accept community health service and their influential factors. [Methods] 1 107 empty nest elderly in rural areas were selected through stratified random cluster sampling. ADL scale and willingness to accept community health service questionnaire were used for the investigation. [ Results ] ADL intact ratio of empty nest elderly was 69.3%; decrease in all instrumental activities of daily living of empty nest elderly differed with gender; age, education level, income and chronic diseases were mainly influential factors of ADL 78.5% of empty nest elderly were willing to accept community health service, and they ranked regular physical examination as the most needed service; previous occupation, income and ability of walking had important influences on willingness to accept community health service of empty nest elderly. [Conclusion] Increasing investment in nursing care for empty nest elderly, doing well in prevention and treatment of chronic diseases, enforcement

  17. Improving the health of the community: Duke's experience with community engagement. (United States)

    Michener, J Lloyd; Yaggy, Susan; Lyn, Michelle; Warburton, Samuel; Champagne, Mary; Black, MaryAnn; Cuffe, Michael; Califf, Robert; Gilliss, Catherine; Williams, R Sanders; Dzau, Victor J


    Evidence is accumulating that the United States is falling behind in its potential to translate biomedical advances into practical applications for the population. Societal forces, increased awareness of health disparities, and the direction of clinical and translational research are producing a compelling case for AHCs to bridge the gaps between scientific knowledge and medical advancement and between medical advancement and health. The Duke University Health System, the city and county of Durham, North Carolina, and multiple local nonprofit and civic organizations are actively engaged in addressing this need. More than a decade ago, Duke and its community partners began collaborating on projects to meet specific, locally defined community health needs. In 2005, Duke and Durham jointly developed a set of Principles of Community Engagement reflecting the key elements of the partnership and crafted an educational infrastructure to train health professionals in the principles and practice of community engagement. And, most recently, Duke has worked to establish the Duke Translational Medicine Institute, funded in part by a National Institutes of Health Clinical Translational Science Award, to improve health through innovative behavioral, social, and medical knowledge, matched with community engagement and the information sciences.

  18. Factors associated with sense of community among allied health students. (United States)

    Haar, Mindy; Scanlan, Craig


    Over the last decade, there has been a substantial increase in online education in the health professions, as well as growing recognition that teamwork and collaboration are essential to success. While the impact of students' sense of community on factors such as course satisfaction and retention has been studied among college enrollees in general, there is little research exploring this concept among allied health students. To address this shortcoming, a convenience sample of students enrolled in a large northeastern school of health-related professions was surveyed to gather information on their demographics, curriculum and selected course attributes, perceived instructor teaching perspectives, and sense of community. Univariate analysis indicated that entry-level students experienced a greater sense of community than post-professional students. Multivariate analysis revealed that instructor-determined factors of encouraging discussion, encouraging expression of opinions, and specifying response times best predicted sense of community. With all other variables controlled, perceptions of community were significantly lower in online courses, among students for whom English was their second language, and in courses where instructors were perceived as focused primarily on content delivery. This study supports promoting selected course and instructor-related attributes associated with sense of community in allied health education, with a particular focus on both non-native English speakers and post-professional students. Enhancement of online courses with strategies that increase instructor presence, better engage students, and facilitate interaction also are warranted.

  19. Iran's disaster risk: now is the time for community-based public health preparedness. (United States)

    Ardalan, Ali; Mowafi, Hani; Burkle, Frederick M


    The Bandar Bushehr, Iran earthquake of April 9, 2013 gravely illustrates how disaster-prone areas of the world are compounding their risk of disaster and major public health emergencies when there is a geographical convergence of natural and technological hazards. Scientists must emphasize to policy makers that ever-increasing regional industrialization and the broader introduction of nuclear facilities, especially in the Middle East, must parallel sound prevention and community-level public health preparedness planning.

  20. Geographic aspects of poverty and health in Tanzania: does living in a poor area matter? (United States)

    Mahmud Khan, M; Hotchkiss, David R; Berruti, Andrés A; Hutchinson, Paul L


    Previous studies have consistently found an inverse relationship between household-level poverty and health status. However, what is not well understood is whether and how the average economic status at the community level plays a role in the poverty-health relationship. The purpose of this study is to investigate the concentration of poverty at the community level in Tanzania and its association with the availability and quality of primary health care services, the utilization of services, and health outcomes among household categories defined by wealth scores. A principal component method has been applied to rank households separately by urban/rural location using reported levels of asset ownership and living conditions. The household wealth scores were also used to classify communities into three cluster-types based on the proportion of households belonging to the poorest wealth tercile. On average, all the wealth terciles living in low poverty concentration areas were found to have better health outcomes and service utilization rates than their counterparts living in high poverty concentration clusters. Consistent with the finding is that high poverty concentration areas were further away from facilities offering primary health care than low poverty concentration areas. Moreover, the facilities closest to the high poverty concentration areas had fewer doctors, medical equipment and drugs. Among the high poverty concentration clusters, the 10 communities with the best women's body mass index (BMI) measures were found to have access to facilities with a greater availability of equipment and drugs than the 10 communities with the worst BMI measures. Although this study does not directly measure quality, the characteristics that differentiate high poverty concentration clusters from low poverty concentration clusters point to quality as more important than physical access among the study population.

  1. Problems of health education in rural areas in Poland. (United States)

    Charzyńska-Gula, Marianna; Sygit, Katarzyna; Sygit, Marian; Goździewska, Małgorzata; Dobrowolska, Beata; Gałęziowska, Edyta


    Health promotion is aimed at the reduction of the differences in society's access to factors determining the frequency of occurrence of pro-health behaviours. This means the construction of health resources and increase in the level of egalitarianism in access to these resources. Health education carried out on a high level in rural schools provides actual possibilities for gaining these resources. Many examples of educational practices confirm that the establishment of health conditioning and health behaviours of schoolchildren, and the diagnosis of rural school on the background of the specificity of the community in which it functions. These are a basis for the construction of effective educational programmes, and not analysis of the differences between urban and rural children and adolescents. In Poland, the performance of health education in rural schools encounters many problems associated both with the lack of infrastructure for health promotion, insufficient perception of the importance of health education at school by the educational authorities, underestimation of primary health care, low activity of the local governments, and lack of qualified rural health promoters. Current health education in Polish rural schools deepens inequalities in access to health, and postpones the moment of providing equal opportunities for rural and urban schoolchildren with access to the resources which condition the maintenance or even an enhancement of health. The objective of the study is to present selected problems in the performance of health education in a Polish rural school in the light of international trends, experiences and discussions related with an optimum form of health promotion in the environment of rural a school and the community.

  2. Species-time-area and phylogenetic-time-area relationships in tropical tree communities. (United States)

    Swenson, Nathan G; Mi, Xiangcheng; Kress, W John; Thompson, Jill; Uriarte, María; Zimmerman, Jess K


    The species-area relationship (SAR) has proven to be one of the few strong generalities in ecology. The temporal analog of the SAR, the species-time relationship (STR), has received considerably less attention. Recent work primarily from the temperate zone has aimed to merge the SAR and the STR into a synthetic and unified species-time-area relationship (STAR) as originally envisioned by Preston (1960). Here we test this framework using two tropical tree communities and extend it by deriving a phylogenetic-time-area relationship (PTAR). The work finds some support for Preston's prediction that diversity-time relationships, both species and phylogenetic, are sensitive to the spatial scale of the sampling. Contrary to the Preston's predictions we find a decoupling of diversity-area and diversity-time relationships in both forests as the time period used to quantify the diversity-area relationship changes. In particular, diversity-area and diversity-time relationships are positively correlated using the initial census to quantify the diversity-area relationship, but weakly or even negatively correlated when using the most recent census. Thus, diversity-area relationships could forecast the temporal accumulation of biodiversity of the forests, but they failed to "back-cast" the temporal accumulation of biodiversity suggesting a decoupling of space and time.

  3. Racism, health status, and birth outcomes: results of a participatory community-based intervention and health survey. (United States)

    Carty, Denise C; Kruger, Daniel J; Turner, Tonya M; Campbell, Bettina; DeLoney, E Hill; Lewis, E Yvonne


    Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N = 629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.

  4. Aligning Provider Team Members With Polyvalent Community Health Workers. (United States)

    Brooks, Beth A; Davis, Sheila; Kulbok, Pamela; Frank-Lightfoot, Loraine; Sgarlata, Lisa; Poree, Shawanda


    In light of the fragmentation of health care services and the need for health promotion and disease prevention, it is time to consider the important role community health workers (CHWs) could play as part of the health care team. Globally, CHWs tend to focus on a single patient condition, resulting in fragmented, uncoordinated health care services. Polyvalent (or multimodal) CHWs can provide a comprehensive, patient-centric range of care coordination services with other members of the health care team, ultimately improving patient outcomes and decreasing the cost of care. The potential benefits of the polyvalent CHW to the health care team are not widely understood in the United States. To fill this knowledge gap, a toolkit for nurse leaders in mainstream health care settings was created. The toolkit outlines the key elements essential to a successful CHW program and offers strategies for navigating the various challenges involved when integrating this new role into existing models of care.

  5. Community-based organizations in the health sector: A scoping review

    Directory of Open Access Journals (Sweden)

    Wilson Michael G


    Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

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


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


    Community Health Worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the healthcare team and enhance care. We tested a model for the integration of a CHW delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using t...

  7. Improving health literacy in community populations: a review of progress. (United States)

    Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav


    Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies.

  8. Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Liza Nyantekyi; Mengistu Legesse; Girmay Medhin; Abebe Animut; Konjit Tadesse; Chanda Macias; Abraham Degarege; Berhanu Erko


    Objective: To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections.Methods:Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique.Results:Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years.Conclusions:Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.

  9. Empowering Minority Communities with Health Information - UDC

    Energy Technology Data Exchange (ETDEWEB)

    McMurray, L.; R. Foster; and R. Womble


    Training update with Environmental a health focus. Training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine - HBCU ACCESS Project at the University of the District of Columbia, Washington, DC on November 2, 2010.

  10. Cloud Communities and Travel Diaries. Virtual Representations of Tourist Areas

    Directory of Open Access Journals (Sweden)

    Marco Platania


    Full Text Available Collective construction of descriptions can radically change the image of an area. This uncontrollable process is destined to become one of the main priority research areas also in tourism studies. The spread of Web sites in which telling stories and descriptions of territories has become a significant element in the network society, and the growing use of social networks and cloud communities, often in planning tourism, contributes to social description of touristic landscapes and influence the collective imaginary. In social space, territories are the result of the superposition of different layers, from the real one to the virtual, bound to a constant exchange of information. This phenomenon that could guide tourist attraction, begins to affect the choices of local institutions and residents.The aim of the paper is to give an interpretation on the construction of collective representation, which takes place, after the journey, through the on-line publication of a diary. The research is divided into two parts. In the first, we explain some theoretical aspects related to the representation of the travel, the sharing of information in virtual form and the construction of an imaginary touristic. Subsequently, are taken into account the results obtained in previous studies related to the analysis of the narratives of tourism experiences, shared within virtual spaces freely accessible on the net. These results will be used to develop a model of interpretation on the virtual representation of tourist areas.

  11. Improving Community Health Using an Outcome-Oriented CQI Approach to Community-Engaged Health Professions Education (United States)

    Clithero, Amy; Ross, Simone Jacquelyn; Middleton, Lyn; Reeve, Carole; Neusy, Andre-Jacques


    Health professionals providing health-care services must have the relevant competencies and clinical experiences needed to improve population health outcomes in different contexts. Current models of health profession education often fail to produce a fit-for-purpose workforce ready and willing to provide relevant, quality care to underserved communities. Evidence is emerging that community-engaged and socially accountable health workforce education, i.e., aligned with priority health needs, produces a workforce ready and willing to work in partnership with underserved regions. This model of education fosters greater affiliation between education and service delivery systems and requires institutions to measure graduate outcomes and institutional impact. The Training for Health Equity Network (THEnet), a partnership of socially accountable health workforce education institutions, has developed and tested a Social Accountability Framework for Health Workforce Education (the Framework) and toolkit to improve alignment of health workforce education with outcomes to assess how well education institutions meet the needs of the communities they serve. The Framework links education and service delivery creating a continuous quality improvement feedback loop to ensure that education addresses needs and maximizes impact on the quality of service delivery. The Framework also provides a unifying set of guidelines for health workforce policy and planning, accreditation, education, research, and service delivery. A key element to ensuring consistent high quality service delivery is an appropriately trained and equitably distributed workforce. An effective and comprehensive mechanism for evaluation is the method of CQI which links the design, implementation, accreditation, and evaluation of health workforce education with health service delivery and health outcomes measurement. PMID:28289678

  12. Local communities and health disaster management in the mining sector

    Directory of Open Access Journals (Sweden)

    Freek Cronjé


    Full Text Available Mining activities throughout the Southern African Development Community (SADC have impacted on the health and safety of mining communities for many decades. Despite the economic contribution of mining to surrounding communities, a huge amount of social and environmental harm is associated with the industry. In this regard, mining companies have, on the one hand, contributed toward improved social development by providing jobs, paying taxes and earning foreign exchange. On the other hand, they have been linked publicly to poor labour conditions, corruption, pollution incidents, health and safety failings, as well as disrespect of human rights. The objectives of this study are to give an overview of social and natural factors relating to health disasters in selected communities in the mining environment. Regarding the findings, this paper focuses on the social and natural factors involved in the creation of health disasters. The social factors include poverty, unemployment, poor housing and infrastructure, prostitution and a high influx of unaccompanied migrant labour. Major health issues in this regard, which will be highlighted, are the extraordinary high incidence rate of HIV and STIs (sexually transmitted infections, addiction and mental illness. The environmental (natural threats to health that will be discussed in the study are harmful particles in the air and water, excessive noise and overcrowded and unhygienic living conditions. In conclusion, the paper also finds that communities need to be ‘fenced in’ in terms of health disaster management instead of being excluded. Specific recommendations to mining companies to reduce health and safety disasters will be made to conclude the paper.

  13. Promoting the Health of Families and Communities: A Moral Imperative. (United States)

    Mason, Diana J


    The Hill Burton Act, which was signed into law in 1946 and ended in 1997, was one of the most significant forces that shaped the health care system we have today. Providing grants and loans for the construction and expansion of hospitals across the country, it required beneficiary hospitals to give some amount of uncompensated care to the poor and uninsured in return. The act not only led to our health care system's current emphasis on the acute-care hospital as the primary site of health care delivery, but it also had a profound effect on nursing, fully involving the profession in an acute-care world. The act created jobs for nurses at an unprecedented level. There are over 3.4 million nurses in the United States, and in 2013, 63 percent of all nurses worked for hospitals. Nursing education continues to emphasize acute care, despite the calls for shifting the curriculum to more community-based content and experiences that focus on health promotion and wellness for individuals, families, and communities. It is my premise that the nursing profession and all who profess to be committed to promoting health have a moral obligation to help the nation adopt a Hill-Burton Act of the twenty-first century that will focus on building healthy communities, supporting families in ways that promote health, and helping individuals to live healthier lives. This would require a shift in resources from a costly health care system to investing in community development, whether job creation, building safe places to play and exercise, providing access to affordable and nutritious foods, advancing the quality of education, or other approaches to addressing and improving the social determinants of health. Making this kind of investment would speak to the principles of beneficence, least harm, and justice, particularly for socioeconomically stressed communities.

  14. The role of the community mental health nurse in Botswana: The needs and problems of carers of schizophrenic clients in the community

    Directory of Open Access Journals (Sweden)

    A. Kgosidintsi


    Full Text Available The purpose of this study was to identify and describe the role of the psychiatric/community mental health nurse in the context of primary health care in which mental health is an integral part of the general health care system and in a specific socio-economic background. Nine (9 community mental health nurses who graduated from a local training program for community mental health nurses at post basic level, twenty five (25 carers responsible for daily care and welfare of schizophrenic clients from rural, semi-rural, urban and semi-urban areas country wide participated in the study. The study was exploratory and both qualitative and quantitative data was collected using semi structured interviews, unstructured observation and documentary search methods were used. Data analysis for both qualitative and quantitative data was done through simple frequency counts.

  15. Bringing Health Policy Issues Front and Center in the Community: Expanding the Role of Community Health Coalitions

    Directory of Open Access Journals (Sweden)

    Joel S. Meister, PhD


    Full Text Available Background Systemic, environmental, and socioeconomic conditions create the context in which community members deal with their health concerns. Comprehensive, community-based chronic disease prevention interventions should address community-wide or regional policy issues that influence lifestyle behaviors associated with chronic diseases. Context In two communities along the Arizona-Mexico border, community coalitions that administered a comprehensive diabetes prevention and control intervention expanded their membership to become policy and advocacy coalitions with broad community representation. These coalitions, or Special Action Groups (SAGs, identified and prioritized policy issues that directly or indirectly affect physical activity or nutrition. Methods Local schools were one focus of advocacy. The Centers for Disease Control and Prevention’s School Health Index was implemented as part of the overall intervention; the SAGs supported schools in advocating for more physical education programs, removal of vending machines, substitution of more healthful options in vending machines, and changes in health education curricula. In the broader community, the SAGs promoted opportunities for walking and bicycling, long-term planning by their cities and counties, and healthy food choices in local grocery stores. Advocacy tactics included attending and making presentations at city council, school board, parks and recreation, and planning and zoning commission meetings; participating on long-range planning committees; organizing an annual community forum for elected and appointed officials; and presenting healthy food and cooking demonstrations in local markets. Consequences After three years, SAGs were able to document changes in local policies and practices attributable to their activities. Interpretation The SAGs contributed to systems changes in their communities and were able to obtain new resources that support protective behaviors. Also, the

  16. Community Gardens for Refugee and Immigrant Communities as a Means of Health Promotion. (United States)

    Hartwig, Kari A; Mason, Meghan


    Refugees and new immigrants arriving in the United States (U.S.) often encounter a multitude of stressors adjusting to a new country and potentially coping with past traumas. Community gardens have been celebrated for their role in improving physical and emotional health, and in the Twin Cities of Minnesota, have been offered as a resource to immigrants and refugees. The purpose of this study is to present a mixed method evaluation of a refugee gardening project hosted by area churches serving primarily Karen and Bhutanese populations. Quantitative data were obtained from early and late season surveys (44 and 45 % response rates, respectively), and seven focus groups conducted at the end of the season provided qualitative data. Although few gardeners (4 %) identified food insecurity as a problem, 86 % indicated that they received some food subsidy, and 78 % reported vegetable intake increased between the early and late season surveys. Twelve percent of gardeners indicated possible depression using the PHQ-2 scale; in focus groups numerous respondents identified the gardens as a healing space for their depression or anxiety. Refugee gardeners expressed receiving physical and emotional benefits from gardening, including a sense of identity with their former selves. Gardens may serve as a meaningful health promotion intervention for refugees and immigrants adjusting to the complexity of their new lives in the U.S. and coping with past traumas.

  17. Measuring Population Health Using Electronic Health Records: Exploring Biases and Representativeness in a Community Health Information Exchange. (United States)

    Dixon, Brian E; Gibson, P Joseph; Frederickson Comer, Karen; Rosenman, Marc


    Assessment is a core function of public health. Comprehensive clinical data may enhance community health assessment by providing up-to-date, representative data for use in public health programs and policies, especially when combined with community-level data relevant to social determinants. In this study we examine routinely collected and geospatially-enhanced EHR data to assess population health at various levels of geographic granularity available from a regional health information exchange. We present preliminary findings and discuss important biases in EHR data. Future work is needed to develop methods for correcting for those biases to support routine epidemiology work of public health.

  18. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)



    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  19. Community health nursing practices in contexts of poverty, uncertainty and unpredictability: a systematization of personal experiences. (United States)

    Laperrière, Hélène


    Several years of professional nursing practices, while living in the poorest neighbourhoods in the outlying areas of Brazil's Amazon region, have led the author to develop a better understanding of marginalized populations. Providing care to people with leprosy and sex workers in riverside communities has taken place in conditions of uncertainty, insecurity, unpredictability and institutional violence. The question raised is how we can develop community health nursing practices in this context. A systematization of personal experiences based on popular education is used and analyzed as a way of learning by obtaining scientific knowledge through critical analysis of field practices. Ties of solidarity and belonging developed in informal, mutual-help action groups are promising avenues for research and the development of knowledge in health promotion, prevention and community care and a necessary contribution to national public health programmers.

  20. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    LENUS (Irish Health Repository)

    Skerritt, Louise


    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  1. Promoting community participation in priority setting in district health systems

    DEFF Research Database (Denmark)

    Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict


    Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting...... of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions....... is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience...

  2. A queer-theoretical approach to community health psychology. (United States)

    Easpaig, Bróna R Nic Giolla; Fryer, David M; Linn, Seònaid E; Humphrey, Rhianna H


    Queer-theoretical resources offer ways of productively rethinking how central concepts such as 'person-context', 'identity' and 'difference' may be understood for community health psychologists. This would require going beyond consideration of the problems with which queer theory is popularly associated to cautiously engage with the aspects of this work relevant to the promotion of collective practice and engaging with processes of marginalisation. In this article, we will draw upon and illustrate the queer-theoretical concepts of 'performativity' and 'cultural intelligibility' before moving towards a preliminary mapping of what a queer-informed approach to community health psychology might involve.

  3. Reimagining community health psychology: maps, journeys and new terrains. (United States)

    Campbell, Catherine; Cornish, Flora


    This special issue celebrates and maps out the 'coming of age' of community health psychology, demonstrating its confident and productive expansion beyond its roots in the theory and practice of small-scale collective action in local settings. Articles demonstrate the field's engagement with the growing complexity of local and global inequalities, contemporary forms of collective social protest and developments in critical social science. These open up novel problem spaces for the application and extension of its theories and methods, deepening our understandings of power, identity, community, knowledge and social change - in the context of evolving understandings of the spatial, embodied, relational, collaborative and historical dimensions of health.

  4. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)


    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  5. Urban Poor community Access to reproductive Health care in Surabaya. An Equity Analysis Using Spider Web

    Directory of Open Access Journals (Sweden)

    Ernawaty Ernawaty


    Full Text Available background:Poverty in urban area triggered new problem related with their access to health care services. Heavy burden of life in urban makes health, especially reproductive health, never become first priority for urban poor community. This study is aimed to analyzed equity of urban poor community when accessing the reproductive health care. Methods:This is descriptive study with cross sectional design applied. There were 78 women residents of Penjaringansari II Flats in Surabaya selected by simple random sampling (α=10% as respondents. Penjaringansari II Flats was choosen because it is a slum area that residence by unskilled labours and odd employees. The need fulfillment of respondents in reproductive health care was analyzed by spider web analysis. result: Most of respondents (55.1% were first married before 20 years old. There were 60.5% of them gave birth before 20 years old also, so it belongs to high risk pregnant women. Spider web area for health care of under age married was less than ideal age married which means that under age married urban poor experienced inequity for ANC health services. Approximately 10.3% of respondents had never use contraceptives because they fear of side effects and inhibiton of their husband. conclutions:Better equity shown in the prevention of cervical cancer. Being perceived as the poor who need assistance, free pap smear was often held by Penjaringansari II residents. Poor conditions experienced by a group not only can promote health care inequity, but also promote health care equity. recomendation:Health care equity for urban poor can be pursued through both aid schemes provided by the community or the government.

  6. Public Participation in Urban Environmental Management: A Model for Promoting Community-Based Environmental Management in Peri-Urban Areas. (United States)

    Yacoob, May; Brantly, Eugene; Whiteford, Linda

    In October 1992, the Water and Sanitation for Health (WASH) Project held a workshop to explore how the U.S. Agency for International Development (USAID) could incorporate community participation as a core element in projects to improve water supply, sanitation, and other environmental conditions of peri-urban areas in developing countries. The…

  7. Professional and community satisfaction with the Brazilian family health strategy

    Directory of Open Access Journals (Sweden)

    Lilian G Perez


    Full Text Available OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals and strengths (community health worker-patient communications, provision of educational information, and pediatric care. Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1, good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3, and family-focused health (OR 4.1, 95%CI 1.6;10.2; and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6, difficulty with access (OR 0.2, 95%CI 0.1;0.4, and poor quality of care (OR 0.3, 95%CI 0.1;0.6. Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and

  8. Community Health Status Indicators (CHSI) to Combat Obesity, Heart Disease and Cancer (United States)

    U.S. Department of Health & Human Services — Community Health Status Indicators (CHSI) to combat obesity, heart disease, and cancer are major components of the Community Health Data Initiative. This dataset...

  9. Students' community health service delivery: experiences of involved parties. (United States)

    Greeff, M; van der Walt, E; Strydom, C; Wessels, C; Schutte, P J


    For several years the School of Nursing Science and the School of Psychosocial Behavioural Science, of a specific university, have been offering health care services in response to some of the health needs of a disadvantaged community as part of their students' experiential learning. However, these health care services were rendered independently by these two schools, implying that no feedback system existed to evaluate the worth and quality of these student-rendered health care services. The objectives of this research were to explore and describe the experiences of senior nursing and social work students, the experiences of health service delivery organisations concerned and the experiences of the disadvantaged community members receiving such health care services, as well as to investigate which communication models were apparent with regard to the major factors within health communication. An exploratory descriptive qualitative research design was used. Focus group discussions were held, interviews were conducted and field notes taken. Focus group discussions and interviews were transcribed and analysed by the research team to determine themes and sub-themes using the open coding technique. The results of the three groups showed similarities. The health service delivery organisations also identified a communication barrier, although the students were prepared to bridge it. The health service delivery organisations and the community felt positive towards the students and what they offered to the organisations and to the patients. A greater need for multi-disciplinary team work was recognised by al parties concerned. Recommendations focus on improved student accompaniment by lecturers; extending health care delivery to include a multi-disciplinary team approach by students; as well as improving the delivery of health care services.

  10. Community mental health nursing in Alberta, Canada: an oral history. (United States)

    Boschma, Geertje


    Community mental health nurses had a central role in the construction of new rehabilitative practices and community mental health services in the 1960s and 1970s. The purpose of this article is, first, to explore how nurses understood and created their new role and identity in the turbulent context of deinstitutionalization. The development of after care services for patients discharged from Alberta Hospital in Ponoka (AH-Ponoka), a large mental institution in Calgary, in the Canadian province of Alberta, will be used as a case study. I specifically focus on the establishment of outpatient services in a new psychiatric department at Foothills General Hospital in Calgary. Second, I examine how deinstitutionalization itself shaped community mental health nurses' work. Oral history interviews with nurses and other mental health professionals, who had a central role in this transformation process, provide a unique lens through which to explore this social change. The article concludes that new rehabilitative, community-based mental health services can better be understood as a transformation of former institutional practices rather than as a definite break with them.

  11. Innovation in Management Plans for Community Conserved Areas: Experiences from Australian Indigenous Protected Areas

    Directory of Open Access Journals (Sweden)

    Jocelyn Davies


    Full Text Available Increasing attention to formal recognition of indigenous and community conserved areas (ICCAs as part of national and/or global protected area systems is generating novel encounters between the customary institutions through which indigenous peoples and local communities manage these traditional estates and the bureaucratic institutions of protected area management planning. Although management plans are widely considered to be important to effective management of protected areas, little guidance has been available about how their form and content can effectively reflect the distinctive socio-cultural and political characteristics of ICCAs. This gap has been particularly apparent in Australia where a trend to rapidly increased formal engagement of indigenous people in environmental management resulted, by 2012, in 50 indigenous groups voluntarily declaring their intent to manage all or part of their estates for conservation in perpetuity, as an indigenous protected area (IPA. Development and adoption of a management plan is central to the process through which the Australian Government recognizes these voluntary declarations and invests resources in IPA management. We identified four types of innovations, apparent in some recent IPA plans, which reflect the distinctive socio-cultural and political characteristics of ICCAs and support indigenous people as the primary decision makers and drivers of knowledge integration in IPAs. These are (1 a focus on customary institutions in governance; (2 strategic planning approaches that respond to interlinkages of stewardship between people, place, plants, and animals; (3 planning frameworks that bridge scales by considering values and issues across the whole of an indigenous people's territory; and (4 varied communication modes appropriate to varied audiences, including an emphasis on visual and spatial modes. Further research is warranted into how governance and management of IPAs, and the plans that

  12. Community based needs assessment in an urban area; A participatory action research project



    Abstract Background Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment. Methods The method of participatory action research (PAR) was used. The study was carried out in a...

  13. The implementation and evaluation of a healthy communities process in central Alberta: some implications for public health practice. (United States)

    Smith, N


    This article describes the implementation and evaluation of a Healthy Communities Initiative (HCI) by the David Thompson Health Region in central Alberta, Canada. The HCI model provided for a facilitated, community-based, strategic planning process. Its key steps include development of a shared vision of health, assessment of needs and strengths, selection of key priority areas for action, and implementation of strategies to achieve change. A three-level evaluation model was developed, which incorporates project-level evaluation, cluster-level evaluation, and critical reflection on the David Thompson Health Region's own capacity to engage in community development work.

  14. Evaluating complex community-based health promotion: addressing the challenges. (United States)

    Jolley, Gwyneth


    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations.

  15. [The practice of the community health agency in health promotion of and disease prevention]. (United States)

    Araújo, Maria Rizoneide Negreiros; Assunção, Raquel Silva


    This article discusses practices developed by the community health agency in the Family Health Program of Divinópolis--MG reporting on practices in the fields of Health Promotion and Disease Prevention, taking as main reference the principles established at the 1st International Health Promotion Conference, which took place in Canada in 1986. Field research was carried out by questionnaire, direct observation of work and open interviews with community health agencies. A qualitative approach was chosen in which the concepts and statements of the subjects were dealt with in the light of historical and dialectical materialism, and the organization and analysis of the discourses according to the Discourse of the Collective Subject. We conclude that the community health agency performs actions recommended by the Ministry of Health, and that its health promoting actions are confined to the creation of environments favorable to health, actions in the home. It works more widely in disease prevention, in individual actions, health education for the community and for groups at risk, and controlling infectious disease and parasites such as dengue and worms. Its focus of attention is predominantly the individual and not the family.

  16. Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey. (United States)

    Sabo, Samantha; Wennerstrom, Ashley; Phillips, David; Haywoord, Catherine; Redondo, Floribella; Bell, Melanie L; Ingram, Maia


    This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field.

  17. HIV/AIDS Community Health Information System. (United States)

    Fulcher, Christopher L; Kaukinen, Catherine E


    Given changes in the faces of AIDS over the last decade, it is crucial that disparities in health and access to healthcare are addressed. An Internet-based GIS was developed using ESRI's Arc Internet Map Server (Arc IMS) to provide users with a suite of tools to interact with geographic data and conduct spatial analyses related to the characteristics that promote or impede the provision of HIV-related services. Internet Mapping allows those engaged in local decision-making to: (1) geographically visualize information via the Internet; (2) Assess the relationship between the distribution of HIV services and spatially referenced socio-economic data; and (3) generate "what if" scenarios" that may direct the allocation of healthcare resources.

  18. Drivers Of Health As A Shared Value: Mindset, Expectations, Sense Of Community, And Civic Engagement. (United States)

    Chandra, Anita; Miller, Carolyn E; Acosta, Joie D; Weilant, Sarah; Trujillo, Matthew; Plough, Alonzo


    Making health a shared value is central to building a culture of health, a new action framework intended to spur faster progress toward equitable health outcomes in the United States. Unlike in other US social movements, such as the environmental and civil rights movements, the necessary understanding of shared values has not yet been achieved for health. Discussions about values regarding health have primarily focused on health care instead of health or well-being. These discussions have not progressed to a clear focus on prioritizing values on health instead of simply health care. The evidence base for understanding health as a shared value is only now emerging. Making health a shared value is the first of four Action Areas in the Robert Wood Johnson Foundation's Culture of Health Action Framework. We assert that the achievement of this shared understanding of health as a cultural value will be enhanced through action in specific drivers: mindset and expectations, sense of community, and civic engagement. Building on a literature review and stakeholder engagement, this article examines the evidence base for these drivers and identifies where policy and research actions are needed to advance positive change on population health and well-being outcomes.

  19. Women's empowerment and its differential impact on health in low-income communities in Mumbai, India. (United States)

    Moonzwe Davis, Lwendo; Schensul, Stephen L; Schensul, Jean J; Verma, Ravi K; Nastasi, Bonnie K; Singh, Rajendra


    This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalised area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy-related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined.

  20. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice. (United States)

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine


    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

  1. Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

    DEFF Research Database (Denmark)

    Makaula, Peter; Bloch, Paul; Banda, Hastings T.


    is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated...... with PHC. The CDI approach has successfully been used to improve the delivery of interventions in areas that have previously used CDTi. However, little is known about the added value of community participation in areas without prior experience with CDTi. This study aimed at assessing PHC in two rural...

  2. Aging, health, and identity in Ecuador's indigenous communities. (United States)

    Waters, William F; Gallegos, Carlos A


    Middle-income countries like Ecuador are in the process of demographic and epidemiological transitions, and their populations are aging. The challenges associated with providing services to growing numbers of citizens who experience the inevitable deterioration associated with aging are mirrored by the manner in which aging is perceived in a culturally heterogeneous society. This paper presents the results of qualitative research conducted among older men and women in indigenous communities in the Ecuadorian highlands in order to investigate the perceptions regarding the ability of family and community networks to provide adequate and appropriate support for older persons in the context of their perceptions of health, health care, and aging. The principal findings are that: (i) perceptions of aging are shaped by chronic illness, fatigue, deteriorating sensory capacities, and vulnerability to accidents; (ii) barriers to health care are exacerbated among aging members of indigenous communities, although in some cases they can be addressed through traditional alternatives; (iii) the sense of identity shifts as aging people are increasingly unable to work the land and participate in community activities; and (iv) family and community support networks for older adults are not as strong as is generally thought. These findings represent the context within which issues related aging in a culturally heterogeneous society can be best understood and addressed.

  3. Occupational Therapy in Multidisciplinary Residency in Family and Community Health

    Directory of Open Access Journals (Sweden)

    Luzianne Feijó Alexandre Paiva


    Full Text Available In this study, we report the experiences of occupational therapist during the Multidisciplinary Residency Program in Family and Community Health in Fortaleza, Ceará state, Brazil. With the creation of the Support Center for Family Health – NASF, occupational therapists began to participate more effectively in the Family Health Strategy of the Brazilian National Health System. Given this rocess, the category, which historically has trained its professionals following the biomedical model, is faced with the challenge to build a new field of knowledge. Objective: To analyze the inclusion of occupational therapy in the Family Health Strategy within the scope of Multidisciplinary Residency. Methodology: This is a descriptive study of qualitative approach, which was based on the experience of four occupational therapy resident students, performed through the documental analysis of field diaries, scientific papers, and case studies produced between 2009 and 2011. Results: The occupational therapists as well as the other NASF professionals operated the logic of Matrix Support to the Family Health teams, sharing their knowledge and assisting in resolving complex cases of the families, groups, and communities served. In this context, we found people with different relationships with their doings and a reduced repertoire of activities. The occupational therapists invested in the creation or consolidation of groups in the Family Health Centers and in the territory, which also stood as living and socializing spaces, focusing on prevention and health promotion.

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

    Directory of Open Access Journals (Sweden)

    Alam Khurshid


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

  5. Initial community perspectives on the Health Service Extension Programme in Welkait, Ethiopia

    Directory of Open Access Journals (Sweden)

    McAuliffe Eilish


    Full Text Available Abstract Background The Health Service Extension Programme (HSEP is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs, who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia's community health system. Methods This study seeks to explore the experience of the HSEP from the perspective of the community who received the service. A random sample of 60 female heads-of-household in a remote area of Tigray participated in a structured interview survey. Results Although Health Extension Workers (HEWs had visited them less frequently than planned, participants generally found the programme to be helpful. Despite this, their basic health knowledge was still quite poor regarding the major communicable diseases and their vectors. Participants felt the new HESP represented an improvement on previous health provision. HEWs were preferred over Traditional Birth Attendants for assistance with labour Conclusion While the introduction of HEWs has been a positive experience for women living at the study site, the frequency of visits, extent of effectively imparted health knowledge and affects of HEWs on other health providers needs to be further explored.

  6. Reproductive, maternal, newborn, and child health in the community: Task-sharing between male and female health workers in an Indian rural context

    Directory of Open Access Journals (Sweden)

    Sara J Elazan


    Full Text Available Background: Male community health workers (CHWs have rarely been studied as an addition to the female community health workforce to improve access and care for reproductive, maternal, newborn, and child health (RMNCH. Objective: To examine how male health activists (MHAs coordinated RMNCH responsibilities with existing female health workers in an Indian context. Materials and Methods: Interviews from male and female CHWs were coded around community-based engagement, outreach services, and links to facility-based care. Results: Community-based engagement: MHAs completed tasks both dependent and independent of their gender, such as informing couples on safe RMNCH care in the antenatal and postnatal periods. MHAs motivated males on appropriate family planning methods, demonstrating clear gendered responsibility. Outreach services: MHAs were most valuable traveling to remote areas to inform about and bring mothers and children to community health events, with this division of labor appreciated by female health workers. Link to facility-based services: MHAs were recognized as a welcome addition accompanying women to health facilities for delivery, particularly in nighttime. Conclusion: This study demonstrates the importance of gendered CHW roles and male-female task-sharing to improve access to community health events, outreach services, and facility-based RMNCH care.

  7. Audit Trail Management System in Community Health Care Information Network. (United States)

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio


    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system.

  8. Infectious Diseases: Current Issues in School and Community Health. (United States)

    Bower, Wilma; And Others


    Some children in American schools have known and unknown communicable diseases, including herpes, cytomegalovirus, AIDS, mononucleosis, pinworms, and hepatitis. This article examines major public health issues, school responsibility, preventative measures (like basic hygiene), and the need for more effective community education programs. A disease…

  9. Building Sustainable Health and Education Partnerships: Stories from Local Communities (United States)

    Blank, Martin J.


    Background: Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high…

  10. Doctoral Education in Community Health Nursing: A National Survey. (United States)

    Clarke, Pamela N.; And Others


    According to responses from 23 of 52 doctoral nursing program directors and interviews with 16, newer programs tend to offer more general rather than specialized curricula. Only four identified community health nursing as a specialty, all in older, long-standing programs. (SK)

  11. Gay Couples, Gay Communities, and HIV: Challenges for Health Education (United States)

    Reece, Michael


    For the last 2 decades, researchers and practitioners dedicated to improving the health of gay and bisexual men have largely focused their work on the need to reduce the incidence of HIV infection. This is certainly warranted given the intensity of this particular epidemic in the gay community and the challenges it has presented to the nation's…

  12. Empowerment and Health: The Theory and Practice of Community Change. (United States)

    Wallerstein, Nina


    Empowerment as social action addresses lack of control by enhancing participation in community action. An alcohol and substance abuse prevention program for New Mexico adolescents used Freire's problem posing and critical thinking philosophy and methods to empower young people to change their health behavior. (SK)

  13. Mental health law in the community: thinking about Africa. (United States)

    Bartlett, Peter; Jenkins, Rachel; Kiima, David


    The new United Nations Convention on the Rights of Persons with Disabilities creates a new paradigm for mental health law, moving from a focus on institutional care to a focus on community-based services and treatment. This article considers implementation of this approach in Africa.

  14. Mental health law in the community: thinking about Africa


    Bartlett, Peter; Jenkins, Rachel; Kiima, David


    The new United Nations Convention on the Rights of Persons with Disabilities creates a new paradigm for mental\\ud health law, moving from a focus on institutional care to a focus on community-based services and treatment. This\\ud article considers implementation of this approach in Africa.

  15. Community-Based Social Marketing: Involvement in Health Programs. (United States)

    Farmer, Frank L.; Clarke, Leslie L.; Flocks, Joan D.; Bryant, Carol A.; Romund, Camilla S.; Albrecht, Stan L.


    Two community-based projects employed social marketing to design and implement interventions to promote health. The Arkansas project involved key informant interviews, actuarial analysis, citizen and student surveys, and participant observation. The Florida approach included focus groups and provider, worker, and employer surveys. (Contains 25…

  16. [The community health team: roles and responsibilities in infection control]. (United States)

    Fu, Yu-Chen; Chen, Mei-Yen; Feng, Huang-Chih


    Over the past three decades, chronic disease has replaced communicable disease as the leading collective cause of death in Taiwan. As a result, medical and public healthcare manpower and budgets dedicated to communicable diseases have been reduced. The 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) changed government epidemic prevention policies and marked a renewed focus on preventing and controlling communicable diseases. This study introduces Taiwan's communicable disease control system and reforms, the domestic status of communicable diseases, the infection control policies of Japanese colonial authorities in the early 20th century, and national / community-level communicable disease control mechanisms in place before and after 2003. This paper further examines the actual health management conditions in a county in southern Taiwan to show how the public health system is rooted in communities, how infection control strategies are promoted, and how social organizations influence community life and mores.

  17. Body perceptions and health behaviors in an online bodybuilding community. (United States)

    Smith, Aaron C T; Stewart, Bob


    In this article we explore the social constructions, body perceptions, and health experiences of a serious recreational and competitive bodybuilder and powerlifter community. Data were obtained from a discussion forum appearing within an online community dedicated to muscular development. Forum postings for a period of 36 months were transposed to QSR NVivo, in which a narrative-based analytical method employing Gee's coding approach was employed. We used a priori codes based on Bourdieu's multipronged conceptual categories of social field, habitus, and capital accumulation as a theoretical frame. Our results expose an extreme social reality held by a devoted muscle-building community with a fanatical obsession with muscular hypertrophy and any accouterment helpful in its acquisition, from nutrition and supplements to training regimes and anabolic androgenic substances. Few health costs were considered too severe in this muscular meritocracy, where the strong commanded deference and the massive dominated the social field.

  18. Community health workers : Bridging the gap between health needs of immigrant elderly and health- and welfare services in the Netherlands

    NARCIS (Netherlands)

    Verhagen, I.


    The aim of this thesis is to assess the effectiveness of a Community Health Worker (CHW) intervention programme to improve immigrant elderly’s access to health- and welfare services. Additionally, effects on loneliness, health related quality of life (HRQOL), and self-efficacy were explored. Anal

  19. Community wide electronic distribution of summary health care utilization data

    Directory of Open Access Journals (Sweden)

    Westert Gert P


    Full Text Available Abstract Background In recent years, the use of digital technology has supported widespread sharing of electronic health care data. Although this approach holds considerable promise, it promises to be a complicated and expensive undertaking. This study described the development and implementation of a community wide system for electronic sharing of summary health care utilization data. Methods The development of the community wide data system focused on the following objectives: ongoing monitoring of the health care system, evaluation of community wide individual provider initiatives, identification and development of new initiatives. The system focused on the sharing of data related to hospital acute care, emergency medical services, long term care, and mental health. It was based on the daily distribution of reports among all health care providers related to these services. Results The development of the summary reports concerning health care utilization produced a system wide view of health care in Syracuse, New York on a daily basis. It was not possible to isolate the results of these reports because of the impact of specific projects and other factors. At the same time, the reports were associated with reduction of hospital inpatient stays, improvement of access to hospital emergency departments, reductions in stays for patients discharged to nursing homes, and increased access of mental health patients to hospital inpatient units. Conclusion The implementation of the system demonstrated that summary electronic utilization data could provide daily information that would support the improvement of health care outcomes and efficiency. This approach could be implemented in a simple, direct manner with minimal expenses.

  20. Sentinel areas: a monitoring strategy in public health

    Directory of Open Access Journals (Sweden)

    Teixeira Maria da Glória


    Full Text Available Available techniques for monitoring the health situation have proven insufficient, thus leading to a discussion of the need for their improvement based on new data collection strategies allowing for data use by local health systems. This article presents the methodological basis for a strategy to monitor health problems utilizing demarcated intra-urban spaces called "sentinel areas" to collect fundamental social, economic, behavioral, and biological data for public health that allow for a closer approach to the reality of complex social spaces. The authors present an experience that is being developed in Salvador, Bahia, Brazil, to evaluate the epidemiological impact of an environmental sanitation program. They discuss selection criteria for the areas and the potential uses of this strategy allowing for the rapid utilization of epidemiological resources by health services and the timely application of the results to reorient and enhance health intervention practices.

  1. Area Health Resources Files (AHRF) National Center for Health Workforce Analysis (United States)

    U.S. Department of Health & Human Services — The Area Health Resource Files (AHRF) website is are a set of query tools, interactive maps, and data downloads with extensive demographic, training, and resource...

  2. Community perceptions and utilization of a consumer health center. (United States)

    Ports, Katie A; Ayers, Antoinette; Crocker, Wayne; Hart, Alton; Mosavel, Maghboeba; Rafie, Carlin


    The purpose of this study was to understand factors that may affect the usage of a consumer health center located in a public library. More specifically, the authors wanted to know what health resources are of interest to the community, what patrons' perceptions of their experience at the center are, and finally, how staff can increase utilization of the center. In general, perceptions of the center were positive. The findings support that participants appreciate efforts to provide health information in the public library setting and that utilization could be improved through marketing and outreach.

  3. Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda

    Directory of Open Access Journals (Sweden)

    Tugumisirize Joshua


    Full Text Available Abstract Background Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented. During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. Methods The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Results Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from

  4. [Management of type 2 diabetes patients in community health care centers in Grenoble]. (United States)

    François, Patrice; Pichon, Philippe; Poulizac, Morgan; Cruaud, Anna; Bal, Gaelle; Hirsch, Martin


    Community health care centers in Grenoble aim to provide quality primary health care, including prevention, to populations living in disadvantaged urban areas. The objective of the study was to assess the quality of follow-up provided by physicians in health care centers in Grenoble to patients with diabetes mellitus. A cross-sectional study was conducted for an observation period of one week in june 2007. All type 2 diabetes patients seen in community health care centers during this given week were included in the study's sample (n=121). During the consultation, the physician collected the data on diabetes follow-up recorded in the patient's medical record over the last year. The data were compared with the recommendations and guidance published by the French National Authority for Health in 2006. The result of a hemoglobin A1c test dated less that three months-old was present in 80% of patients' medical records. Serum creatinine concentration, blood lipids, and microalbuminuria levels were obtained and confirmed with annual tests, and were present and recorded in the last year in 95%, 91%, and 77% of cases, respectively. The patient's weight, recorded within the last year, was noted in all cases. An ophthalmology consultation had been provided within the year for 57% of patients and 55% had received an electrocardiogram. Compliance with French National Authority for Health recommendations for the follow-up of diabetics in the community health care centers was satisfactory. Thus, it seems relevant to analyze their organizational methods.

  5. The Relationship between Health and Community across Aging Cohorts

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    Julie Norstrand


    Full Text Available Research is needed to examine the connection between older adults and their community as they age. This is important as increasing numbers of older adults wish to age in place. Regression models were examined across 3 cohorts testing relationships among social capital indicators (neighborhood trust, neighborhood support, neighborhood cohesion, neighborhood participation, and telephone interaction with health outcomes (self-rated health, activities of daily living (ADL, and instrumental activities of daily living (IADL. Results showed that most social capital indicators remained significant for all health outcomes into very old age. Development of tools for individual and community interventions to ensure optimal fit between the aging individual and their environment is discussed, along with recommendations for enhancing social work theory and practice.

  6. A Multidimensional Data Warehouse for Community Health Centers. (United States)

    Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N


    Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise.

  7. Community health workers and their value to social work. (United States)

    Spencer, Michael S; Gunter, Kathryn E; Palmisano, Gloria


    Community health workers (CHWs) play a vital and unique role in linking diverse and underserved populations to health and social service systems. Despite their effectiveness, as documented by empirical studies across various disciplines including public health, nursing, and biomedicine, the value and potential role of CHWs in the social work practice and research literature has been largely absent. Thus, this article introduces social workers to CHWs, their role in promoting culturally appropriate practice, and their utility in collaboration with social workers in community settings. This integrative review also discusses current challenges identified by the CHW literature, including potential barriers to the expansion of CHW programs, as well as issues of training, certification, and sustainability. The review also discusses the close alignment of CHWs with social work values and principles of social justice, suggesting opportunities for enhanced social work practice and research.

  8. Mining consumer health vocabulary from community-generated text. (United States)

    Vydiswaran, V G Vinod; Mei, Qiaozhu; Hanauer, David A; Zheng, Kai


    Community-generated text corpora can be a valuable resource to extract consumer health vocabulary (CHV) and link them to professional terminologies and alternative variants. In this research, we propose a pattern-based text-mining approach to identify pairs of CHV and professional terms from Wikipedia, a large text corpus created and maintained by the community. A novel measure, leveraging the ratio of frequency of occurrence, was used to differentiate consumer terms from professional terms. We empirically evaluated the applicability of this approach using a large data sample consisting of MedLine abstracts and all posts from an online health forum, MedHelp. The results show that the proposed approach is able to identify synonymous pairs and label the terms as either consumer or professional term with high accuracy. We conclude that the proposed approach provides great potential to produce a high quality CHV to improve the performance of computational applications in processing consumer-generated health text.

  9. Unlocking community capability through promotion of self-help for health: experience from Chakaria, Bangladesh

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    Abbas Bhuiya


    Full Text Available Abstract Background People’s participation in health, enshrined in the 1978 Alma Ata declaration, seeks to tap into community capability for better health and empowerment. One mechanism to promote participation in health is through participatory action research (PAR methods. Beginning in 1994, the Bangladeshi research organization ICDDR,B implemented a project “self-help for health,” to work with existing rural self-help organizations (SHOs. SHOs are organizations formed by villagers for their well-being through their own initiatives without external material help. This paper describes the project’s implementation, impact, and reflective learnings. Methods Following a self-help conceptual framework and PAR, the project focused on building the capacity of SHOs and their members through training on organizational issues, imparting health literacy, and supporting participatory planning and monitoring. Quarterly activity reports and process documentation were the main sources of qualitative data used for this paper, enabling documentation of changes in organizational issues, as well as the number and nature of initiatives taken by the SHOs in the intervention area. Health and demographic surveillance system (HDSS data from intervention and comparison areas since 1999 allowed assessment of changes in health indicators over time. Results Villagers and members of the SHOs actively participated in the self-help activities. SHO functionality increased in the intervention area, in terms of improved organizational processes and planned health activities. These included most notably in convening more regular meetings, identifying community needs, developing and implementing action plans, and monitoring progress and impact. Between 1999 and 2015, while decreases in infant mortality and increases in utilization of at least one antenatal care visit occurred similarly in intervention and comparison areas, increases in immunization, skilled birth

  10. Understanding the importance of medical student clerkships in poor health outcome regions served by Area Health Education Centers (AHECs) in impoverished locations of Southern United States. (United States)

    Patel, Ashruta


    Area Health Education Centers provide health professional students the opportunity to explore the benefits of practicing in a rural and underserved location. The status of health conditions in chronic disease patients residing in impoverished regions of the US provides the chance to understand the factors that are responsible for constant inadequate outcomes in underserved and rural communities. Many limiting barriers to positive health outcomes occur in disproportionate numbers in the Southern Black Belt. Students should consider participating in rural and underserved clerkships, and ultimately a career as a health care provider in a poor health outcome region. In addition, promising programs (e.g. telemedicine, community health workers) to help implement patient-centered evidence-based interventions can tackle current chronic disease issues commonly encountered by health professionals who work with diverse patient populations.

  11. Community perspectives on public health biobanking: an analysis of community meetings on the Michigan BioTrust for Health. (United States)

    Thiel, Daniel B; Platt, Tevah; Platt, Jodyn; King, Susan B; Kardia, Sharon L R


    Biobanks raise challenges for developing ethically sound and practicable consent policies. Biobanks comprised of dried bloodspots (DBS) left over from newborn screening, maintained for long-term storage, and potential secondary research applications are no exception. Michigan has been a leader in transforming its DBS collection, marketing its biobank of de-identified samples for health research use. The Michigan BioTrust for Health includes approximately 4 million unconsented retrospective samples collected as early as 1984 and prospective samples added since the fall of 2010 with blanket parental consent. We engaged Michigan citizens to ascertain public attitudes, knowledge, and beliefs about the BioTrust and informed consent. A convenience sampling of 393 participants from communities around the state of Michigan (oversampling for minority populations) participated in meetings addressing newborn screening, the BioTrust and informed consent, yielding quantitative and qualitative survey and discussion data. Participants affirmed the principle of voluntary informed participation in research and advocated for greater public awareness of the existence of the BioTrust. Most expressed support for the use of DBS for research and a desire for greater involvement in granting permission for research use. Opinions varied as to which specific research uses were acceptable. Participants indicated a desire for greater engagement, public awareness, and more active decision making on the part of biobank participants and parents. Diversity of opinion over which research areas were deemed acceptable problematizes the blanket consent model that currently applies to the BioTrust's prospective DBS collection and that could become the new norm for research using de-identified data under proposed changes to the Common Rule.

  12. Personal health communities: a phenomenological study of a new health-care concept.

    NARCIS (Netherlands)

    Aarts, J.W.M.; Vennik, F.; Nelen, W.L.D.M.; Eijk, M. van; Bloem, B.R.; Faber, M.J.; Kremer, J.A.M.


    CONTEXT: Fragmentation of care, complexity of diseases and the need to involve patients actively in their individual health care led to the development of the personal health community (PHC). In a PHC, patients can -regardless of the nature of their condition- invite all professionals that are invol

  13. Personal health communities: A phenomenological study of a new health-care concept

    NARCIS (Netherlands)

    J.W.M. Aarts (Johanna); F.D. Vennik (Femke); W.L.D.M. Nelen (Willianne); M. van der Eijk (Martijn); B.R. Bloem (Bastiaan); M.J. Faber (Marjan); J.A.M. Kremer


    textabstractContext: Fragmentation of care, complexity of diseases and the need to involve patients actively in their individual health care led to the development of the personal health community (PHC). In a PHC, patients can -regardless of the nature of their condition- invite all professionals th

  14. Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform. (United States)

    Puertas, B; Schlesser, M


    Health reform is an important movement in countries throughout the region of the Americas, which could profoundly influence how basic health services are provided and who receives them. Goals of health sector reform include to improve quality, correct inefficiencies, and reduce inequities in current systems. The latter may be especially important in countries with indigenous populations, which are thought to suffer from excess mortality and morbidity related to poverty. The purpose of this paper is to report the results of a community health assessment conducted in 26 indigenous communities in the Province of Cotopaxi in rural Ecuador. It is hoped that this information will inform the health reform movement by adding to the current understanding of the health and socioeconomic situation of indigenous populations in the region while emphasizing a participatory approach toward understanding the social forces impacting upon health. This approach may serve as a model for empowering people through collective action. Recommended health reform strategies include: 1) Develop a comprehensive plan for health improvement in conjunction with stakeholders in the general population, including representatives of minority groups; 2) Conduct research on the appropriate mix between traditional medicine, primary health care strategies, and high technology medical services in relation to the needs of the general population; 3) Train local health personnel and traditional healers in primary health care techniques; 4) Improve access to secondary and tertiary health services for indigenous populations in times of emergency; and 5) Advocate for intersectoral collaboration among government institutions as well as non-governmental organizations and the private sector.

  15. Integration of community health workers into health systems in developing countries: Opportunities and challenges

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    Collins Otieno Asweto


    Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

  16. Collaborating with consumer and community representatives in health and medical research in Australia: results from an evaluation

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    Bartu Anne E


    Full Text Available Abstract Objective To collaborate with consumer and community representatives in the Alcohol and Pregnancy Project from 2006-2008 and evaluate researchers' and consumer and community representatives' perceptions of the process, context and impact of consumer and community participation in the project. Methods We formed two reference groups and sought consumer and community representatives' perspectives on all aspects of the project over a three year period. We developed an evaluation framework and asked consumer and community representatives and researchers to complete a self-administered questionnaire at the end of the project. Results Fifteen researchers (93.8% and seven (53.8% consumer and community representatives completed a questionnaire. Most consumer and community representatives agreed that the process and context measures of their participation had been achieved. Both researchers and consumer and community representatives identified areas for improvement and offered suggestions how these could be improved for future research. Researchers thought consumer and community participation contributed to project outputs and outcomes by enhancing scientific and ethical standards, providing legitimacy and authority, and increasing the project's credibility and participation. They saw it was fundamental to the research process and acknowledged consumer and community representatives for their excellent contribution. Consumer and community representatives were able to directly influence decisions about the research. They thought that consumer and community participation had significant influence on the success of project outputs and outcomes. Conclusions Consumer and community participation is an essential component of good research practice and contributed to the Alcohol and Pregnancy Project by enhancing research processes, outputs and outcomes, and this participation was valued by community and

  17. Particulate matter in urban areas: health-based economic assessment. (United States)

    El-Fadel, M; Massoud, M


    The interest in the association between human health and air pollution has grown substantially in recent years. Based on epidemiological studies in several countries, there is conclusive evidence of a link between particulate air pollution and adverse health effects. Considering that particulate matter may be the most serious pollutant in urban areas and that pollution-related illness results in financial and non-financial welfare losses, the main objective of this study is to assess the economic benefits of reducing particulate air pollution in Lebanese urban areas. Accordingly, the extent and value of health benefits due to decreasing levels of particulate in the air are predicted. Health impacts are expressed in both physical and monetary terms for saved statistical lives, and productivity due to different types of morbidity endpoints. Finally, the study concludes with a range of policy options available to mitigate particulate air pollution in urban areas.

  18. Evaluation of Community Health Education Workshops among Chinese Older Adults in Chicago: A Community-Based Participatory Research Approach (United States)

    Dong, Xinqi; Li, Yawen; Chen, Ruijia; Chang, E-Shien; Simon, Melissa


    Background: Health education is one of the proven ways to improve knowledge and change health attitudes and behaviors. This study is intended to assess the effectiveness of five health workshops in a Chinese community, focusing on depression, elder abuse, nutrition, breast cancer and stroke. Methods: A community-based participatory research…

  19. Health Seeking Behaviour of Peri-Urban Community of Chandkheda

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    Patel PB, Trivedi KN, Nayak SN, Patel Priyanka


    Full Text Available The study conducted in peri-urban area, reveals that utilization of government health care facilities was poor in the study area compare to national level surveys. Utilization of public health care facilities was significantly higher in lower socio-economical class. Large number of poor families presently utilizes the services provided by private health providers for a multitude of reasons like Long waiting period (53.8%, distance location (50.2% and inadequate facilities (25.4% etc, the majority of which can be rectified with minimal resources input.

  20. Patient neglect in 21st century health-care institutions: a community health psychology perspective. (United States)

    Reader, Tom W; Gillespie, Alex; Mannell, Jenevieve


    Despite the technological and organisational advances of 21st century health-care systems, care scandals and burgeoning complaints from patients have raised concerns about patient neglect in hospitals. This article reviews the concept of patient neglect and the role of community health psychology in understanding its occurrence. Patient neglect has previously been conceptualised as a problem associated with hospital staff attitudes and behaviours, with regulation and training cited as solutions. Yet, a community health psychology perspective shows that the wider symbolic, material and relational aspects of care are crucial for understanding why patient neglect occurs and for outlining new solutions to augment existing interventions.

  1. E-health-oriented community health information system in china: our challenges, solution, and experience. (United States)

    Zhao, Junping; Zhang, Zhenjiang; Guo, Huayuang; Li, Yi; Xue, Wanguo; Ren, Lianzhong; Chen, Yunqi; Chen, Shifu; Liu, Tongze; Jia, Ru; Zhao, Yi; Chai, Chang


    China has been implementing regional collaborative medical service (also known as e-health) for >5 years, but is still facing the challenges of bridging different community health information systems (CHISs). The fact that different communities have different systems makes it difficult to share information and data between different CHISs. To explore a solution for addressing this problem, we constructed a demonstration CHIS in Beijing's Dongcheng District. This system is based on the Software-as-a-Service model, in which a central data center is used to store users' health records and to provide different services. This system provides a comprehensive platform combining disease prevention, health protection, medical care, rehabilitation, health education, and family planning. In this article, we first show the challenge of implementing e-health-oriented CHIS in China, then we briefly introduce our solution, and finally we share our experience learned from the modern CHIS implementation practice.

  2. Community care in practice: social work in primary health care. (United States)

    Lymbery, M; Millward, A


    This paper examines the establishment of social work within primary health care settings in Great Britain, following the passage of the National Health Service and Community Care Act in 1990. Although the improvement of relationships between social workers and primary health care teams has been promoted for a number of years, the advent of formal policies for community care has made this a priority for both social services and health. This paper presents interim findings from the evaluation of three pilot projects in Nottinghamshire, Great Britain. These findings are analysed from three linked perspectives. The first is the extent to which structures and organisations have worked effectively together to promote the location of social workers within health care settings. The second is the impact of professional and cultural factors on the work of the social worker in these settings. The third is the effect of interpersonal relationships on the success of the project. The paper will conclude that there is significant learning from each of these perspectives which can be applied to the future location of social workers to primary health care.

  3. Policy paradox and political neglect in community health services. (United States)

    Hudson, Bob


    Community health services (CHSs) have never had a settled organisational existence but the turmoil has intensified since the publication of Transforming Community Services in 2009. CHSs are now beset by three dilemmas: ongoing organisational fragmentation; the extension of competition law and the spread of privatisation; inadequate workforce development and lack of clarity on the nature of CHS activity. This has left the services in a position of policy and political vulnerability. The solution may be for the service to be part of horizontal integration models such as the accountable care organisation, with a focus on locality and multi-professional teams wrapped around patient pathways.

  4. Health effects of the war in two rural communities in Nicaragua. Nicaragua Health Study Collaborative at Harvard, CIES, and UNAN. (United States)


    We report on a pilot study to assess the effects of low intensity war in Nicaragua on the health of the civilian population. The study compared data from two regions in Nicaragua, one in an area of intense conflict, the other further removed from the war's violence. Information was obtained from a questionnaire administered to female heads of randomly selected households; structured interviews with community leaders and health workers; group discussions with community residents; and a review of regional and municipal death records. Height and mid-upper arm circumference of children were measured, and immunization records reviewed. The war has had a serious negative effect on the lives of the civilian population in both the war zone and the non-war zone, with the effects most severe in the war zone. In both communities, over half of the respondents reported the death of a friend or relative. In the war zone community, over one-fourth of respondents reported attacks on family members in non-combat situations around their homes. Death by firearms was the leading cause of death in persons over age 6 in the war zone. Vaccination coverage, nutritional indices, and familial disruption were worse in the war zone community. The findings suggest that continued funding of the Nicaraguan contra forces by the United States may be harming the ostensible beneficiaries of that policy, and that use of such low intensity conflict as a foreign policy tool should be questioned.

  5. Health, function and disability in stroke patients in the community

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    Bárbara P. B. Carvalho-Pinto


    Full Text Available ABSTRACT Background Stroke patients commonly have impairments associated with reduction in functionality. Among these impairments, the motor impairments are the most prevalent. The functional profile of these patients living in the community who are users of the primary health-care services in Brazil has not yet been established Objective To describe the functional profile of stroke patients who are users of the primary health-care services in Brazil, looking at one health-care unit in the city of Belo Horizonte, Brazil. Method From medical records and home visits, data were collected regarding health status, assistance received following the stroke, personal and environmental contextual factors, function and disability, organized according to the conceptual framework of the International Classification of Functioning, Disability and Health (ICF. Test and instruments commonly applied in the assessment of stroke patients were used. Results Demographic data from all stroke patients who were users of the health-care unit (n=44, age: 69.23±13.12 years and 67±66.52 months since the stroke participated of this study. Most subjects presented with disabilities, as changes in emotional function, muscle strength, and mobility, risks of falling during functional activities, negative self-perception of quality of life, and perception of the environment factors were perceived as obstacles. The majority of the patients used the health-care unit to renew drug prescriptions, and did not receive any information on stroke from health professionals, even though patients believed it was important for patients to receive information and to provide clarifications. Conclusion Stroke patients who used primary health-care services in Brazil have chronic disabilities and health needs that require continuous health attention from rehabilitation professionals. All of these health needs should be considered by health professionals to provide better management as part of

  6. Model Development for Health Promotion in the Elderly Participating in Communities

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    Supat Jampawai


    Full Text Available Problem statement: The problem of the research derives from a lack of research study to develop the suitable model for health promotion in the elderly and examine factors concerning the health promotion in the elderly. This research aimed to study and develop suitable health promotion model for elderly participating in communities and examine factors related to the health promotion of the elderly. Approach: The samples were 654 older people. This study was participatory action research including many stages which were situation analysis, action and assessment. The explored location was the area of Nonsa-ad Sub-District, Nong Ruea District, Khon Kaen Province. Results: The results of the study led to the process of health promotion for the elderly participating in the communities in the action stage including the participation of the communities, local administrative organizations and government agencies consisting of health service centers and department of social development and human security to drive the thinking of the elderly and push it into real practice. The activities for the health promotion were health check-up, home visit of volunteers and public health staff, exercise, having suitable food, stress management, adequate sleep, avoidance to alcohol, steroids, smoking, accidents and resistance to hard work. After a year of these activities, the health condition of the aged people was better while several health problems decreased such as the rate of sickness, risk group of chronic diseases, join and muscular pain. Besides, diabetes and blood pressure were at the same level. The patients with diabetes and blood pressure were able to better control glucose level and blood pressure at the safe rate without any complications. The whole quality of life of the elderly on physical and mental health, daily routine, society and finance were also increased by 63.15%. Furthermore, sex and age were significantly related to the health promotion for

  7. Supporting the Mental Health Needs of Veterans in the Metro Detroit Area. (United States)

    Tanielian, Terri; Hansen, Michael L; Martin, Laurie T; Grimm, Geoffrey; Ogletree, Cordaye


    Supporting the mental health needs of veterans is a national priority. Over the past decade, there have been several studies describing the needs of the veteran population, particularly those who served in the post-9/11 era, calling for improved access to high-quality mental health services. In response, the federal government has expanded funding and services to meet increasing demand. At the same time, there has also been a proliferation of nongovernmental support to improve services for veterans in local communities. Often, in an attempt to deploy resources quickly, new programs and services are implemented without a full understanding of the specific needs of the population. This article discusses findings and recommendations from a study designed to gather information on the mental health-related needs facing veterans in the Detroit metropolitan area to identify gaps in the support landscape and inform future investments for community-level resources to fill the identified gaps.

  8. [Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units]. (United States)

    Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria


    Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

  9. Population health improvement: a community health business model that engages partners in all sectors. (United States)

    Kindig, David A; Isham, George


    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  10. Issues in the Development of an All-Digital Public Health Library in Michigan: The Michigan Community Health Electronic Library (United States)

    Brenneise, Harvey R.


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

  11. Demanda de serviço de saúde comunitária na periferia de área metropolitana The demand for community health services in the metropolitan periphery area

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    Sônia Maria Radaelli


    Full Text Available Para melhor conhecer o conteúdo da assistência ambulatórial em Assistência Primária à Saúde, procedeu-se a um estudo com uma amostra de 4.319 atendimentos, representando 7% da população atendida de março de 1985 a março de 1986. O estudo foi realizado na Unidade Sanitária Murialdo (SSMA, localizada na Vila São José, na periferia de Porto Alegre, RS (Brasil. O sexo feminino ocupou 67% do total de atendimentos. A composição etária esteve mais significativamente representada por crianças até 10 anos (37% e mulheres em idade fértil (21%. As vinte primeiras razões de encontro corresponderam a 63% do total, e a razão principal de procura do serviço foi para renovação de receitas e pedido de medicamentos (9,3%. De todos os diagnósticos do estudo, os vinte primeiros correponderam a 61%, sendo que hipertensão arterial sistêmica (8,8%, infecções de vias aéreas superiores (7,8% e imunizações (5,5% foram os mais freqüentes. O procedimento mais realizado foi fornecer, prescrever ou administrar medicação. Foram encaminhadas 7,3% do total das pessoas atendidas, mais da metade (5,0% para profissionais do próprio serviço e apenas 0,6% foram encaminhadas para hospitalização. Estes dados, acrescidos daqueles de pesquisas que captaram os aspectos de morbi-mortalidade não facilmente obtidos em estudos de demanda, poderiam servir para orientar o planejamento dos serviços sanitários e treinamento de pessoal.The content of 4,319 consultations in primary health care representing 7% of all consultations from March, 1985 to March, 1986 at the Murialdo Health Center, was analyzed The health center is located in the outskirts of Porto Alegre, RS (Brazil. Woman represented 67% of the total demand. Most consultations were for children under 10 years of age (37% and woman of childbearing age (21%. The first twenty reasons for the visit corresponded to 63% of the total, and the most common reason for visiting the health center was for

  12. Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

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    Waiswa Peter


    Full Text Available Abstract Background Many malarious countries plan to introduce artemisinin combination therapy (ACT at community level using community health workers (CHWs for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs. Methods The study was conducted in Iganga district using 10 focus group discussions (FGDs with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs. Results CMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred. Conclusion Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical

  13. Referral patterns of community health workers diagnosing and treating malaria

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Magnussen, Pascal;


    Malaria-endemic countries have implemented community health worker (CHW) programs to provide malaria diagnosis and treatment to populations living beyond the reach of health systems. However, there is limited evidence describing the referral practices of CHWs. We examined the impact of malaria...... (ACT) for malaria and recognize signs and symptoms for referral to health centers. CHWs in the control arm used a presumptive diagnosis for malaria based on clinical symptoms, whereas intervention arm CHWs used mRDTs. CHWs recorded ACT prescriptions, mRDT results, and referral inpatient registers...... more distant from health centers were more likely to be referred (low transmission only). CHWs using mRDTs and ACTs increased referral compared with CHWs using a presumptive diagnosis. To address these concerns, referral training should be emphasized in CHW programs as they are scaled-up....

  14. Experiences from three community health promotion projects in Greenland

    DEFF Research Database (Denmark)

    Curtis, Tine; Olesen, Ingelise; Kjeldsen, Ann B


    aspects of community capacity building. CONCLUSION: We need to learn more about how to employ the resources of communities, how to achieve better partnerships and how to support people in their efforts in order to secure population participation at all project stages. It is important to build coalitions......OBJECTIVES AND METHODS: Three community health promotion projects have been implemented in Greenland in the municipalities of Upernavik, Ittoqqortoormiit and Qasigiannguit. Based on project reports and other written material, this paper describes experiences from the three projects and discusses...... the implications of the differences in project design and organization for potential outcomes. RESULTS: None of the three projects were formally evaluated. They all experienced problems and have only been partially successful in reaching their goals. The Upernavik and the Ittoqqortoormiit projects were organised...

  15. Motivational Interviewing Approach Used by a Community Mental Health Team. (United States)

    Tan, Sharon Chay Huang; Lee, Mindy Wen Hui; Lim, Gentatsu Tan Xiong; Leong, Joseph Jern-Yi; Lee, Cheng


    The current study aimed to (a) evaluate the effectiveness of motivational interviewing, as applied by a community mental health team (CMHT) based in Singapore; (b) reduce hospital admissions and length of hospital stay; and (c) improve global functioning and satisfaction of individuals with mental illness. The current study used a quasi-experimental method. A convenience sample of 120 participants was selected from the caseload of the CMHT. Participants received motivational interviewing sessions at least once every month for 1 year. Data on the number of hospital admissions, length of hospitalization, Global Assessment of Functioning, and patient satisfaction were collected at baseline and 6 and 12 months. Participants who underwent the CMHT services with motivational interviewing were more compliant to treatment, resulting in significant reduction in hospitalization and improvement in functionality. Motivational interviewing is effective in facilitating better illness management for patients in the community. Adoption of the motivational interviewing approach may potentially provide significant benefits for psychiatric support services in the community.

  16. 76 FR 38281 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated... (United States)


    .... Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans... 3206-AM39 Federal Employees Health Benefits Program: New Premium Rating Method for Most Community...

  17. Responsiveness Evaluation of the Community Health Ser-vice in Shenzhen City

    Institute of Scientific and Technical Information of China (English)

    杨德华; 彭绩; 程锦泉; 刘军安; 夏挺松; 卢祖洵


    RESPONSIVENESS is recognized worldwidely as akey aspect of health system performance. The commu-nity health system is the sub-system of health system.There are very few studies using responsiveness as themarker to evaluate the community health system. OnJune 6th 1999, Shenzhen city became one of the 12 ex-perimental centers for community health services inChina, as decided by the health department. Since theformal commencement of the community health systemin Shenzhen, the health department and the governme...

  18. Does "community social capital" contribute to population health? (United States)

    Folland, Sherman


    Robert Putnam showed that a social capital index, created as a weighted sum of 14 variables chosen to describe the civic degree of sociability and community mindedness, is correlated with many community outcomes, such as education, child well-being, crime, and the total mortality rate. Although correlation does not establish causation, we can find that in a large number of studies this index, a selection of its elements, or similar measures register as significantly correlated with health variables, virtually always in a direction consistent with the hypothesis that social capital improves health. The potential benefit of this relationship is substantial, especially if it proves to be robust to differences in time and place, statistical contexts, and ultimately if the relation can be supported to be causal. This paper subjects the social capital and health hypothesis to an expanded set of rigorous tests, which, by surviving, it becomes stronger or, by failing, its weaknesses are better revealed. The paper seeks to extend this body of research by a combination of study characteristics that are each relatively unusual in social capital and health research. Though causality cannot be established by these tests, the work shows that the association of social capital with health is quite robust when challenged in the following ways: (1) seven different health measures are studied, including five mortality rates; (2) the 48 contiguous states are observed at six points in time covering the years from 1978 to 1998 over four year intervals, thus forming a panel; (3) the multivariate tests feature economic variables from the production of health literature; and (4) a statistical method (instrumental variables) is applied to account for the possibility that omitted variables are confounding the social capital estimates. The results and the discussion find cases for which the social capital and health hypothesis performs only weakly, but, on the whole, the hypothesis is

  19. Management behaviour of one community health nurse supervisor. (United States)

    Field, P A; Larsen, J


    Mintzberg's theoretical framework of management, which examines the roles and functions of a manager in relation to effective communication, is used to analyse observational data of managerial conflict within a community health setting. In this setting the manager failed to establish sound interpersonal relations with her peers or with the clinic nurses. This led to a poor information base from which she could make decisions. The result was that the group became stressed and developed signs of disintegration.

  20. Sex-specific difference of the association between ambient air pollution and the prevalence of obesity in Chinese adults from a high pollution range area: 33 Communities Chinese Health Study (United States)

    Li, Meng; Qian, Zhengmin; Vaughn, Michael; Boutwell, Brian; Ward, Patrick; Lu, Tao; Lin, Shao; Zhao, Yang; Zeng, Xiao-Wen; Liu, Ru-Qing; Qin, Xiao-Di; Zhu, Yu; Chen, Wen; Dong, Guang-Hui


    Experimental data suggests that exposure to airborne fine particulate matter is associated with obesity. There is little supporting epidemiologic evidence of this, however. To evaluate the effects of ambient air pollution on the prevalence of obesity among adults living in a primarily industrial province of northeast China, 24,845 Chinese adults between the ages of 18 and 74 were randomly recruited from 33 communities in 11 districts of three northeastern Chinese cities during 2009. The participants' weight and height were measured. Three-year (2006-2008) average concentrations of particles with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were calculated from monitoring stations in each of the 11 districts. Two-level logistic regressions models were used to examine the effects of pollutants exposure. Overall, 35.3% (8764) were overweight and 5.8% (1435) were obese. After adjusting for confounding factors, significant associations between concentrations of air pollutants and prevalence of obesity were found. When the analysis was stratified by sex, the associations were significant only in women. Among women, an increased prevalence of obesity was associated with an interquartile range increase in PM10 (19 μg/m3; odds ratio [ORs] = 1.18; 95% confidence interval [CI]:1.06-1.32), NO2 (9 μg/m3; ORs = 1.24; 95% CI: 1.09-1.41), and O3 (22 μg/m3; ORs = 1.14; 95% CI: 1.01-1.30). Associations were stronger among older participants. In conclusion, this study reveals a positive association between the long-term exposure to ambient air pollution and increased prevalence of obesity, and that these associations were more apparent in women than in men.

  1. Precepts of community health and hygiene from the Holy Bible. (United States)

    Subhaktha, P K J P; Prasad, P V V; Narayana, A


    Every Society, in its unending process of evolution, devises its own methods of survival in ethical, medical and emotional aspects. The urge for good and healthy living, the desire for longevity of life are not only inherent but also largely evident in all the societies right from the time of its primitivity. Jews are a wonder community. Though negligible in numbers, they managed to win 17.5% of noble prizes announced so far. Besides, almost all the major inventions in the world are by Jews. This despite the years of persecution and trials the community was subjected to in the history. The pages of the human history are smeared with the blood patches of the Jews in the hands of oppressors for several centuries. Apart from the fact that theirs is the community chosen specially by God, the intellectual prowess and tenacity of the Jewish community basically stems from the discipline and dietary code they received from their leader Moses in wilderness. Jewish nation was conceived in the vision of their patriarch Abraham but in fact, born on the night they left as slaves from Egypt for good under the dynamic leadership of Moses. Mosaic code for all aspects of life has made Jews or Israelites what they are today. A modest effort is being made in this article to trace their community's health and hygiene social behavioral precepts as given by Moses.

  2. Mapping heatwave health risk at the community level for public health action

    Directory of Open Access Journals (Sweden)

    Buscail Camille


    Full Text Available Abstract Background Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution acquired during a localized heatwave (June 2001 was used to estimate land surface temperature (LST and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence. Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R2 = 0.87 and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000 yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave

  3. The In-Between People: Community Health Workers in the Circle of Care

    Centers for Disease Control (CDC) Podcasts


    Community Health Workers in Native American and Latino communities help bridge the gap between communities and the health care system.  Created: 1/1/2006 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/7/2012.

  4. Relation between the insertion of the Oral Health Team in the Family Health Strategy and the level of knowledge of community health workers

    Directory of Open Access Journals (Sweden)

    Ronald Jefferson Martins


    Full Text Available Objective: to identify the relation between the level of knowledge of community health workers on oral health and the presence of the Oral Health Team in the Family Health Strategy. Methods: we performed a survey with 173 community health workers allocated in public health services of five municipalities in the northwest of São Paulo, Brazil, through a self-administered and structured instrument. The survey instrument contemplated questions related to the presence of the Oral Health Team in the Family Health Strategy and questions regarding oral health. Results: the majority of community health workers was inserted in strategies with the presence of Oral Health Teams (60.1%. We found that the oral health knowledge of most participants was good (48%. Conclusion: there is relation between the level of knowledge of community health workers and the presence of the Oral Health Team in the Family Health Strategy.

  5. Community health promotion approaches within institutions for disabled

    DEFF Research Database (Denmark)

    Holm, Jesper

    From a two years study of 3 special educational institutions for disabled in Zealand, Denmark, we have done qualitative studies of the focus-areas that the institutions have pointed out as their Best Practices of Health Promotion in everyday life. We have in general followed research questions......: What practices do special institutions for people with developmental disabilities believe to be health promoting, and will a research based reconstruction of these practices with health promotion concepts have anything to offer for professionals in this area? How will the involved parties experience...... each other practices and is possible to establish a mutual institutional learning process, as a surplus to normal quality control (NPM)? What understandings of psyche, individual, mind-body-spirit, health promotion etc. are involved in these practices, and how do they relate to the institutional...

  6. Impact of Chronic Drought on Nutritional Status of the Community in Drought affected areas in India

    Directory of Open Access Journals (Sweden)

    Venkaiah Kodavalla


    Full Text Available Background: Communities affected by chronic drought conditions face a wide variety of challenges including an adverse effect on their nutritional status. The Government of India, during the year 2002-03, declared nine States viz., Andhra Pradesh, Karnataka, Tamil Nadu, Madhya Pradesh, Maharashtra, Rajasthan, Gujarat, Chhattisgarh and Orissa as drought affected. Material and Methods: At the request of Department of Agriculture, Government of India, a rapid community based cross-sectional study was carried out adopting multistage random sampling procedure with the objective to assess the nutritional status of community in these nine chronic drought affected states in India. Results: In general, the intakes of all the nutrients were grossly deficit as against their RDAs. The nutrition intervention programmes initiated by the Government of India, in general, contributed to meet the daily requirement of staples like cereals & millets in most of the States. Conclusion: In drought-affected areas, where the level of famine impact is unknown, an early rapid assessment of the nutritional status and the health needs of the population are critical to estimate the degree of impact to plan timely and appropriate interventions.

  7. Job stress among community health workers: a multi-method study from Pakistan

    Directory of Open Access Journals (Sweden)

    Iqbal Zafar


    Full Text Available Abstract Background In low income countries, the task of providing primary health care is often the responsibility of community health workers. In Pakistan, community workers called Lady Health Workers (LHW deliver basic health care at the doorstep in the rural areas and urban slums. Evaluations show that it is a successful programme but point out inconsistencies in the quality of service provided. In order achieve this, it would be important to obtain the workers' viewpoint on their job-description, the problems they face and the levels of stress they encounter. Methods We conducted a multi-method study to investigate the aforementioned issues. All LHWs from one typical rural sub-district in Rawalpindi were surveyed. Focus group discussions with a sub-set of these workers were also conducted. Results About a quarter of the LHWs were found to have significant occupational stress. Factors associated with stress included having low socio-economic status and having to travel long distances for work. Inconsistent medical supplies, inadequate stipends, lack of career structure and not being equipped to communicate effectively with families were the main factors for job dissatisfaction among these workers. Recommendations Improvement in remuneration, better administration of supplies and a structured career path should be ensured for better performance of community health workers. In addition, communication skills learning should be an essential part of their training programme.

  8. Implementation of the principles of primary health care in a rural area of South Africa

    Directory of Open Access Journals (Sweden)

    Surona Visagie


    Full Text Available Background: The philosophy of primary healthcare forms the basis of South Africa’s health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas.Objectives: The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa.Method: A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis.Results: Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, healthworker attitudes, referral services and the management of complex conditions.Conclusion: The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcareservices and increasing the doctors’ hours.

  9. Comparison of high- versus low-intensity community health worker intervention to promote newborn and child health in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    Findley SE


    the five prior years (baseline: n = 6,906; follow-up: n = 2,310. The follow-up respondents were grouped by level of intensity of the CHW interventions in their community, with “low” including group activities led only by a trained community volunteer and “high” including the community volunteer activities plus CBSD from a CHW providing one-on-one advice and assistance. t-tests were used to test for significant differences from baseline to follow-up, and F-statistics, which adjust for the stratified cluster design, were used to test for significant differences between the control, low-intensity, and high-intensity intervention groups at follow-up. These analyses focused on changes in newborn and sick child care practices.Results: Anti-tetanus vaccination coverage during pregnancy increased from 69.2% at baseline to 85.7% at follow-up in the intervention areas. Breastfeeding within 24 hours increased from 42.9% to 59.0% in the intervention areas, and more newborns were checked by health workers within 48 hours (from 16.8% at baseline to 26.8% at follow-up in the intervention areas. Newborns were more likely to be checked by trained health personnel, and they received more comprehensive newborn care. Compared to the control communities, more than twice as many women in intervention communities knew to watch for specific newborn danger signs. Compared to the control and low-intensity intervention communities, more mothers in the high-intensity communities learned about the care of sick children from CHWs, with a corresponding decline those seeking advice from family or friends or traditional birth attendants. Significantly fewer mothers did nothing when their child was sick. High-intensity intervention communities experienced the most decline. Those who did nothing for children with fever or cough declined from 35% to 30%, and with diarrhea from 40% to 31%. Use of medications, both traditional and modern, increased from baseline to follow-up, with no

  10. 78 FR 26630 - Applications for New Awards; NIDDR DRRP-Community Living and Participation, Health and Function... (United States)


    ... Applications for New Awards; NIDDR DRRP--Community Living and Participation, Health and Function, and... and Rehabilitation Research Projects (DRRPs)-- Community Living and Participation, Health and Function... access the electronic grant application for the Community Living and Participation, Health and...

  11. Utilization pattern of antenatal health care services among married women of reproductive age group in the rural area of Surendranagar district, Gujarat, India: a community based cross sectional study

    Directory of Open Access Journals (Sweden)

    Nishant R. Bhimani


    Results: A total of 403 women were included in the study. Pregnancy registration was done by 88.77% of the women at either government facility or private doctor. Out of total registered women, majority i.e. 54.25% had registered their pregnancy during 2nd trimester. In response to frequency of antenatal visits, study showed that, 59.18% (216 women had availed three or more than three antenatal visits. It was found that 81.92% (299 had taken complete (2 doses tetanus immunization. About 47% of women had completed full course of iron and folic acid tablets. It was observed that only 46.03% women had availed complete ANC package. Conclusions: Although Antenatal services in India have been created, strengthened and expanded over the years, their output in terms of utilization particularly in rural area is still limited. The present study has brought out many significant socio cultural barriers like caste, women's literacy, husband's literacy, occupation of women, socio-economic class and parity of women affecting the utilization of services. [Int J Res Med Sci 2016; 4(1.000: 252-261

  12. Community participation in primary health care projects of the Muldersdrift Health and Development Programme

    Directory of Open Access Journals (Sweden)

    M. Barker


    Full Text Available After numerous teething problems (1974-1994, the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP. The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC activities and the involvement of a variety of community groups. As the PHC projects evolved overtime, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question “What was the level of community participation in PHC projects of the MHDP?” Based on the question the following objectives were set, i.e. i to evaluate the community participation in PHC initiatives; ii to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; iii to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; iv to evaluate the MHDP’s implementation of a people-centred approach to community participation in PHC; and v the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twentythree (N=23 PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the “Criteria to evaluate community participation in PHC projects” instrument (a quantitative tool. Structured group interviews were done with PHC projects’ executive committee members. The Joint Management Committee’s data was collected through mailed

  13. [Violence against women in the perspective of community health agents]. (United States)

    Hesler, Lilian Zielke; da Costa, Marta Cocco; Resta, Darielli Gindri; Colomé, Isabel Cristina dos Santos


    The current study has the objective of learning and understanding how Community Health Agents conceptualize, develop and perform strategies to counter violence against women attending the Family Health Strategies in a northeastern municipality of Rio Grande do Sul. It is an exploratory research, utilizing a descriptive and qualitative approach, carried out with 35 Community Health Agents. Semi-structured interviews were performed to collect the data, which were analyzed using the thematic model. Conceptions of violence against women are centered around violence as a social construction based on gender inequalities and on violence as having a multifactorial construction. Regarding care practices and interventions to counter violence, the following tools are highlighted construction of intervention strategies within the staff forming bonds, listening and dialogue with the women victims of violence; and directing victims to support services. We believe that this study contributes to the visibility of this theme as a need in health care, as well as for the construction of strategies to counter it.

  14. Humpback whale populations share a core skin bacterial community: towards a health index for marine mammals?

    Directory of Open Access Journals (Sweden)

    Amy Apprill

    Full Text Available Microbes are now well regarded for their important role in mammalian health. The microbiology of skin--a unique interface between the host and environment--is a major research focus in human health and skin disorders, but is less explored in other mammals. Here, we report on a cross-population study of the skin-associated bacterial community of humpback whales (Megaptera novaeangliae, and examine the potential for a core bacterial community and its variability with host (endogenous or geographic/environmental (exogenous specific factors. Skin biopsies or freshly sloughed skin from 56 individuals were sampled from populations in the North Atlantic, North Pacific and South Pacific oceans and bacteria were characterized using 454 pyrosequencing of SSU rRNA genes. Phylogenetic and statistical analyses revealed the ubiquity and abundance of bacteria belonging to the Flavobacteria genus Tenacibaculum and the Gammaproteobacteria genus Psychrobacter across the whale populations. Scanning electron microscopy of skin indicated that microbial cells colonize the skin surface. Despite the ubiquity of Tenacibaculum and Psychrobater spp., the relative composition of the skin-bacterial community differed significantly by geographic area as well as metabolic state of the animals (feeding versus starving during migration and breeding, suggesting that both exogenous and endogenous factors may play a role in influencing the skin-bacteria. Further, characteristics of the skin bacterial community from these free-swimming individuals were assembled and compared to two entangled and three dead individuals, revealing a decrease in the central or core bacterial community members (Tenacibaculum and Psychrobater spp., as well as the emergence of potential pathogens in the latter cases. This is the first discovery of a cross-population, shared skin bacterial community. This research suggests that the skin bacteria may be connected to humpback health and immunity and could

  15. Humpback whale populations share a core skin bacterial community: towards a health index for marine mammals? (United States)

    Apprill, Amy; Robbins, Jooke; Eren, A Murat; Pack, Adam A; Reveillaud, Julie; Mattila, David; Moore, Michael; Niemeyer, Misty; Moore, Kathleen M T; Mincer, Tracy J


    Microbes are now well regarded for their important role in mammalian health. The microbiology of skin--a unique interface between the host and environment--is a major research focus in human health and skin disorders, but is less explored in other mammals. Here, we report on a cross-population study of the skin-associated bacterial community of humpback whales (Megaptera novaeangliae), and examine the potential for a core bacterial community and its variability with host (endogenous) or geographic/environmental (exogenous) specific factors. Skin biopsies or freshly sloughed skin from 56 individuals were sampled from populations in the North Atlantic, North Pacific and South Pacific oceans and bacteria were characterized using 454 pyrosequencing of SSU rRNA genes. Phylogenetic and statistical analyses revealed the ubiquity and abundance of bacteria belonging to the Flavobacteria genus Tenacibaculum and the Gammaproteobacteria genus Psychrobacter across the whale populations. Scanning electron microscopy of skin indicated that microbial cells colonize the skin surface. Despite the ubiquity of Tenacibaculum and Psychrobater spp., the relative composition of the skin-bacterial community differed significantly by geographic area as well as metabolic state of the animals (feeding versus starving during migration and breeding), suggesting that both exogenous and endogenous factors may play a role in influencing the skin-bacteria. Further, characteristics of the skin bacterial community from these free-swimming individuals were assembled and compared to two entangled and three dead individuals, revealing a decrease in the central or core bacterial community members (Tenacibaculum and Psychrobater spp.), as well as the emergence of potential pathogens in the latter cases. This is the first discovery of a cross-population, shared skin bacterial community. This research suggests that the skin bacteria may be connected to humpback health and immunity and could possibly serve

  16. Community participation mode of ecotourism in Tibetan area of Shangri-La County, Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    Cheng Zhu


    Community participation is one of the focuses of the research on ecotourism. The research on community participative model is of great theoretical and practical significance. Based on the former experts' studies, this paper analyzes ecotourism demonstration areas in Diqing Shangri-La of Yunnan as a case study. It mainly expounds the relationship between ecotourism and community participation and puts forward such a community participative model of ecotourism in Shangri-La.

  17. Referral patterns of community health workers diagnosing and treating malaria

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Magnussen, Pascal


    Malaria-endemic countries have implemented community health worker (CHW) programs to provide malaria diagnosis and treatment to populations living beyond the reach of health systems. However, there is limited evidence describing the referral practices of CHWs. We examined the impact of malaria...... rapid diagnostic tests (mRDTs) on CHW referral in two cluster-randomized trials, one conducted in a moderate-to-high malaria transmission setting and one in a low-transmission setting in Uganda, between January 2010 and July 2012. All CHWs were trained to prescribe artemisinin-based combination therapy...... (ACT) for malaria and recognize signs and symptoms for referral to health centers. CHWs in the control arm used a presumptive diagnosis for malaria based on clinical symptoms, whereas intervention arm CHWs used mRDTs. CHWs recorded ACT prescriptions, mRDT results, and referral inpatient registers...

  18. Understanding the Business Case for Telemental Health in Rural Communities. (United States)

    Lambert, David; Gale, John; Hartley, David; Croll, Zachariah; Hansen, Anush


    Telemental health has been promoted to address long-standing access barriers to rural mental health care, including low supply and long travel distances. Examples of rural telemental health programs are common; there is a less clear picture of how widely implemented these programs are, their organization, staffing, and services. There is also a need to understand the business case for these programs and assess whether and how they might realize their promise. To address these gaps, a national study was conducted of rural telemental health programs including an online survey of 53 programs and follow-up interviews with 23 programs. This article describes the current landscape and characteristics of these programs and then examines their business case. Can rural telemental health programs be sustained within current delivery systems and reimbursement structures? This question is explored in four areas: need and demand, infrastructure and workforce, funding and reimbursement, and organizational fit and alignment.

  19. 新医改制度下垦区社区卫生服务人员工作满意度评价及影响因素分析%Study on Job Satisfaction and Influencing Factors of Community Health Service Person-nel in Reclamation Area under the Background of New Medical Reform Plan

    Institute of Scientific and Technical Information of China (English)

    远丽昉; 吴群红; 郭梦童; 宋健; 高力军


    目的:对新医改后黑龙江省垦区社区卫生服务发展现况及问题进行调研,探讨研究影响社区卫生人员工作满意度的多种因素.方法选取北安管理局社区卫生服务中心工作人员为调查对象,采用单因素和多因素 Lo-gistic回归分析方法进行工作满意度影响因素筛选.结果员工总体满意度很低,其中对工作量满意度最低,仅为1%、其次是对职业发展机会以及收入和福利满意度.多因素分析结果显示,缺乏职业发展机会和空间是影响其工作满意度的首要原因,其OR 值为3.897;此外,员工对其工资及福利待遇以及对个人收入和工作环境的评价,是影响其工作满意度的突出因素.结论应通过制定优惠的、面向基层卫生人力资源培训和开发的政策,建立向基层倾斜的职业晋升评价体系以拓展其职业发展的机会和空间,此外还可构建合理的补偿机制、提高工资福利等方法提高垦区卫生服务工作人员满意度.%Objectives To investigate the current situation and problems of community health services (CHS)in Heilongjiang reclamation area,and explore various factors which influenced community health staff’s job satisfac-tion.Methods The staff of CHS center of Beian administration was selected for the survey.Univariate and multiva-riate Logistic regression analysis method were applied for screening the influencing factors of job satisfaction.Results Overall employee satisfaction was very low.The lowest satisfaction was the workload,which only reached 1%, followed by career development opportunities and income and welfare satisfaction.Multivariate analysis showed that the lack of career development opportunities and space were the primary factor affecting their job satisfaction (OR= 3.897).In addition,salaries and welfare as well as their evaluation of personal income and working environment were the prominent factors that affected staff’s job

  20. Using Social Network Analysis as a Method to Assess and Strengthen Participation in Health Promotion Programs in Vulnerable Areas. (United States)

    Hindhede, Anette Lykke; Aagaard-Hansen, Jens


    This article provides an example of the application of social network analysis method to assess community participation thereby strengthening planning and implementation of health promotion programming. Community health promotion often takes the form of services that reach out to or are located within communities. The concept of community reflects the idea that people's behavior and well-being are influenced by interaction with others, and here, health promotion requires participation and local leadership to facilitate transmission and uptake of interventions for the overall community to achieve social change. However, considerable uncertainty exists over exact levels of participation in these interventions. The article draws on a mixed methods research within a community development project in a vulnerable neighborhood of a town in Denmark. It presents a detailed analysis of the way in which social network analysis can be used as a tool to display participation and nonparticipation in community development and health promotion activities, to help identify capacities and assets, mobilize resources, and finally to evaluate the achievements. The article concludes that identification of interpersonal ties among people who know one another well as well as more tenuous relationships in networks can be used by community development workers to foster greater cohesion and cooperation within an area.

  1. Recovery practice in community mental health teams: national survey (United States)

    Leamy, M.; Clarke, E.; Le Boutillier, C.; Bird, V.; Choudhury, R.; MacPherson, R.; Pesola, F.; Sabas, K.; Williams, J.; Williams, P.; Slade, M.


    Background There is consensus about the importance of ‘recovery’ in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Method In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). Results Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31–0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery. PMID:27340113

  2. Community intervention in higher education of environmental health

    Directory of Open Access Journals (Sweden)

    Cidália Guia


    Full Text Available Currently, in the Bologna context, university teaching methods focus on the student and on a learning experience based on practical methods. Under the guidance of teachers, students in the second year of the first Environmental Health Course at the Polytechnic Institute of Beja have designed and developed the following nine community intervention projects relating to environmental health: dangerous products (mercury; habitability and geriatrics; health education and the environment; drinking water; information and communication in environmental health; efficient use of resources in public buildings; child development in outdoor spaces; and allergenic factors in housing. This pedagogical action takes place over three semesters, corresponding to the three distinct phases: design, implementation and evaluation / dissemination. To ensure the viability of the projects, each group of three students has established partnerships with various entities, such as city and parish councils, hospitals, schools, consumer cooperatives, companies dealing with hazardous waste, the Youth Institute and other commercial enterprises. Although it has not been possible to evaluate the whole project, preliminary results suggest that the planned activities have been very successful, with health benefits for the people involved, through environmental improvements or an increase in empowerment. It was also possible to achieve economic gains and contribute to the conservation of the environment. The students were able to gain skills and knowledge in a teaching model characterized by the absence of lectures in which students, assisted by teachers, take decisions and independent action, simulating a real context of professional practice. This experience suggests that, by utilizing the Bologna method, the polytechnic institutions may improve their real contribution to the health of communities.

  3. Mobile health and patient engagement in the safety net: a survey of community health centers and clinics. (United States)

    Broderick, Andrew; Haque, Farshid


    Patient-centered technologies have emerged as a way to actively engage patients in care. The reach and potential of cell phones to engage diverse patient populations is great. Evidence of their effectiveness in improving health-related outcomes is limited. Researchers conducted an online survey of community health centers and clinics to assess if and how health care providers in the safety net use cell phones to support patient engagement. The findings indicate that the use of cell phones in patient care is at an early stage of deployment across the safety net. Organizations identify chronic disease management as an area where cell phones offer considerable potential to effectively engage patients. To promote widespread adoption and use, technical assistance to support the implementation and management of interventions, evidence-based or best practice models that highlight successful implementation strategies in care delivery, and the introduction of new payment or reimbursement policies will be essential.

  4. Delivering health information services and technologies to urban community health centers: the Chicago AIDS Outreach Project. (United States)

    Martin, E R; McDaniels, C; Crespo, J; Lanier, D


    Health professionals cannot address public health issues effectively unless they have immediate access to current biomedical information. This paper reports on one mode of access, the Chicago AIDS Outreach Project, which was supported by the National Library of Medicine through outreach awards in 1995 and 1996. The three-year project is an effort to link the programs and services of the University of Illinois at Chicago Library of the Health Sciences and the Midwest AIDS Training and Education Center with the clinic services of community-based organizations in Chicago. The project was designed to provide electronic access to AIDS-related information for AIDS patients, the affected community, and their care givers. The project also provided Internet access and training and continued access to library resources. The successful initiative suggests a working model for outreach to health professionals in an urban setting.

  5. An integrative review of community health advisors in type 2 diabetes. (United States)

    Hunt, Caralise W; Grant, Joan S; Appel, Susan J


    The purpose of this paper was to report findings from an integrative literature review conducted to identify the theoretical basis of interventions for studies using community health advisors; populations and settings served by community health advisors; characteristics, training, and roles and activities of community health advisors; and the effectiveness of interventions by community health advisors for improving self-management of patients living with type 2 diabetes mellitus. Community health advisors' theoretical interventions were based on providing culturally appropriate care and resolution of health disparities within minority populations. Typically community health advisors were patients themselves living with type 2 diabetes mellitus. Major roles of community health advisors included: supporter, educator, case manager, advocate, and program facilitator. Activities of community health advisors were: coordinating educational programs, conducting educational courses for patients, serving as a link between patients and healthcare professionals, providing counseling, and leading peer support meetings. The effectiveness of interventions by community health advisors was mixed. Examples of outcome criteria were improvements in: knowledge, hemoglobin A1C, low density lipoprotein levels, blood pressure, and physical activity. Community health advisors provide culturally appropriate interventions to promote and restore health and prevent diseases while serving as links between community and healthcare providers.

  6. A Study of Volunteer Community Health Workers Promoting Maternal Health Services in Rural Kenya: A Christian Viewpoint

    Directory of Open Access Journals (Sweden)

    Bradly Alexander Kimbrough


    Full Text Available Introduction: Despite the call for community-based health care interventions in the developing world, there is little research examining the effectiveness of paid versus volunteer community health worker (CHW programs to increase women’s use of maternal health services. From a Christian perspective, the CHW model is, at its root, discipleship: a credible person leads a neighbor to a source of help and health. This effective model can be expanded to address the health of the whole person, both spiritual and physical. This study of a government health center program in rural Kenya addresses these issues. Methods: The current study analyzed the change in maternal health services after a government program, starting with 30 volunteer CHWs, had been in place for nine months. The intervention was designed and carried out by the authors in collaboration with Sigoti District Health Center in the western Kenyan province of Nyanza. Results: The proportion of facility-based deliveries (FBDs showed a statistically significant increase (p=0.003, from an average of 38 deliveries before the intervention to 60 after-wards. The proportion of health center deliveries of HIV-positive women also significantly increased (p=0.04 from an average of 6.5 to 14 FBDs. Compared to another program in rural Lesotho with paid CHWs, the Sigoti intervention led to a similar increase in FBDs. Despite their successes, the community-based strategies were time-intensive for both programs, with one CHW adding between 1.12 and 1.7 FBDs per year. Discussion: This study demonstrates that a CHW program can be successful, even when using volunteers. Using solely a metric of time and/or money, the CHW model produces value at a high cost. However, the concerns of cost-effectiveness and CHW attrition, as well as the success of the CHW model, can be meaningfully addressed from a Christian perspective. Using the outcome measure of changed lives, volunteer CHWs could be motivated by a

  7. The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program. (United States)

    Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A; De La Rosa, Mario


    There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.

  8. Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh

    Directory of Open Access Journals (Sweden)

    Bari Sanwarul


    Full Text Available Abstract Background Well-trained and highly motivated community health workers (CHWs are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Methods Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation, and informal discussion with key project personnel. Results Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay. Conclusions The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.

  9. Scientific and Popular Health Knowledge in the Education Work of Community Health Agents in Rio de Janeiro Shantytowns (United States)

    Zanchetta, M. S.; Kolawole Salami, B.; Perreault, M.; Leite, L. C.


    Health education for socially marginalized populations challenges the efficacy of existing strategies and methods, and the pertinence of the educational and philosophical principles that underpin them. The Brazilian Community Health Agents Initiative (CHAI) hires residents of deprived marginalized communities to undertake health promotion and…

  10. [The role of the community health agent in control of the in-house stock of medication in communities served by the family health strategy]. (United States)

    Laste, Gabriela; Deitos, Alícia; Kauffmann, Carla; Castro, Luís César de; Torres, Iraci Lucena da Silva; Fernandes, Luciana Carvalho


    The scope of this study was to investigate the in-house stock of medication in communities served by the Family Health Strategy (FHS) in a city located in the south of Brazil. A sample of 10% of households in five FHS areas was studied. Data were collected by Community Healthcare Workers using the adapted Fernandes questionnaire (2000). The mean age of the interviewees was 42 years and of the residents was 16 years, 51% of which were female. Low income (1 to 3 minimum wages) was observed (69.1%), and low education levels (0 to 4 years of study) (42%). Of the households visited 98.7% had at least one medication in stock. In 533 of the storage places located, 43.5% of such places were exposed to heat, 39.6% were exposed to humidity and 16.51% to light. Of the 2,717 medicines found, 6.9% were past the validity date, 35.3% were not in the secondary wrapping and 67.9% were without the patient information leaflet. Analgesics were the most common medications in in-house stock (21%). This study revealed the need for a multi-professional team to promote health and the rationalization of in-house stock since the Community Healthcare Worker is an indispensable professional to promote the rational use of medication.

  11. Knowledge, beliefs and attitudes of community health workers about hypertension in the Cape Peninsula, South Africa

    Directory of Open Access Journals (Sweden)

    M.J. Sengwana


    Full Text Available This article explores the perceptions and attitudes of community health workers (CHWs about hypertension. The level of knowledge of hypertension, as well as their personal attitude towards this is crucial in the style and quality of their interventions. CHWs, whose role in health promotion is being increasingly recognised, can help contain or reduce the prevalence of hypertension by influencing the community to adopt healthy lifestyles. Forty-three CHWs employed by Zanempilo in two study areas, Sites B and C in Khayelitsha in the Cape Peninsula, South Africa, were included in the study. Firstly, focus group discussions were conducted with 17 purposively selected CHWs to explore attitudes, beliefs and perceptions of hypertension. Secondly, interviews were conducted to assess their basic knowledge about causes, prevention and control of hypertension. The focus group discussions revealed that CHWs were uncertain about the causes of hypertension. They also found it difficult to grasp the fact that people without risk factors, such as overweight or a family history of hypertension, could be hypertensive. Many CHWs believe in traditional medicines and home-brewed beer as the best treatment for hypertension. They believe that people who take medical treatment become sicker and that their health deteriorates rapidly. Risk factors of hypertension mentioned during the structured interviews include inheritance, lack of physical activity, consuming lots of salty and fatty food. Conclusions drawn from the findings of the CHWs’ responses highlighted their insufficient knowledge about hypertension as a chronic disease of lifestyle. Meanwhile they are expected to play a role in stimulating community residents’ interest in the broad principle of preventive health maintenance and follow-up. Data obtained from this research can be used for the planning of health-promotion programmes. These should include preventing hypertension and improving primary management

  12. Community oral health literacy: improving use of oral-health care guarantee in children aged 6.

    Directory of Open Access Journals (Sweden)

    Marco Cornejo-Ovalle


    Full Text Available The assessment of comprehensive oral health care for children aged 6 (GES-6years showed low utilization of this guarantee, with lower use for children from municipal public schools. The empowerment and health literacy of parents improve their role as oral-health promoters for their children. Objective: To implement and to assess a strategy of empowerment and health literacy of the community about their guaranteed health rights to increase the use of GES-6years. Methods: A mixed design. Using qualitative methodology we will design a communication tool, culturally and socially appropriate to be sent to the beneficiary community of this guarantee. Using a nonrandomized community trial, this instrument designed to empower and improve oral health literacy on GES-6 guarantee, will be sent as personalized letter (intervention signed by the mayor of the municipality with a message aimed to children beneficiaries for GES -6years and another addressed to their parents/guardians. Schools would be selected from clusters (communes of the two regions selected for convenience. Communes will be randomly selected amog those whose authorities agree to participate, and will be selected as for intervention or control. Data analysis will assess the differences in the prevalence of use of this guarantee among children from municipal schools belonging to the intervention or control arm.

  13. Business and faith: key community partnerships for school-based health centers. (United States)

    Juszczak, L; Moody, J K; Vega-Matos, C


    School-based health centers need to form partnerships with organizations in the community. These relationships are essential to the viability of the centers because they can provide support and resources. However, benefits should be accrued by all partners, not just the health centers. Although there are many communities for school-based health centers to connect to, this article focuses on two integral ones--communities of business and faith. Key findings from a project formed to develop communication strategies and to generate support from the business community are reviewed. Recommendations for school-based health centers in approaching the business community are provided. Similarities and differences between communities of faith and strategies of develop relationships with these communities are presented. School-based health centers are encouraged to understand the characteristics and priorities of their partners in communities of business and faith, and to pursue strong relationships with both communities.


    Energy Technology Data Exchange (ETDEWEB)

    Wike, L; Doug Martin, D; Michael Paller, M; Eric Nelson, E


    Ecosystem health with its near infinite number of variables is difficult to measure, and there are many opinions as to which variables are most important, most easily measured, and most robust, Bioassessment avoids the controversy of choosing which physical and chemical parameters to measure because it uses responses of a community of organisms that integrate all aspects of the system in question. A variety of bioassessment methods have been successfully applied to aquatic ecosystems using fish and macroinvertebrate communities. Terrestrial biotic index methods are less developed than those for aquatic systems and we are seeking to address this problem here. This study had as its objective to examine the baseline differences in ant communities at different seral stages from clear cut back to mature pine plantation as a precursor to developing a bioassessment protocol. Comparative sampling was conducted at four seral stages; clearcut, 5 year, 15 year and mature pine plantation stands. Soil and vegetation data were collected at each site. All ants collected were preserved in 70% ethyl alcohol and identified to genus. Analysis of the ant data indicates that ants respond strongly to the habitat changes that accompany ecological succession in managed pine forests and that individual genera as well as ant community structure can be used as an indicator of successional change. Ants exhibited relatively high diversity in both early and mature seral stages. High ant diversity in the mature seral stages was likely related to conditions on the forest floor which favored litter dwelling and cool climate specialists.

  15. Connection and Community: Diné College Emphasizes Real-World Experience in Public Health (United States)

    Bauer, Mark


    The Summer Research Enhancement Program (SREP) at Diné College provides students with a solid foundation of public health research methods and includes a hands-on internship in their home community to test their newly acquired skills while enhancing the communities' health. Focusing on health issues prioritized by Navajo health leaders, from…

  16. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion (United States)

    Flaherty, Mary Grace; Miller, David


    Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…

  17. [Reflections around the performance of community health agents in oral health strategies]. (United States)

    de Holanda, Ana Larissa Fernandes; Barbosa, Aldenísia Alves de Albuquerque; Brito, Ewerton William Gomes


    The Community Health Agent (CHA) has traditionally been linked to doctors and nurses, being considered exclusive 'property' of these professionals. Historically, oral health tended to operate isolated, disconnecting the mouth from the rest of the body and the individual from his environment. The Family Health Program (FHP) points to important changes in the organization of services as well as in the work process. One of the differences is the teamwork joining different professionals, including oral health which was previously excluded. The objective of the study is to show the experience of the CHA qualifying course, which allowed the entrance of different professional categories into teaching. The course included three odontologists as lecturers, and CHA recognized other individuals as health team members, as well as expand the view of its role within oral health. The professors also had their practices modified, given that they could understand the often ignored suffering and limitations of the CHAs.

  18. Investigating community-based health and health promotion for homeless people: a mixed methods review. (United States)

    Coles, E; Themessl-Huber, M; Freeman, R


    Homeless people are susceptible to a range of health problems, yet in terms of health promotion, tend to be a hard-to-reach, marginalized group. Robust evidence regarding the ability to engage with this population via effective health promotion programmes is essential if policy and practice are to be informed to improve the health of homeless people. A structured review was conducted with the aim of examining what is known about community-based health promotion for homeless people. Six databases were searched and 8435 records screened. Thirteen studies met the inclusion criteria. A mixed-methods 'combined separate synthesis' approach was used to accommodate both quantitative and qualitative evidence within one review. Three themes emerged: (i) incorporating homelessness, (ii) health improving and (iii) health engaging. The review has implications for health promotion design, with evidence suggesting that as part of a tailored approach, homeless people must be actively involved in intervention development, ensuring that appropriate, acceptable and potentially effective individual elements are incorporated into community-based interventions.

  19. Competency requirements for middle and senior managers in community health services. (United States)

    Liang, Zhanming; Howard, Peter F; Koh, Lee C; Leggat, Sandra


    The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development.

  20. Using the arts in teaching and learning: building student capacity for community-based work in health psychology. (United States)

    Thomas, Elizabeth; Mulvey, Anne


    Perspectives have emerged within health psychology that focus on the social constitution of health and emphasize community development and social change strategies to reduce human suffering and improve quality of life. Education and training are needed to build student capacity in these areas. Our analysis, grounded in theoretical, empirical, and experiential evidences, suggests that the arts may play a leading role in building this student capacity for community research and action. Major themes are that the arts promote student understandings of the values, goals, and practices of community-based work and enable meaningful student roles in community-based partnerships. Narrative accounts of our use of creative writing, visual arts, poetry, film, and theater in classroom and community-based practice with students illustrate these themes.

  1. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National... (United States)


    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public... Unable To Pay § 124.515 Compliance alternative for community health centers, migrant health centers and... migrant health center under section 329 of the Act is in substantial compliance with the terms...

  2. Community health facility preparedness for a cholera surge in Haiti. (United States)

    Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert


    With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.

  3. 42 CFR 5.3 - Procedures for designation of health professional(s) shortage areas. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for designation of health professional(s) shortage areas. 5.3 Section 5.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS § 5.3 Procedures for designation of health professional(s)...

  4. From Subject to Participant: Ethics and the Evolving Role of Community in Health Research


    Bromley, Elizabeth; Mikesell, Lisa; Jones, Felica; Khodyakov, Dmitry


    Community members play an increasingly important role in public health and health services research. New models of community-engaged research may entail novel ethical priorities. For example, the principles described in the Belmont Report focus on the wellbeing of the research subject, yet community-engaged investigators often eschew the role of subject for that of participant. We conducted semi-structured interviews with 29 community and academic investigators working on 10 community-engaged...

  5. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham;


    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children ... sensitivity of current mRDTs in patients with low parasite density are a concern. For community-based treatment in areas of low transmission and/or non-immune populations, presumptive treatment of all fevers as malaria may be advisable, until more sensitive diagnostic assays, suitable for routine use by CHWs...

  6. Mental health system historians: adults with schizophrenia describe changes in community mental health care over time. (United States)

    Stein, Catherine H; Leith, Jaclyn E; Osborn, Lawrence A; Greenberg, Sarah; Petrowski, Catherine E; Jesse, Samantha; Kraus, Shane W; May, Michael C


    This qualitative study examined changes in community mental health care as described by adults diagnosed with schizophrenia with long-term involvement in the mental health system to situate their experiences within the context of mental health reform movements in the United States. A sample of 14 adults with schizophrenia who had been consumers of mental health services from 12 to 40 years completed interviews about their hospital and outpatient experiences over time and factors that contributed most to their mental health. Overall, adults noted gradual changes in mental health care over time that included higher quality of care, more humane treatment, increased partnership with providers, shorter hospital stays, and better conditions in inpatient settings. Regardless of the mental health reform era in which they were hospitalized, participants described negative hospitalization experiences resulting in considerable personal distress, powerlessness, and trauma. Adults with less than 27 years involvement in the system reported relationships with friends and family as most important to their mental health, while adults with more than 27 years involvement reported mental health services and relationships with professionals as the most important factors in their mental health. The sample did not differ in self-reported use of services during their initial and most recent hospitalization experiences, but differences were found in participants' reported use of outpatient services over time. Findings underscore the importance of the lived experience of adults with schizophrenia in grounding current discourse on mental health care reform.

  7. Providing nursing leadership in a community residential mental health setting. (United States)

    Hughes, Frances A; Bamford, Anita


    The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.

  8. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar (United States)

    Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin


    Background Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations’ (EHOs) and community-based organizations’ (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion Despite the chronic conflict in Burma/Myanmar, this

  9. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar

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    Sharon Low


    Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in

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


    Adams, Alexandra K.; Scott, Jamie R.; Prince, Ron; Williamson, Amy


    Background American Indian communities have a high prevalence of chronic diseases including diabetes, obesity, cardiovascular disease, and cancer. Innovative community-based approaches are needed to identify, prioritize, and create sustainable interventions to reduce environmental barriers to healthy lifestyles and ultimately improve health. Community Context Healthy Children, Strong Families was a family-based and community-based intervention to increase healthy lifestyles on Wisconsin Ameri...

  11. Disease maps as context for community mapping: a methodological approach for linking confidential health information with local geographical knowledge for community health research. (United States)

    Beyer, Kirsten M M; Comstock, Sara; Seagren, Renea


    Health is increasingly understood as a product of multiple levels of influence, from individual biological and behavioral influences to community and societal level contextual influences. In understanding these contextual influences, community health researchers have increasingly employed both geographic methodologies, including Geographic Information Systems (GIS), and community participatory approaches. However, despite growing interest in the role for community participation and local knowledge in community health investigations, and the use of geographical methods and datasets in characterizing community environments, there exist few examples of research projects that incorporate both geographical and participatory approaches in addressing health questions. This is likely due in part to concerns and restrictions regarding community access to confidential health data. In order to overcome this barrier, we present a method for linking confidential, geocoded health information with community-generated experiential geographical information in a GIS environment. We use sophisticated disease mapping methodologies to create continuously defined maps of colorectal cancer in Iowa, then incorporate these layers in an open source GIS application as the context for a participatory community mapping exercise with participants from a rural Iowa town. Our method allows participants to interact directly with health information at a fine geographical scale, facilitating hypothesis generation regarding contextual influences on health, while simultaneously protecting data confidentiality. Participants are able to use their local, geographical knowledge to generate hypotheses about factors influencing colorectal cancer risk in the community and opportunities for risk reduction. This work opens the door for future efforts to integrate empirical epidemiological data with community generated experiential information to inform community health research and practice.


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    Ilona Małuszyńska


    Full Text Available Urban areas are exposed on those originating in various sources, emissions of pollutants that pose a threat to the health of living organisms. The type of pollutant and its toxicity to organisms and mold exposure as well as the frequency of their occurrence in the environment can have a negative impact on living organisms occurring in the area. Another element negatively affecting the environmental health is a rush of individuals and communities to prosperity, which, combined with a weak nervous resistance to stressful situations contributes to the reduction of resistance to disease becoming the scourge of society as bulimia, diabetes and cancer. The tendency to increase building occurring in urban areas and the increasing number of urban dwellers in Europe as well as increasing awareness of the population about the need to protect environmental health, points to the need to seek alternative and innovative solutions for urban greenery. Investments included in that group, the green roofs and green walls, the implementation of which will increase the biologically active surface in the cities, may be an essential element of urban infrastructure that contributes to improving the quality of life of communities living in the city.

  13. A case study of a distance-based public health nursing/community health nursing practicum. (United States)

    Vandenhouten, Christine; Block, Derryl


    Facilitating a distance-based public health/community health nursing practicum for RN to BSN students posed challenges and opportunities. Challenges included time involved in arranging the practicum, relationship building with agencies and staff, communicating with students, and the need for flexible practicum scheduling. Exposure to practice models from across the nation allowed students to compare and contrast these public health nursing models. Programs planning to offer this type of course should consider faculty workload particularly during the semester prior to teaching the practicum.

  14. Identity theft in community mental health patients: two case reports. (United States)

    Klopp, Jonathon; Konrad, Shane; Yanofski, Jason; Everett, Anita


    Identity theft is a serious problem in the United States, and persons with enduring mental illnesses may be particularly vulnerable to becoming victims of this crime. Victims of identity theft experience a variety of consequences that include financial loss and serious emotional distress. Little is known about the impact of identity theft on individuals with mental illnesses. The two cases from a community mental health center presented in this article demonstrate many of the facets that may be associated with an increased risk for becoming the victim of identity theft. A summary of preventive steps as well as steps involved in resolving the crime once one has become a victim are presented.

  15. Towards a new theory of practice for community health psychology. (United States)

    Nolas, Sevasti-Melissa


    The article sets out the value of theorizing collective action from a social science perspective that engages with the messy actuality of practice. It argues that community health psychology relies on an abstract version of Paulo Freire's earlier writing, the Pedagogy of the Oppressed, which provides scholar-activists with a 'map' approach to collective action. The article revisits Freire's later work, the Pedagogy of Hope, and argues for the importance of developing a 'journey' approach to collective action. Theories of practice are discussed for their value in theorizing such journeys, and in bringing maps (intentions) and journeys (actuality) closer together.

  16. The health perception rural community adolescents: between the ideal and the real

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    Anny Giselly Milhome da Costa


    Full Text Available This qualitative exploratory-descriptive study was performed by means of the Community Based Participant Research. The main objective was to understand the health perception of adolescents from a rural community. The focal group and field journal techniques were used to collect data from 26 adolescents of a rural community. The results were analyzed and qualitatively interpreted, expressed through two thematic categories that showed the ideal and real health conception of the adolescents. From this group’s perspective, the health of rural community adolescents is determined by positive and negative aspects, with reveal their perception of health and disease. It is concluded that nursing can reduce the distance between the ideal and real health in the rural community by taking hold of the sociocultural approach of becoming adolescent and developing intersectoral interventions to promote satisfactory sanitary conditions and encourage the adolescent’s potential as a social actor. Descriptors: Adolescent; Rural Population; Public Health; Health Education; Community Health Nursing.

  17. Health Impacts of Air Pollution around Major Industrial Areas

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    Mathilde Pascal


    Full Text Available We performed a literature review to investigate how epidemiological studies have been used to assess the health consequences of living in the vicinity of industries. 77 papers on the chronic effects of air pollution around major industrial areas were reviewed. Major health themes were cancers (27 studies, morbidity (25 studies, mortality (7 studies, and birth outcome (7 studies. Only 3 studies investigated mental health. While studies were available from many different countries, a majority of papers came from the United Kingdom, Italy, and Spain. Several studies were motivated by concerns from the population or by previous observations of an overincidence of cases. Geographical ecological designs were largely used for studying cancer and mortality, including statistical designs to quantify a relationship between health indicators and exposure. Morbidity was frequently investigated through cross-sectional surveys on the respiratory health of children. Few multicenter studies were performed. In a majority of papers, exposed areas were defined based on the distance to the industry and were located from 20 km from the plants. Improving the exposure assessment would be an asset to future studies. Criteria to include industries in multicenter studies should be defined.

  18. A novel community-based model to enhance health promotion, risk factor management and chronic disease prevention. (United States)

    Carson, Shannon Ryan; Carr, Caroline; Kohler, Graeme; Edwards, Lynn; Gibson, Rick; Sampalli, Tara


    Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams (CHTs), that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming. In this paper, the development and implementation of the CHTs are discussed. Preliminary outcomes for the model are significant and promising. Formal and large-scale studies are planned to validate these outcomes with additional research rigour.

  19. [Incorporation of controlling dengue by community health agent]. (United States)

    Cazola, Luiza Helena de Oliveira; Tamaki, Edson Mamoru; Pontes, Elenir Rose Jardim Cury


    The purpose of this study was to identify self-perceived differences in the work processes of community health agents (CHA) in two counties of Mato Grosso do Sul, regarding dengue control and Family Health Strategy (FHS) activities. Structured interviews were applied to 57 CHA. The subjects had similar sociodemographic characteristics. Agents in Rio Verde de Mato Grosso county, who performed only FHS tasks, failed to complete essential data of the Form A. In São Gabriel do Oeste county, CHA currently perform tasks pertaining to dengue fever control, previously conducted by Endemic Disease Control Agents (now abolished), while in Rio Verde de Mato Grosso county, dengue control remained assigned to the latter group. In São Gabriel do Oeste county, CHA did not view the double workload of two programs as affecting their professional productivity. The pooling of tasks from the two programs proved to be feasible, with no detrimental effects on performance.

  20. [Work community--a threat and support to mental health]. (United States)

    Sinokki, Marjo


    The absolute and relative amount of employees who have disability pensions due to mental disorders has increased over the last few decades. During the last ten years, both disability pensions and absences due to sickness have increased about 1.5-fold. The significance of a good work environment and community to an employee's mental health is and has been widely studied. Many of these studies have shown that poor organization and problems with social relationships and management at work may increase the probability of mental disorders. At the same time, a positive environment and atmosphere at work with suitable challenges for the employees can motivate them to commit to their work. This can increase the employees willingness to continue working until the proper retirement age and promote mental health.

  1. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India (United States)

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh


    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  2. Variability of community interaction networks in marine reserves and adjacent exploited areas (United States)

    Montano-Moctezuma, G.; Li, H.W.; Rossignol, P.A.


    Regional and small-scale local oceanographic conditions can lead to high variability in community structure even among similar habitats. Communities with identical species composition can depict distinct networks due to different levels of disturbance as well as physical and biological processes. In this study we reconstruct community networks in four different areas off the Oregon Coast by matching simulated communities with observed dynamics. We compared reserves with harvested areas. Simulations suggested that different community networks, but with the same species composition, can represent each study site. Differences were found in predator-prey interactions as well as non-predatory interactions between community members. In addition, each site can be represented as a set of models, creating alternative stages among sites. The set of alternative models that characterize each study area depicts a sequence of functional responses where each specific model or interaction structure creates different species composition patterns. Different management practices, either in the past or of the present, may lead to alternative communities. Our findings suggest that management strategies should be analyzed at a community level that considers the possible consequences of shifting from one community scenario to another. This analysis provides a novel conceptual framework to assess the consequences of different management options for ecological communities. ?? 2008 Elsevier B.V. All rights reserved.

  3. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

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    David Eisenman


    Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  4. Community Health Workers and Mobile Technology: A Systematic Review of the Literature (United States)

    Braun, Rebecca; Catalani, Caricia; Wimbush, Julian; Israelski, Dennis


    Introduction 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. Methods 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. Results 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. Discussion 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

  5. Community health workers and mobile technology: a systematic review of the literature.

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    Rebecca Braun

    Full Text Available INTRODUCTION: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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


    Directory of Open Access Journals (Sweden)

    Grayce Alencar Albuquerque


    Full Text Available The aim of this study was to understand the perception of Community Health Agents (ACS on the health of man. Methods: This was an exploratory research, descriptive and qualitative approach with ACS's the city of Juazeiro do Norte - Ceará. Results: Data were grouped into categories and subcategories, where he observed that the ACS's still has a woman as the main focus of care and that the male population is not addressed routinely by the refusal of such information, the work, the macho culture and hours of operation of health facilities. However, the ACS's develop health education at home, hosting and search active at different times. Conclusions: It is assumed then, the importance of the ACS approach to articulate practices of prevention, promotion and support men's health.

  7. A Congolese community-based health program for survivors of sexual violence

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    Kohli Anjalee


    Full Text Available Abstract Many survivors of gender based violence (GBV in the Democratic Republic of Congo (DRC report barriers to access health services including, distance, cost, lack of trained providers and fear of stigma. In 2004, Foundation RamaLevina (FORAL, a Congolese health and social non-governmental organization, started a mobile health program for vulnerable women and men to address the barriers to access identified by GBV survivors and their families in rural South Kivu province, Eastern DRC. FORAL conducted a case study of the implementation of this program between July 2010-June 2011 in 6 rural villages. The case study engaged FORAL staff, partner health care providers, community leaders and survivors in developing and implementing a revised strategy with the goal of improving and sustaining health services. The case study focused on: (1 Expansion of mobile clinic services and visit schedule; (2 Clinical monitoring and evaluation system; and (3 Recognition, documentation and brief psychosocial support for symptoms suggestive of anxiety, depression and PTSD. During this period, FORAL treated 772 women of which 85% reported being survivors of sexual violence. Almost half of the women (45% reported never receiving health services after the last sexual assault. The majority of survivors reported symptoms consistent with STI. Male partner adherence to STI treatment was low (41%. The case study demonstrated areas of strengths in FORAL’s program, including improved access to health care by survivors and their male partner, enhanced quality of health education and facilitated regular monitoring, follow-up care and referrals. In addition, three critical areas were identified by FORAL that needed further development: provision of health services to young, unmarried women in a way that reduces possibility of future stigma, engaging male partners in health education and clinical care and strengthening linkages for referral of survivors and their partners

  8. The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine

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    Olena Hankivsky


    Full Text Available Background The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH. Methods The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. Results The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine

  9. Coalition Building for Health: A Community Garden Pilot Project with Apartment Dwelling Refugees. (United States)

    Eggert, Lynne K; Blood-Siegfried, Jane; Champagne, Mary; Al-Jumaily, Maha; Biederman, Donna J


    Refugees often experience compromised health from both pre- and post-migration stressors. Coalition theory has helped guide the development of targeted programs to address the health care needs of vulnerable populations. Using the Community Coalition Action Theory as a framework, a coalition was formed to implement a community garden with apartment-dwelling refugees. Outcomes included successful coalition formation, a community garden, reported satisfaction from all gardeners with increased vegetable intake, access to culturally meaningful foods, and evidence of increased community engagement. The opportunity for community health nurses to convene a coalition to affect positive health for refugees is demonstrated.

  10. Does arsenic play an important role in the soil microbial community around a typical arsenic mining area? (United States)

    Wu, Fan; Wang, Jun-Tao; Yang, Jun; Li, Jing; Zheng, Yuan-Ming


    Arsenic (As) can cause serious hazards to human health, especially in mining areas. Soil bacterial communities, which are critical parts of the soil ecosystem, were analyzed directly for soil environmental factors. As a consequence, it is of great significance to understand the ecological risk of arsenic contamination on bacteria, especially at the local scale. In this study, 33 pairs of soil and grain samples were collected from the corn and paddy fields around an arsenic mining area in Shimen County in Hunan Province, China. Significant differences were found between the soil nitrogen, As concentrations, and bacteria activities among these two types of land use. According to the structural equation model (SEM) analysis, compared with other environmental factors, soil As was not the key factor affecting the bacterial community, even when grain As was beyond the threshold of the national food hygiene standards of China. In the corn field, soil pH was the main factor dominating the bacterial richness, composition and grain As. Meanwhile, in the paddy field the soil total nitrogen (TN) and total carbon (TC) were the main factors impacting the bacterial richness, and the bacterial community composition was mainly affected by pH. The interactions between grain As and soil As were weak in the corn field. The bacterial communities played important roles in the food chain risk of As. The local policy of transforming paddy soil to dry land could greatly reduce the health risk of As through the food chain.

  11. Community Health Centers and the Rural Economy: The Struggle for Survival. (United States)

    National Rural Health Association, Kansas City, MO.

    The intent of this project was to determine the financial impact of the rural economic crisis on rural community health centers. A 1986-87 survey reported changes in accounts receivable, bad debt, and sliding fee use, and the effect such changes may have on the cash position of rural community health centers. Of 284 rural community and migrant…

  12. 76 FR 35683 - Medicare Program; Conditions of Participation (CoPs) for Community Mental Health Centers (United States)


    ... 42 CFR Part 485 Medicare Program; Conditions of Participation (CoPs) for Community Mental Health... 485 RIN 0938-AP51 Medicare Program; Conditions of Participation (CoPs) for Community Mental Health... proposed rule would establish, for the first time, conditions of participation (CoPs) that community...

  13. A Community Health Advisor Program to Reduce Cardiovascular Risk among Rural African-American Women (United States)

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


    The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and…

  14. Burden & pattern of illnesses among the tribal communities in central India : A report from a community health programme. (United States)

    Jain, Yogesh; Kataria, Raman; Patil, Sushil; Kadam, Suhas; Kataria, Anju; Jain, Rachna; Kurbude, Ravindra; Shinde, Sharayu


    Tribals are the most marginalised social category in the country and there is little and scattered information on the actual burden and pattern of illnesses they suffer from. This study provides information on burden and pattern of diseases among tribals, and whether these can be linked to their nutritional status, especially in particularly vulnerable tribal groups (PVTG) seen at a community health programme being run in the tribal areas of Chhattisgarh and Madhya Pradesh States of India. This community based programme, known as Jan Swasthya Sahyog (JSS) has been serving people in over 2500 villages in rural central India. It was found that the tribals had significantly higher proportion of all tuberculosis, sputum positive tuberculosis, severe hypertension, illnesses that require major surgery as a primary therapeutic intervention and cancers than non tribals. The proportions of people with rheumatic heart disease, sickle cell disease and epilepsy were not significantly different between different social groups. Nutritional levels of tribals were poor. Tribals in central India suffer a disproportionate burden of both communicable and non communicable diseases amidst worrisome levels of undernutrition. There is a need for universal health coverage with preferential care for the tribals, especially those belonging to the PVTG. Further, the high level of undernutrition demands a more augmented and universal Public Distribution System.

  15. Health Promotion of University Students: contributions of community therapy.

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    Cintia Poleto Buzeli


    Full Text Available With this experience report of a master’s degree and two teachers of graduate Nursing School of Nursing Federal University of Mato Grosso, we sought to reflect on the Community Therapy (TC as a practice of collective care offered to students university students. Our goal is to report the experience of performing TC wheels in an academic environment, offer theoretical and methodological principles for the structuring and implementation of this practice care to college students at other universities. Was used for data collection direct observation of the wheels of TC the professional experiences as nurses and therapists community and appreciation of documents of such as the registration form filled out by the TC meetings and therapist co-therapist after each wheel TC. The reported experience has demonstrated the effectiveness of TC for the promotion of health thin this group, showing its importance as a practice for the creation and strengthening of ties between the community, the establishment of solidarity networks among students, as being a space speech and listening to their sufferings, their appreciation of life and its potential for promoting self-esteem and to encourage the development of a democract and civic consciousness.

  16. Short-term adverse health effects in a community exposed to a large polyvinylchloride plastics fire. (United States)

    Upshur, R; James, M L; Richardson, E; Brunton, G; Hunter, W; Chambers, L


    The purpose of this study was the documentation of the short-term morbidity and mortality experiences of an urban community exposed to the airborne byproducts of a large polyvinylchloride plastics fire. The authors administered a survey to representatives of each household who had lived in an area evacuated during the fire. A time-series analysis was performed on emergency room visits and admissions for all hospitals in the city. Chloracne surveillance was instituted. Sixty-two percent of the individuals surveyed from the evacuation area reported no health concerns or symptoms related to the fire. Thirty-eight percent of the residents reported symptoms, and less than 2% of those surveyed reported that they sought medical attention for their health concerns. There was no evidence of increased hospital admissions or emergency room use during and immediately following the fire. No cases of chloracne were reported, and no deaths or serious injuries occurred during the fire. Polyvinylchloride plastics recycling plants pose potential health hazards to civilian populations. Public health authorities should be prepared to assess population health status rapidly and to disseminate relevant health information in a timely way during a crisis.

  17. The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices (United States)

    Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H


    Context Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. Methods We used key informant interviews, supplemented by document analysis. Findings The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. Conclusions In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. PMID:25199899

  18. Risk factors for falls in older Korean adults: the 2011 Community Health Survey. (United States)

    Choi, Eun Jin; Kim, Sun A; Kim, Nu Ri; Rhee, Jung-Ae; Yun, Yong-Woon; Shin, Min-Ho


    Falls are a major health problem for elderly populations worldwide. We analyzed data from the 2011 Korean Community Health Survey to identify potential risk factors for falls in a representative population-based sample of community-dwelling older Korean adults. Risk factors for falls were assessed by multivariate survey logistic regression models. The prevalence of falls was 16.9% in males and 24.3% in females [Corrected]. Age and female sex were associated with a higher risk of falls. Similarly, living alone, living in an urban area, poor self-rated health, and high stress were associated with a high risk of falls. Subjects with diabetes mellitus, stroke, osteoarthritis, osteoporosis, urinary incontinence, cataracts, or depression had a high risk of falls. However, subjects with hypertension were at low risk for falls. In conclusion, age, female sex, marital status, residence location, self-rated health, stress, and several chronic conditions were significantly associated with the risk for falls in the older Korean adults. Our findings suggest that these risk factors should be addressed in public health policies for preventing falls.

  19. The Brazilian research contribution to knowledge of the plant communities from Antarctic ice free areas

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    Full Text Available This work aims to summarize the results of research carried out by Brazilian researchers on the plant communities of Antarctic ice free areas during the last twenty five years. Since 1988 field work has been carried out in Elephant Island, King George Island, Nelson Island and Deception Island. During this period six papers were published on the chemistry of lichens, seven papers on plant taxonomy, five papers on plant biology, two studies on UVB photoprotection, three studies about the relationships between plant communities and bird colonies and eleven papers on plant communities from ice free areas. At the present, Brazilian botanists are researching the plant communities of Antarctic ice free areas in order to understand their relationships to soil microbial communities, the biodiversity, the distribution of the plants populations and their relationship with birds colonies. In addition to these activities, a group of Brazilian researchers are undertaking studies related to Antarctic plant genetic diversity, plant chemistry and their biotechnological applications.

  20. Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study


    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len


    Objectives To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experie...

  1. Promoting oral health as part of an interprofessional community-based women's health event. (United States)

    Price, Shelia S; Funk, Amy D; Shockey, Alcinda K; Sharps, Gina M; Crout, Richard J; Frere, Cathryn L; Morgan, Susan K; DeBiase, Christina B; Hobbs, Gerald R


    Heart disease is the number one killer of women, and studies have shown connections between cardiovascular and oral health. However, interprofessional community-based participatory initiatives promoting women's oral health have received little research attention. This study evaluated the effectiveness of personalized oral health education (POHE) during a free one-day interprofessional women's health promotion event. The objectives were to 1) assess the participants' knowledge about the connection between oral health and heart disease; 2) disseminate information about oral-systemic linkages; 3) encourage comprehensive dental examinations; and 4) evaluate POHE outcomes. West Virginia University School of Dentistry faculty and students delivered POHE to the participants. These POHE instructors were calibrated with a standardized script regarding periodontal disease, health impact of tobacco, xerostomia-inducing medications, and oral hygiene instruction. Immediately prior to and following each POHE session, all the participants (N=165; 100 percent response rate) completed a number-coded questionnaire. The findings showed that the participants' knowledge of oral-systemic health linkages had increased following the POHE. The respondents received oral health kits and were offered discount vouchers toward the cost of a comprehensive oral examination at the dental school. This replicable model may prove useful to other dental schools in promoting women's oral health.

  2. Mosquito Vector Biting and Community Protection in a Malarious Area, Siahoo District, Hormozgan, Iran

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    KH Shahandeh


    Conclusion: Study subjects were aware of an association between mosquito bite and malaria transmission. Health work­ers at different levels of the health care delivery system should disseminate relevant information about self-protection to help community members to be involved more in malaria control.

  3. Community health orientation of Indian Journal of Endocrinology and Metabolism: A bibliometric analysis of Indian Journal of Endocrinology and Metabolism (United States)

    Kaushal, Kanica; Kalra, Sanjay


    Background: Endocrine and metabolic diseases especially diabetes have become focus areas for public health professionals. Indian Journal of Endocrinology and Metabolism (IJEM), a publication of Endocrine Society of India, is a peer-reviewed online journal, which covers technical and clinical studies related to health, ethical and social issues in field of diabetes, endocrinology and metabolism. This bibliometric analysis assesses the journal from a community health perspective. Materials and Methods: Every article published in IJEM over a period of 4 years (2011–2014) was accessed to review coverage of community health in the field of endocrinology. Results: Seven editorials, 30 review articles, 41 original articles, 12 brief communications, 20 letter to editors, 4 articles on guidelines and 2 in the section “endocrinology and gender” directly or indirectly dealt with community health aspects of endocrinology. Together these amounted to 17% of all articles published through these 4 years. There were 14 articles on general, 60 pertaining to pancreas and diabetes, 10 on thyroid, 7 on pituitary/adrenal/gonads, 21 on obesity and metabolism and 4 on parathyroid and bone; all community medicine related. Conclusion: Community health is an integral part of the modern endocrinology diabetology and metabolism practice and it received adequate journal space during the last 4 years. The coverage is broad based involving all the major endocrine disorders. PMID:25932398

  4. Community health orientation of Indian Journal of Endocrinology and Metabolism: A bibliometric analysis of Indian Journal of Endocrinology and Metabolism

    Directory of Open Access Journals (Sweden)

    Kanica Kaushal


    Full Text Available Background: Endocrine and metabolic diseases especially diabetes have become focus areas for public health professionals. Indian Journal of Endocrinology and Metabolism (IJEM, a publication of Endocrine Society of India, is a peer-reviewed online journal, which covers technical and clinical studies related to health, ethical and social issues in field of diabetes, endocrinology and metabolism. This bibliometric analysis assesses the journal from a community health perspective. Materials and Methods: Every article published in IJEM over a period of 4 years (2011-2014 was accessed to review coverage of community health in the field of endocrinology. Results: Seven editorials, 30 review articles, 41 original articles, 12 brief communications, 20 letter to editors, 4 articles on guidelines and 2 in the section "endocrinology and gender" directly or indirectly dealt with community health aspects of endocrinology. Together these amounted to 17% of all articles published through these 4 years. There were 14 articles on general, 60 pertaining to pancreas and diabetes, 10 on thyroid, 7 on pituitary/adrenal/gonads, 21 on obesity and metabolism and 4 on parathyroid and bone; all community medicine related. Conclusion: Community health is an integral part of the modern endocrinology diabetology and metabolism practice and it received adequate journal space during the last 4 years. The coverage is broad based involving all the major endocrine disorders.

  5. Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda (United States)

    Chandani, Yasmin; Andersson, Sarah; Heaton, Alexis; Noel, Megan; Shieshia, Mildred; Mwirotsi, Amanda; Krudwig, Kirstin; Nsona, Humphreys; Felling, Barbara


    Background A UNICEF review of the challenges to scaling up integrated community case management (iCCM) found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM’s purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome. Methods SC4CCM selected three countries to implement supply chain innovations and developed a theory of change (TOC) framework for the learning phase, which identified the main drivers of product availability and was used for baseline assessments, design, implementation and evaluation of interventions in Ethiopia, Malawi, and Rwanda. Interventions were developed in each country and tested over 12–24 months. Mixed–method follow up assessments were conducted in each country in 2012–2013. The Supply Chain for Community Case Management (SC4CCM) Project then simplified the TOC into a Community Health Supply Chain (CHSC) framework to enable cross country analysis Results The findings from interventions in the three countries suggest that the greatest supply chain benefits are realized when all three CHSC framework elements (data flow, product flow, and effective people) are in place and working together. The synergistic effect of these three elements on supply chain performance was most effectively demonstrated by results from the Enhanced Management and Quality Collaborative interventions in Malawi and Rwanda, respectively, which were characterized by lower mean stockout rates and higher in stock rates on day of visit, when compared to other interventions. Conclusions Many conditions are necessary to ensure continuous product availability at the community level, however a supply chain works

  6. Religious Communities, Immigration, and Social Cohesion in Rural Areas: Evidence from England (United States)

    Andrews, Rhys


    Religious communities are important sources of bridging and bonding social capital that have varying implications for perceptions of social cohesion in rural areas. In particular, as well as cultivating cohesiveness more broadly, the bridging social capital associated within mainline religious communities may represent an especially important…

  7. Using Social Impact Assessment to Strengthen Community Resilience in Sustainable Rural Development in Mountain Areas

    NARCIS (Netherlands)

    Imperiale, Angelo Jonas; Vanclay, Frank


    Building community resilience is an important topic in the current debate about achieving positive community development outcomes from sustainable place-based policies, especially in mountain regions and less-favored areas. At the practical, grassroots level, however, it remains unclear how communit

  8. Chongqing Economic and Technological Development Area:Community Overview

    Institute of Scientific and Technical Information of China (English)


    @@ Chongqing Economic and Technological Development Area, for 13 years of development, has made detailed work in building the investment environment, bold job in the management system innovation, full strengths in business recruitment and investment attacting,hard job in cultivating new point of economic growth.

  9. Child health inequities in developing countries: differences across urban and rural areas

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    Fotso Jean-Christophe


    Full Text Available Abstract Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS of 15 countries in sub-Saharan Africa (SSA are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural, and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Results Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. Conclusion The urban advantage in health masks enormous disparities

  10. Chiropractic care and public health: answering difficult questions about safety, care through the lifespan, and community action. (United States)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre; Hestbaek, Lise; Injeyan, H Stephen; Puhl, Aaron; Green, Bart; Napuli, Jason G; Dunn, Andrew S; Dougherty, Paul; Killinger, Lisa Zaynab; Page, Stacey A; Stites, John S; Ramcharan, Michael; Leach, Robert A; Byrd, Lori D; Redwood, Daniel; Kopansky-Giles, Deborah R


    The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?

  11. 78 FR 71584 - Applications for New Awards; NIDDR DRRP-Community Living and Participation, Health and Function... (United States)


    ... Applications for New Awards; NIDDR DRRP-Community Living and Participation, Health and Function, and Employment... and Rehabilitation Research ] Projects (DRRPs)--Community Living and Participation, Health and... (Development), Community Living 500,000 and Participation of Individuals with Disabilities. ]...

  12. UK community health visiting: challenges faced during lean implementation

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    Carr SM


    Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

  13. A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness (United States)

    Williams, Beth B.


    Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

  14. Sense of Community Belonging and Health in Canada: A Regional Analysis (United States)

    Kitchen, Peter; Williams, Allison; Chowhan, James


    This article investigates the association between sense of community belonging and health among settlements of different size and across the urban to rural continuum in Canada. Using data from the recent 2007/08 Canadian Community Health Survey (CCHS), the objective is to identify the major health, social and geographic determinants of sense of…

  15. Clinical application of the Omaha system with the Nightingale Tracker: a community health nursing student home visit program. (United States)

    Sloan, Helen L; Delahoussaye, Carolyn P


    The application of computer use in the clinical and educational arena needs to be emphasized for both the improved management of patient data and nursing knowledge. Faculty commitment to automation of home visit documentation records was essential to sustain the trial of implementing the Nightingale Trackers in the clinical area. The Nightingale Tracker is a software program that automates the Omaha system, a community-friendly nursing language that encourages a focus on health promotion. A team approach involving students, faculty, and technical support enabled the automation of the patient record of a home visiting program in a community health nursing course.

  16. Psychological distress and community approach to the voice of the community health agent. (United States)

    Paiva, Pâmela Câmpelo; Torrenté, Mônica de Olivera Nunes de; Landim, Fátima Luna Pinheiro; Branco, July Grassiely de Oliveira; Tamboril, Bruna Caroline Rodrigues; Cabral, Ana Larisse Teles


    The user in psychological distress needs a service that provides a targeted assistance, that welcomes when required, acting as originator care device to the user on the network of health care. This study aimed to describe how people in psychological distress are perceived by the community in the voice of the community health worker. It is a qualitative research conducted with eighteen Community Health Agents, a Primary Care Unit Health (UAP) located in BE IV, in Fortaleza, Ceará. We used a semi-structured and individual interview. Data processing was due to the content analysis. Ethical and legal aspects on the advice No. 957,595. Through the speeches of ACS, it describes how the community perceives the person in psychic suffering and how it positions itself in the face of your everyday problems, as regards the rejection, prejudice, discrimination ne loss of identity. However it is emphasized that, because of being inserted in the community, the community health worker realizes more accurate way in which this social group is the person in mental distress. The rejection of the person who became ill is seen as a fairly common reaction, accompanied by prejudice and discrimination, marginalizing her from society. O usuário em sofrimento psíquico necessita de um serviço que proporcione uma assistência direcionada, que acolha no momento necessário, atuando como dispositivo ordenador do cuidado ao usuário na rede de atenção a saúde. Objetivou-se descrever como as pessoas em sofrimento psíquico são percebidas pela comunidade na voz do agente comunitário de saúde. Trata-se de uma pesquisa qualitativa, realizada junto a dezoito Agentes Comunitários de Saúde, de uma Unidade de Atenção Primaria a Saúde (UAPS) situada na SER IV, em Fortaleza-Ceará. Utilizou-se uma entrevista semiestruturada e individual. O processamento dos dados deu-se pela análise de conteúdo. Aspectos éticos e legais sob parecer Nº 957.595. Através dos discursos dos ACS, descrevemos

  17. A unique strategy for pediatric community health nursing for ADN students. (United States)

    Janvier, K A


    Students were overwhelmingly positive when given the opportunity to evaluate the pilot project and the model of pediatric community health nursing. According to the students, the strong points of the model were the orientation before the community experience, the presence of faculty of the community, the ability to contact faculty when needed, and the postclinical conference. The students' comments confirmed the faculty's belief that a clinical experience in community health nursing must place more emphasis on the specialty of community health nursing to be meaningful for students. To do the of job of educating tomorrow's nurses, ADN faculty should develop new strategies for teaching the pediatric clinical component of community health nursing. Clearly, hospitals are no longer the exclusive sites where students learn about patient and family needs and nursing care delivery. Community-based and community-focused experiences will continue to be required so that nursing students are prepared to practice in a dynamic and changing healthcare environment.

  18. The Avalon Gardens Men's Association: A Community Health Psychology Case Study. (United States)

    Borg, Mark B


    This article follows the development and progress of the US Department of Housing and Urban Development's 'Healthy and Safe Communities' initiative as it was implemented by a community empowerment organization during a four-year community revitalization project in the aftermath of the Los Angeles riots. The author explores practical aspects of Community Health Psychology through assessing the ways in which its organizing principles were manifest in community-wide processes of individual and community change in one low-income housing project in South Central Los Angeles called Avalon Gardens. Specifically highlighted is how a group of African American and Latino men in the community created a group forum that helped foster, support and sustain an empowerment process that supported health promotion, health consciousness and significant health improvement in the community.

  19. The Best Laid Plans: Access to the Rajiv Aarogyasri community health insurance scheme of Andhra Pradesh

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    H. Narasimhan


    Full Text Available This paper is a qualitative assessment of a public health insurance scheme in the state of Andhra Pradesh, south India, called the Rajiv Aarogyasri Community Health Insurance Scheme (or Aarogyasri, using the case-study method. Focusing on inpatient hospital care and especially on surgical treatments leaves the scheme wanting in meeting the health care needs of and addressing the impoverishing health expenditure incurred by the poor, especially those living in rural areas. Though well-intentioned, people from vulnerable sections of society may find the scheme ultimately unhelpful for their needs. Through an in-depth qualitative approach, the paper highlights not just financial difficulties but also the non-financial barriers to accessing health care, despite the existence of a scheme such as Aarogyasri. Narrative evidence from poor households offers powerful insights into why even the most innovative state health insurance schemes may not achieve their goals and systemic corrections needed to address barriers to health care.

  20. Predictors of recovery-oriented competencies among mental health professionals in one community mental health system. (United States)

    Stuber, Jennifer; Rocha, Anita; Christian, Ann; Johnson, David


    A survey of 813 mental health professionals serving adults with severe mental illness clustered in 25 community mental health centers assessed the extent to which mental health professionals possess clinical competencies that support recovery and the predictors of these competencies. The results suggest there is room for improvement in recovery-oriented competencies. In-depth professional training in recovery, greater job variety, more years practicing in mental health, participation on an intensive case management team, and perceptions of workplace recovery culture were predictors of recovery-oriented competencies. Prioritization of on-going professional, worker retention, and management strategies that incorporate a team approach to treatment and improvements in workplace recovery culture may potentially increase recovery-oriented clinical practice.

  1. Tropical Deforestation, Community Forests, and Protected Areas in the Maya Forest

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    David Barton. Bray


    Full Text Available Community forests and protected areas have each been proposed as strategies to stop deforestation. These management strategies should be regarded as hypotheses to be evaluated for their effectiveness in particular places. We evaluated the community-forestry hypothesis and the protected-area hypothesis in community forests with commercial timber production and strict protected areas in the Maya Forest of Guatemala and Mexico. From land-use and land cover change (LUCC maps derived from satellite images, we compared deforestation in 19 community forests and 11 protected areas in both countries in varying periods from 1988 to 2005. Deforestation rates were higher in protected areas than in community forests, but the differences were not significant. An analysis of human presence showed similar deforestation rates in inhabited protected areas and recently inhabited community forests, but the differences were not significant. There was also no significant difference in deforestation between uninhabited protected areas, uninhabited community forests, and long-inhabited community forests. A logistic regression analysis indicated that the factors correlated with deforestation varied by country. Distance to human settlements, seasonal wetlands, and degree and length of human residence were significant in Guatemala, and distance to previous deforestation and tropical semideciduous forest were significant in Mexico. Varying contexts and especially colonization histories are highlighted as likely factors that influence different outcomes. Poorly governed protected areas perform no better as a conservation strategy than poorly governed community forests with recent colonists in active colonization fronts. Long-inhabited extractive communities perform as well as uninhabited strict protected areas under low colonization pressure. A review of costs and benefits suggests that community forests may generate more local income with lower costs. Small sample sizes

  2. 75 FR 26167 - Designation of Medically Underserved Populations and Health Professions Shortage Areas; Intent To... (United States)


    ... Underserved Populations and Health Professions Shortage Areas; Intent To Form Negotiated Rulemaking Committee... of Medically Underserved Populations (MUPs) and Primary Care Health Professions Shortage Areas (HPSAs... indicators, representing the public's interest in assuring that the areas, populations and entities to...

  3. Unraveling Health Risk and Speciation of Arsenic from Groundwater in Rural Areas of Punjab, Pakistan

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    Muhammad Bilal Shakoor


    Full Text Available This study determined the total and speciated arsenic (As concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62 were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L−1 (range = 1.5–201 µg·L−1. Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L−1. Speciation of As in groundwater samples (n = 13 showed the presence of inorganic As only; arsenite (As(III constituted 13%–67% of total As and arsenate (As(V ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11–18 and 46–600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10−6, respectively. In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl−, NO3−, SO42−, Fe, Mn, Pb also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures.

  4. Butterfly Community Conservation Through Ecological Landscape Design in Urban Areas

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    Orsolya Borsai


    Full Text Available Due urbanization and extension of agricultural areas most of the ecosystems are strongly affected. As a result, preservation of biodiversity becomes more and more important aiming to reestablish the lost habitats of different species (mammals, birds, amphibians, insects, etc.. Our research focuses on butterflies which constitute an extremely important group of ‘model’ organisms. We have identified 12 diurnal ‘flying beauties’ specific to Cluj area (threatened and unthreathened species and investigated their ecological requirements that have to be provided for in any landscapes. Furthermore, based on the data colleted we have illustrated the utility of our approach by applying it to a hypothetical urban landscape (private garden following the traditional environmental guidelines in our landscape design.

  5. A Qualitative Systematic Review of Older Persons’ Perceptions of Health, Ill Health, and Their Community Health Care Needs

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    Anne Lise Holm


    Full Text Available The aim of this qualitative systematic review was to report a synthesis of older persons’ perceptions of health, ill health, and their community health care needs. The review questions were what characterizes older persons’ perceptions of health and ill health? and what are their community health care needs? Ten studies were identified in a systematic search for relevant qualitative papers published between January 2000 and January 2013 in the following electronic databases: PubMed, EBSCOhost/Academic Search Premier, and CINAHL. Publications were evaluated for quality, and a thematic analysis was performed. Two main themes were interpreted on a higher level: reconciliation with how life has become: and desire to regain their identity and sense of self-worth despite disability. Two themes emerged: creating meaning led to the experience of being valued in health care and society and a mental struggle to regain independence with the help of caregivers. Of special interest is the finding of perceptions related to the fear of becoming dependent on caregivers as well as the sorrow and pain caused by encountering caregivers who did not understand their desire to create meaning in their lives or their struggle for autonomy and independency.

  6. Potential human health risks associated with historic ore processing at Berg Aukas, Grootfontein area, Namibia (United States)

    Mapani, Benjamin; Ellmies, Rainer; Kamona, Frederick; Kříbek, Bohdan; Majer, Vladimír; Knésl, Ilja; Pašava, Jan; Mufenda, Maria; Mbingeneeko, Filadelphia


    Health risks to people living at Berg Aukas have been identified through a geochemical study of mine dumps and soils at Berg Aukas. Berg Aukas once served as a mining town, where ores of Pb, V, and Zn were mined and roasted on site until 1979. Roasting of ores produced an unintended hazardous risk in the surrounding area. For this study, soil, crops, and water from the Berg Aukas area were analysed for various pollutants. The main pollutants are metals like Pb, Zn, Cu, Cd, As, Hg and Mo. They are bound to layered silicates, to easily soluble sulphide minerals, or occur in native form. The analytical results show severe heavy metal contamination of the surface soils south and east of Berg Aukas. Crops grown at the National Youth Service, like sweet potatoes, cabbage, and Irish potatoes, accumulate heavy elements that are deleterious to health. Prolonged exposure to As and heavy metals in concentrations as found in the soils and some crops in Berg Aukas can cause severe health problems like diabetes, skin lesions, bladder problems, neurological effects, as well as skin, kidney or lung cancer. Pb affects mental development of children and Pbs to brain retardation. The study aims to help the local community to delineate no-go areas for agricultural use and to either diversify the crops grown on contaminated soils or to grow crops that are less vulnerable to high heavy metal contents in soils or transfer the crops grown on contaminated soils to areas that are not contaminated.

  7. Hawaii’s “7 by 7” for School Health Education: A PowerPoint Presentation on Integrating the National Health Education Standards With Priority Content Areas for Today’s School Health Education in Grades Kindergarten Through 12

    Directory of Open Access Journals (Sweden)

    Beth Pateman, HSD, MPH


    Full Text Available School-based health education can help young people develop the knowledge, skills, motivation, and support they need to choose health-enhancing behaviors and resist engaging in behaviors that put them at risk for health and social problems and school failure. The health of school-age youth is significantly associated with their school achievement. However, in the midst of today’s increased emphasis on school accountability in the areas of reading, writing, and mathematics, subject areas such as health education tend to receive less prominence in the school curriculum. Recalling their own lackluster school experiences related to health topics, decision makers may not realize that today’s skills-based school health curriculum involves a highly interactive and engaging approach to promoting good health and preventing the most serious health problems among youth. Health education is one important component of a coordinated school health program that includes health education, physical education, school health services, nutrition services, school counseling and psychological services, a healthy school environment, school promotion for faculty and staff, and involvement of family and community members. The purpose of this PowerPoint presentation — Healthy Keiki, Healthy Hawaii: Hawaii's "7 by 7" for School Health Education — is to educate health and education decision makers, teachers, parents, and community members on how Hawaii has integrated seven health education standards with seven priority health content areas to create an effective approach to school health education in grades kindergarten through 12. The goal of Hawaii’s “7 by 7” curriculum focus is to ensure that all of Hawaii’s keiki (children have well-planned opportunities at school to become fit, healthy, and ready to learn.

  8. Dissemination of an Electronic Manual to Build Capacity for Implementing Farmers’ Markets with Community Health Centers


    Guest, M. Aaron; Freedman, Darcy; Alia, Kassandra A.; Brandt, Heather M.; Friedman, Daniela B.


    Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, “Building Farmacies,” describes an approach for developing capacity and sustaining a community health center-based farmers’ market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multi-vendor, produce-only farmers’ market a...

  9. Comparing the implementation of team approaches for improving diabetes care in community health centers


    Wees, P.J. van der; Friedberg, M.W.; Guzman, E.; Ayanian, J.Z.; Rodriguez, H.P.


    Background Patient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. Methods Mixed m...

  10. Teaching Community Health Assessment Skills in a Problem-based Format. (United States)

    Sass, Pamela; Edelsack, Pyser


    Describes a four-week rotation at the State University of New York Health Science Center in Brooklyn in which medical residents are taught community health assessment using a problem-based format. They use demographic and health data to create rates they believe will help to illuminate the health status and health issues of their assigned…

  11. Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries

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    Bhuyan Khanindra


    Full Text Available Abstract Background The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a window of opportunity for promoting self care and community participation for health promotion. Discussion A broad outline is proposed for designing a health promotion programme in developing countries, following key strategies of the Ottawa Charter for health promotion and principles of self care and community participation. Supportive policies may be framed. Self care clearinghouses may be set up at provincial level to co-ordinate the programme activities in consultation with district and national teams. Self care may be promoted in the schools and workplaces. For developing personal skills of individuals, self care information, generated through a participatory process, may be disseminated using a wide range of print and audio-visual tools and information technology based tools. One such potential tool may be a personally held self care manual and health record, to be designed jointly by the community and professionals. Its first part may contain basic self care information and the second part may contain outlines of different personally-held health records to be used to record important health and disease related events of an individual. Periodic monitoring and evaluation of the programme may be done. Studies from different parts of the world indicate the effectiveness and cost-effectiveness of self care interventions. The proposed outline has potential for health promotion and cost reduction of health services in the developing countries, and may be adapted in different situations. Summary Self care, community participation and health

  12. Mitigating social and health inequities: community participation and Chagas disease in rural Argentina. (United States)

    Llovet, Ignacio; Dinardi, Graciela; De Maio, Fernando G


    Chagas disease (CD) causes 12,500 deaths annually in Latin America. As a neglected disease primarily associated with poverty, it is a major driver of health inequity. Argentina's efforts to control vector transmission have been unsuccessful. Using new survey data (n=400 households), we compare the social patterning of the burden of CD by examining socio-demographic predictors of self-reported CD and the presence of vinchucas in two areas of rural northern Argentina known to have experienced different interventions in surveillance and control. Our analyses suggest that Avellaneda, an area known for horizontal intervention strategies which nurture community participation is quite distinct from Silipica, an area which has experienced a vertical intervention strategy since 1990. Avellaneda has higher level of self-reported Chagas infection and lower level of vinchuca presence; Silipica has pronounced and statistically significant differences patterned by the head of household's level of educational attainment. A greater awareness of the disease and its transmission, along with community mobilisation and spraying, may bring about more self-reported CD and less vinchuca presence in Avellaneda than in Silipica. This suggests that strategies based on community participation may be effective in reducing the social patterning of the burden of disease, even in poor places.

  13. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

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    Li Zhijian


    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  14. Community Residency Programme (CRP)--a tool for research and rural health training for medical students. (United States)

    Yadav, H


    Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.

  15. Level of Educational Objectives Achievement in Health and Community Medicine Internship Course; Interns Viewpoint



    Aims: Nowadays, the community oriented medicine education model has been mainly noticed. The aim of this study was to survey the interns about achievement to the educational goals confirmed by Health Ministry in health internship and community medicine courses.    Instrument & Methods: In the descriptive cross-sectional study, 56 health internship and community medicine students of one of the military universities of medical sciences in Tehran were studied in 2014 and 2015....

  16. A theory of how rural health services contribute to community sustainability. (United States)

    Farmer, Jane; Prior, Maria; Taylor, Judy


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

  17. HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study. (United States)

    Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine


    This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

  18. Green areas and health outcomes: a systematic review of the scientific literature

    Directory of Open Access Journals (Sweden)

    Francesco Di Nardo


    Full Text Available

    Background: Growing medical evidence shows that access to the natural environment improves health and wellbeing, prevents disease and helps people recover from illness. Experiencing nature in the outdoors can help tackle obesity and coronary heart disease. Green areas exert their benefits on both physical and mental health, promoting physical activity and strengthening the sense of community thus positively influencing social interaction. Urbanization poses problems through effects such as environmental pollution, accidents, heat island effects, climate change and a consequent demand for urban green areas.

    Material and methods: We performed literature searches of electronic journal databases for studies and reviews that focused on the relationship between green spaces and health. We looked at the effects on physical health, mental health, social health, physical activity and well-being in its broadest sense and then we categorically organized our findings.

    Results: We found many contradictory and unexpected results. However, the reported findings were generally consistent and supported the current view that urban design and the availability of urban green spaces are key elements of prosperity and individual/collective comfort, so as to influence both the perceived health and the objective physical conditions in a measurable way. A weak relationship between physical activity levels and green space availability is observed.

    Conclusions: The occasionally contradictory results that emerged in this study suggest that a opulation’s esponse to urban design interventions is often unpredictable. Further research is needed to quantify the trength of relation between green spaces and urban health, but also to investigate the social and behavioural spects which are more difficult to measure and understand.

  19. A health study of two communities near the Stringfellow Waste Disposal site. (United States)

    Baker, D B; Greenland, S; Mendlein, J; Harmon, P


    A health survey of 2,039 persons in 606 households located near the Stringfellow Hazardous Waste Disposal site, Riverside County, California, and in a reference community was conducted to assess whether rates of adverse health outcomes were elevated among persons living near the site. Data included a household questionnaire, medical records of reported cancers and pregnancies, and birth and death certificates. The study areas appeared similar with respect to mortality, cancer incidence, and pregnancy outcomes. In contrast, rate ratios were greater than 1.5 for 5 of 19 reported diseases, i.e., ear infections, bronchitis, asthma, angina pectoris, and skin rashes. Prevalence odds ratios for 23 symptoms were uniformly greater than 1.0, and 8 symptoms had odds ratios greater than 1.5: blurred vision, pain in ears, daily cough for more than a month, nausea, frequent diarrhea, unsteady when walking, and frequent urination. The apparent broad-based elevation in reported diseases and symptoms may reflect increased perception or recall of conditions by respondents living near the site. These results indicate that future community-based health studies should include medical and psychosocial assessment instruments sufficient to distinguish between changes in health status and effects of resident reporting tendency.

  20. Groundwater contaminated with hexavalent chromium [Cr (VI]: a health survey and clinical examination of community inhabitants (Kanpur, India.

    Directory of Open Access Journals (Sweden)

    Priti Sharma

    Full Text Available BACKGROUND: We assessed the health effects of hexavalent chromium groundwater contamination (from tanneries and chrome sulfate manufacturing in Kanpur, India. METHODS: The health status of residents living in areas with high Cr (VI groundwater contamination (N = 186 were compared to residents with similar social and demographic features living in communities having no elevated Cr (VI levels (N = 230. Subjects were recruited at health camps in both the areas. Health status was evaluated with health questionnaires, spirometry and blood hematology measures. Cr (VI was measured in groundwater samples by diphenylcarbazide reagent method. RESULTS: Residents from communities with known Cr (VI contamination had more self-reports of digestive and dermatological disorders and hematological abnormalities. GI distress was reported in 39.2% vs. 17.2% males (AOR = 3.1 and 39.3% vs. 21% females (AOR = 2.44; skin abnormalities in 24.5% vs. 9.2% males (AOR = 3.48 and 25% vs. 4.9% females (AOR = 6.57. Residents from affected communities had greater RBCs (among 30.7% males and 46.1% females, lower MCVs (among 62.8% males and less platelets (among 68% males and 72% females than matched controls. There were no differences in leucocytes count and spirometry parameters. CONCLUSIONS: Living in communities with Cr (VI groundwater is associated with gastrointestinal and dermatological complaints and abnormal hematological function. Limitations of this study include small sample size and the lack of long term follow-up.

  1. Exploring mHealth Participation for Emergency Response Communities

    Directory of Open Access Journals (Sweden)

    David G. Schwartz


    Full Text Available We explore the challenges of participation by members of emergency response communities who share a similar condition and treatment, and are called upon to participate in emergency events experienced by fellow members. Smartphones and location-based social networking technologies present an opportunity to re-engineer certain aspects of emergency medical response. Life-saving prescription medication extended in an emergency by one individual to another occurs on a micro level, anecdotally documented. We illustrate the issues and our approach through the example of an app to support patients prone to anaphylaxis and prescribed to carry epinephrine auto-injectors. We address unique participation challenges in an mHealth environment in which interventions are primarily short-term interactions which require clear and precise decision-making and constant tracking of potential participants in responding to an emergency medical event. The conflicting effects of diffused responsibility and shared identity are identified as key factors in modeling participation.

  2. From Sociocultural Disintegration to Community Connectedness Dimensions of Local Community Concepts and Their Effects on Psychological Health of Its Residents

    Directory of Open Access Journals (Sweden)

    Tom Sørensen


    Full Text Available In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs.

  3. Current Methods in Health Behavior Research Among U.S. Community College Students: A Review of the Literature. (United States)

    Pokhrel, Pallav; Little, Melissa A; Herzog, Thaddeus A


    The majority of health behavior research involving college students in the United States has focused on 4-year college students. Two-year or community college students have been less studied, although a significant proportion of U.S. undergraduates, primarily those from disadvantaged socioeconomic and/or racial/ethnic background, are enrolled in community colleges. Thus, there is a need to enhance health behavior and health promotion research among community college students. This study systematically reviewed 42 published, peer-reviewed health behavior studies conducted among U.S. community college students in order to determine the current state of research in the area with regard to behaviors studied, research designs used, recruitment and data collection strategies practiced, rates of student participation, and characteristics of the participants represented. Findings identified the methodological limitations of current research and suggested optimal recruitment and data collection methods suitable for various research needs. Findings are discussed in the context of enhancing health behavior research among U.S. community college students.

  4. Bridging the gap between health care professionals and communities

    Directory of Open Access Journals (Sweden)

    Sally Hartley


    Full Text Available Introduction Bridging the gap between health care professionals and communities is a difficult task. It involves establishing a culture of community participation and improving the process of communication between the two groups. Effective communication between these groups is not easy. The people concerned often speak different languages, have different levels of education and competence, different priorities in life and generally understand things differently. In addition, the greatest proportion of communication is transmitted non-verbally, through gestures, facial expressions and ‘body language’. This is important for two reasons. Firstly, any feelings of pity, superiority, frustration, dismissal or respect, will almost certainly be transmitted through these alternative modes of communication, they carry much more powerful messages than those contained in what is said. Secondly, many of these non-verbal messages, with the major exception of speech intonation, are visual and are therefore missed by people who cannot see well enough to pick them up. This combines to give an effective recipe for communication breakdown.

  5. Level of Integration of Community Health Workers in Missouri Health Systems. (United States)

    Rhodes, Darson; Visker, Joseph; Cox, Carol; Banez, J Christian; Wang, Anna


    The purpose of this study was to describe the level of integration of community health workers (CHWs) into Missouri public healthcare systems using a cross-sectional survey research design. Representatives of all Missouri Local Public Health Agencies, Rural Health Clinics, and Federally Qualified Health Centers were pre-contacted by telephone to provide the electronic mail of the most knowledgeable person in the facility/location to complete a brief electronic survey on their use of CHWs. 103 representatives of the 273 (37.7% response rate) contacted from the health systems completed the Profile of Community Health Workers in Missouri Health Systems to assess role, professional development, and information needs of CHWs used in the key informants' agencies. An Abridged Survey was created for participants who responded to the survey but indicated that CHWs were not currently working for their organization. Descriptive statistics and measures of central tendency were computed. Only 16% (16/103) of participants noted that CHWs were employed in their organizations; and most CHWs connected people with services, served low-income and rural populations, and addressed heart disease issues. Participants who did not currently employ CHWs indicated they did not anticipate needing them in the near future. Of those utilizing CHWs, most perceived CHWs have a vital role in healthcare (M = 4.27/5.0, SD = 0.64) but securing sustainable funding for CHWs was challenging (M = 4.18/5.0, SD = 0.87). Utilization of CHWs in Missouri healthcare systems is limited. If their role in Missouri healthcare systems is to expand, a campaign to educate on their role and value is needed.

  6. Assessment of community health needs of Chongqing residents: a qualitative study

    Institute of Scientific and Technical Information of China (English)

    Li Ying; Li Daikun; He Jia; Shi Kai; Liu HongHong; Zhang Hu


    Objective: The aim of this preliminary qualitative study was to gain insight into community health needs in order to develop health program for community in Chongqing. Methods: Totally 40 participants were assigned into 6 focus group discussions. All groups were led by local language speakers, and their talking was recorded after gaining informed consent. Transcribed data were coded and subjected to thematic analysis. Results: The main obtained themes were that community health problems were chronic noncommunicable disease, main health service needs included regularly free check-up and health education, and perceived health risk factors were unhealthy lifestyle and behavior as well as environment problems. Conclusion: Our community health needs assessment (CHNA) with FGDs indicate that residents realize the importance of prevention of disease. Our study identifies that primarily community health promotion is one of the priorities of community health service needs, including reorienting health service, health education, guiding behavior or lifestyle, and creating healthy environments. The findings of this study can provide guidance to the development of more effective and pertinent health program in this community.

  7. Community-Based Tourism - Option for Forest-Dependent Communities in 1A IUCN Protected Areas? Cameroon Case Study

    Directory of Open Access Journals (Sweden)

    Burgin Shelley


    Full Text Available In developing countries, ‘exponential’ growth in IUCN protected lands has occurred in the last 25 years. Approximately 6% of protected areas are ‘Strict Nature Reserve[s]’ (1A with emphasis on conservation and strict restrictions on human access. Before Bakossi Forest Reserve (Cameroon had 1A protection, 95% of local families used the Reserve for their livelihood. They farmed cash crops, collected fire wood, timber, and food with incomes equivalent to US$35,000/annually/family. Post-protection, the Reserve’s local communities lacked support to develop alternative livelihoods, and 75% reported being intercepted illegally trespassing by Reserve guards. Without illegal activity economic impacts would have been substantially greater. Protection has also meant foregone national income from timber and coffee exports. We used Bakossi Forest Reserve as a case study to identify issues facing local communities excluded from the Reserve that traditionally provided their livelihood. We also investigated potential alternative family livelihoods based on critical evaluation of the literature. We identified ‘exceptional’ community-based tourism potential. We also found that Cameroon was the first African country to develop community-based forestry with the dual roles of conservation and poverty alleviation. Using this model, community-based tourism could be a cost-effectively initiative to deliver the same dual roles as community-based forestry.

  8. Spatio-temporal variability of airborne bacterial communities and their correlation with particulate matter chemical composition across two urban areas. (United States)

    Gandolfi, I; Bertolini, V; Bestetti, G; Ambrosini, R; Innocente, E; Rampazzo, G; Papacchini, M; Franzetti, A


    The study of spatio-temporal variability of airborne bacterial communities has recently gained importance due to the evidence that airborne bacteria are involved in atmospheric processes and can affect human health. In this work, we described the structure of airborne microbial communities in two urban areas (Milan and Venice, Northern Italy) through the sequencing, by the Illumina platform, of libraries containing the V5-V6 hypervariable regions of the 16S rRNA gene and estimated the abundance of airborne bacteria with quantitative PCR (qPCR). Airborne microbial communities were dominated by few taxa, particularly Burkholderiales and Actinomycetales, more abundant in colder seasons, and Chloroplasts, more abundant in warmer seasons. By partitioning the variation in bacterial community structure, we could assess that environmental and meteorological conditions, including variability between cities and seasons, were the major determinants of the observed variation in bacterial community structure, while chemical composition of atmospheric particulate matter (PM) had a minor contribution. Particularly, Ba, SO4 (2-) and Mg(2+) concentrations were significantly correlated with microbial community structure, but it was not possible to assess whether they simply co-varied with seasonal shifts of bacterial inputs to the atmosphere, or their variation favoured specific taxa. Both local sources of bacteria and atmospheric dispersal were involved in the assembling of airborne microbial communities, as suggested, to the one side by the large abundance of bacteria typical of lagoon environments (Rhodobacterales) observed in spring air samples from Venice and to the other by the significant effect of wind speed in shaping airborne bacterial communities at all sites.

  9. Using Ant Communities For Rapid Assessment Of Terrestrial Ecosystem Health

    Energy Technology Data Exchange (ETDEWEB)

    Wike, L


    Measurement of ecosystem health is a very important but often difficult and sometimes fractious topic for applied ecologists. It is important because it can provide information about effects of various external influences like chemical, nuclear, and physical disturbance, and invasive species. Ecosystem health is also a measure of the rate or trajectory of degradation or recovery of systems that are currently suffering impact or those where restoration or remediation have taken place. Further, ecosystem health is the single best indicator of the quality of long term environmental stewardship because it not only provides a baseline condition, but also the means for future comparison and evaluation. Ecosystem health is difficult to measure because there are a nearly infinite number of variables and uncertainty as to which suites of variables are truly indicative of ecosystem condition. It would be impossible and prohibitively expensive to measure all those variables, or even all the ones that were certain to be valid indicators. Measurement of ecosystem health can also be a fractious topic for applied ecologists because there are a myriad of opinions as to which variables are the most important, most easily measured, most robust, and so forth. What is required is an integrative means of evaluating ecosystem health. All ecosystems are dynamic and undergo change either stochastically, intrinsically, or in response to external influences. The basic assumption about change induced by exogenous antropogenic influences is that it is directional and measurable. Historically measurements of surrogate parameters have been used in an attempt to quantify these changes, for example extensive water chemistry data in aquatic systems. This was the case until the 1980's when the Index of Biotic Integrity (IBI) (Karr et al. 1986), was developed. This system collects an array of metrics and fish community data within a stream ecosystem and develops a score or rating for the

  10. Community as classroom: teaching and learning public health in rural Appalachia. (United States)

    Florence, James; Behringer, Bruce


    Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the

  11. Evaluation of the forest ecosystem health in Beijing area

    Institute of Scientific and Technical Information of China (English)

    Ma Li; Han Hai-rong; Ma Qin-yan; Liu Hong-wen; Xia Wei-wei; Cheng Xiao-qin


    The evaluation of ecosystem health has become one of the main research topics of ecosystem science, thus more and more assessment methods and frameworks have been put forward in recent years. However, the attention people pay to ecosystem health is actually more about what the social functions the ecosystem affords, which depend on the integrity and maintenance of the ecosystem structure and function, and the intensity of disturbance from outside. Accordingly, this research commenced from three main aspects,selected the evaluation indices, and then established the Evaluation Index System of Beijing Forest Ecosystem Health (EIS-BFEH).In the EIS-BFEH, each of the three foundations contained an easily-operated and standard sub-index system, which compounded the specific natural and social conditions of Beijing and was concrete enough to measure and evaluate. Then with the method of the Analytical Hierarchy Process (AHP), the comprehensive index (CI) could be obtained, which represented the health of the forest ecosystem. As a case study, the forest ecosystems in the Badaling area were sampled, evaluated, compared and ranked by use of the EIS-BFEH. The result show that the health of natural forests is much better than that of plantations in the Badaling forest center: the average comprehensive index of the former is 7.9, while the latter is only 6.6. From the results, it could also be found that there are nine units in the healthy state, two units in the subhealthy state, and only one unit of Robinia pseudoacacia in the morbid state.

  12. Legacy, legitimacy, and possibility: an exploration of community health worker experience across the generations in Khayelitsha, South Africa. (United States)

    Swartz, Alison


    In South Africa, the response to HIV and TB epidemics is complex, varied, and contextually defined. "Task-shifting" and a movement toward a decentralized model of care have led to an increased reliance on community health workers (CHWs) providing health care services to residents of impoverished, peri-urban areas. Public health policy tends to present CHWs as a homogeneous group, with little attention paid to the nuances of experience, motivation, and understanding, which distinguish these care workers from one another and from other kinds of health workers. An exploration of the layered meanings of providing community health care services under financially, politically, and socially difficult conditions reveals clear distinctions of experience across the generations. Many older CHWs say that ubuntu, a notion of shared African humanity, is being "killed off" by the younger generation, whereas younger CHWs often describe older women as being "jealous" of the opportunities that this younger generation has for education, training, and employment. The structure of the South African health system, past and present responses to disease epidemics, and the legacy of apartheid's structural violence have amplified these generational differences among CHWs. Using ethnographic data collected from approximately 20 CHWS in a peri-urban settlement in Cape Town, South Africa, I explore how CHWs experience and understand legitimacy in the moral economy of care. A call for closer attention to the experiences of CHWs is critical when designing public health policies for the delivery of health care services in impoverished communities in South Africa.

  13. Brokering Community Engagement: Proactive Strategies for Supporting Indigenous Australians with Mental Health Problems. (United States)

    Sayers, Jan Maree; Hunt, Glenn E; Cleary, Michelle; Burmeister, Oliver K


    This qualitative study explored the experiences of mental health employees working with Indigenous clients living with mental illness. Interviews were conducted with 20 mental health workers to identify strategies they adopt to facilitate community engagement with Indigenous clients. Using a thematic analysis approach, 'Brokering community engagement' was the umbrella theme from which two subthemes related to community engagement for the service and clients emerged (1) enabling connections -community and family; and (2) recovery and reconnecting with community. Participant insights enabled a deeper understanding of the role of community in the recovery process for Indigenous clients and highlight the importance of community engagement as a primary, yet multifaceted strategy used by mental health workers in the communities they serve.

  14. Family, School, Community Engagement, and Partnerships: An Area of Continued Inquiry and Growth (United States)

    Molina, Sarina C.


    This article responds to the theme issue by providing a glimpse of the historical and contemporary efforts in the area of developing school, family, and community partnerships, a long-standing area of need and inquiry in the literature. It reports on the collective learning from these articles where implications of the findings pointed to the…

  15. Community health clinical education in Canada: part 1--"state of the art". (United States)

    Cohen, Benita E; Gregory, David


    This paper presents the findings of a survey of community health clinical education in twenty-four Canadian pre-licensure baccalaureate nursing programs. A qualitative research design was used, involving a content analysis of Canadian course syllabi and supporting documents for community health courses. This study afforded a cross-sectional understanding of the "state of the art" of community health clinical education in Canadian schools of nursing. Clinical course conceptual approaches, course objectives, types of clinical sites, format and number of clinical hours, and methods of student evaluation are identified. The findings suggest the need for a national dialogue or consensus building exercise regarding curriculum content for community health nursing. Informing this dialogue are several strengths including the current focus on community health (as opposed to community-based) nursing education, and a solid socio-environmental perspective informing clinical learning and practice. The national data set generated by this study may have relevance to nursing programs globally.

  16. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

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    Henry Bonnie


    Full Text Available Abstract Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and

  17. Community health needs assessment with precede-proceed model: a mixed methods study

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    Wang Yang


    Full Text Available Abstract Background Community health services in China have developed over the last few decades. In order to use limited health resources more effectively, we conducted a community health needs assessment. This aimed to provide an understanding of the community's health problems and the range of potential factors affecting risk behaviours for the priority health problems. Methods We used the precede-proceed model for the needs assessment. Triangulation of data, methods and researchers were employed in data collection. Results Main findings include: cardiovascular diseases (CVDs were identified as the priority health problems in the study communities; risk factors associated with CVDs included smoking, physical inactivity and unhealthy eating behaviours, particularly amongst male residents with low education level; factors negatively affecting behaviours were classified into predisposing factors (limited knowledge, beliefs and lack of perceived needs, enabling factors (limited access to health promotion activities, unawareness of health promotion, lack of work-site and school health promotion, absence of health promotion related policy and reinforcing factors (culture. Policies and organization were not perfect; there were limited staff skilled in providing health promotion in the community. Conclusion CVDs were identified by the communities as priority health problems. Future health programs should focus on smoking, physical inactivity and unhealthy eating behaviours. Behaviour change strategies should take predisposing factors, enabling factors and reinforcing factors into consideration. Policies, organization and human resource need strengthening.

  18. Quantitative Analysis on Economic Contribution of Community Health Service in China

    Institute of Scientific and Technical Information of China (English)

    张新平; 王铁军


    Summary: In China, the implementation of community health service shows that the prevention is an essential and important part of our national health system and is helpful to decrease the medical expenditure gradually. According to the data from Health Statistic Information Center of Ministry of Health in China, we calculated that the total health expenditure of China would be decreased 8000. 0 million yuan only in 2001, among which, 1188.3 million, 1953.9 million and 4833.0 million yuan were respectively saved for the government budget, the society and resident if implementing the policy of community health service powerfully. And every outpatient can save 15.46 yuan per time. By the quantitative analysis on the economic contribution of community health service, it can be proved that a great economic benefit could be gotten from the implementation of community health service.

  19. Improving Dental Health in Underserved Communities | NIH MedlinePlus the Magazine (United States)

    ... please turn Javascript on. Feature: Oral Health Improving Dental Health in Underserved Communities Past Issues / Summer 2012 ... Colorado pediatrician Dr. Patty Braun. "Brown or missing teeth don't help kids—or adults—one bit." ...

  20. Predictors of consumer satisfaction in community mental health center services. (United States)

    Sohn, Minji; Barrett, Hope; Talbert, Jeffery


    Kentucky Department for Behavioral Health Developmental and Intellectual Disabilities conducted a survey to evaluate consumers' satisfaction with services delivered at the Community Mental Health Centers (CMHCs) in Kentucky. The survey was administered at outpatient clinics operated by fourteen CMHCs in 2010. The purpose of this study was to identify factors that predict whether clients will respond that they were "generally satisfied" with services received from CMHCs. A logistic regression model was developed using respondents' characteristics and their responses to survey questions. Survey questions were grouped into seven core domains: general satisfaction, access, quality, participation in treatment planning, outcomes, functioning, and social connectedness. In result, responses to domains of access, quality and participation in treatment planning significantly affected clients' perception of general satisfaction. Respondents who positively assessed those domains of services were more likely to answer that they were generally satisfied with services. Based on the analysis in this report, improvement in certain domains of services, especially access, quality and participation in treatment planning could increase the level of positive responses in general satisfaction.

  1. Indigenous community health and climate change: integrating biophysical and social science indicators (United States)

    Donatuto, Jamie; Grossman, Eric E.; Konovsky, John; Grossman, Sarah; Campbell, Larry W.


    This article describes a pilot study evaluating the sensitivity of Indigenous community health to climate change impacts on Salish Sea shorelines (Washington State, United States and British Columbia, Canada). Current climate change assessments omit key community health concerns, which are vital to successful adaptation plans, particularly for Indigenous communities. Descriptive scaling techniques, employed in facilitated workshops with two Indigenous communities, tested the efficacy of ranking six key indicators of community health in relation to projected impacts to shellfish habitat and shoreline archaeological sites stemming from changes in the biophysical environment. Findings demonstrate that: when shellfish habitat and archaeological resources are impacted, so is Indigenous community health; not all community health indicators are equally impacted; and, the community health indicators of highest concern are not necessarily the same indicators most likely to be impacted. Based on the findings and feedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessing climate change sensitivities and creating adaptation plans.

  2. Community Health Workers-Promotores de Salud in Mexico: History and Potential for Building Effective Community Actions. (United States)

    Balcazar, Hector; Perez-Lizaur, Ana Bertha; Izeta, Ericka Escalante; Villanueva, Maria Angeles


    This article takes a historical perspective combining 3 illustrative examples of the origins of the community health worker (CHW) model in Mexico, as a community-based participatory strategy. Three examples were identified from the sparse literature about CHWs in Mexico emphasizing their key roles and functions in various community settings. The CHW models illustrate what is known of training-development and planning, implementation, and evaluation of the CHWs model in different settings addressing cardiovascular disease and risk factors. The potential exists for integrating CHW projects to expand the health promotion model with new emphasis on municipality and regional participation.

  3. Community characteristics associated with HIV risk among injection drug users in the San Francisco Bay Area: a multilevel analysis. (United States)

    Bluthenthal, Ricky N; Do, D Phuong; Finch, Brian; Martinez, Alexis; Edlin, Brian R; Kral, Alex H


    Community characteristics have been associated with racial and ethnic health disparities for a wide range of ailments and conditions. Previous research has found that rates of AIDS cases among injection drug users (IDUs) vary by community characteristics. However, few studies have examined whether community characteristics are associated with HIV risk behaviors among IDUs. To address this gap in the literature, we examined the associations between census-tract-level community characteristics and injection-related and sex-related HIV risk behaviors among IDUs in the San Francisco Bay Area. Individual HIV risk behaviors were collected from 4,956 IDUs between 1998 and 2002. Using 2000 US census data, we constructed four census-level community measures: percent African American, percent male unemployment, percent of households that receive public assistance, and median household income. All community variables were measured continuously. Multilevel modeling was used to determine if community characteristics were associated with recent (in the last 6 months) receptive and distributive syringe sharing, multiple sex partners, and unprotected sex risk while controlling for potential individual-level confounders. In bivariate analysis, most of the census-tract-level community characteristics were significantly associated with injection-related HIV risk, while no community characteristics were associated with sex-related risk. However, results from multivariate multilevel models indicate that only percent African American in a census tract was associated with receptive [adjusted odds ratio (AOR) = 0.93; 95% confidence interval (CI) = 0.89, 0.99] and distributive syringe sharing (AOR = 0.94; 95% CI = 0.92, 0.99), net of individual-level characteristics. Accounting for individual-level factors in the multivariate model in the sex-related risk models revealed a significant inverse relationship between percent African American and propensity to engage in unprotected sex (AOR = 0

  4. Using public relations strategies to prompt populations at risk to seek health information: the Hanford Community Health Project. (United States)

    Thomas, Gregory D; Smith, Stephen M; Turcotte, Joseph A


    The Hanford Community Health Project (HCHP) addressed health concerns among "downwinders" exposed to releases of radioactive iodine (I-131) from the Hanford Nuclear Reservation in the 1940s and 1950s. After developing educational materials and conducting initial outreach, HCHP had to decide whether to apply its limited resources to an advertising or public relations approach. The decision to apply public relations strategies was effective in driving awareness of the risk communication message at the community level, reinvigorating the affected community, and ultimately increasing the number of people who sought information about their risk of exposure and related health issues. HCHP used a series of communication tools to reach out to local and regional media, medical and health professionals, and community organizations. The campaign was successful in increasing the number of unique visitors to HCHP Web site and educating and activating the medical community around the releases of I-131 and patient care choices.

  5. The relative influence of the community and the health system on work performance: a case study of community health workers in Colombia. (United States)

    Robinson, S A; Larsen, D E


    A central component of the primary health care approach in developing countries has been the development and utilization of community-based health workers (CHWs) within the national health system. While the use of these front line workers has the potential to positively influence health behavior and health status in rural communities, there continues to be challenges to effective implementation of CHW programs. Reports of high turnover rates, absenteeism, poor quality of work, and low morale among CHWs have often been associated with weak organizational and managerial capacity of government health systems. However, no systematic research has examined the contribution of work-related factors to CHW job performance. The research reported in this paper examines the relative influence of reward and feedback factors associated with the community compared to those associated with the health system on the performance of CHWs. The data are drawn from a broader study of health promoters (CHWs) conducted in two departments (provinces) in Colombia in 1986. The research was based on a theoretical model of worker performance that focuses on job related sources of rewards and feedback. A survey research design was employed to obtain information from a random sample of rural health promoters (N = 179) and their auxiliary nurse supervisors about CHW performance and contributing factors. The findings indicate that feedback and rewards from the community have a greater influence on work performance (defined as degree of perceived goal attainment on job tasks) than do those stemming from the health system.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Investigating health disparities through community-based participatory research: lessons learned from a process evaluation. (United States)

    Bryan, Valerie; Brye, Willette; Hudson, Kenneth; Dubose, Leevones; Hansberry, Shantisha; Arrieta, Martha


    This article describes one university's efforts to partner with a local agency (the "Coalition") within a disadvantaged, predominantly African American neighborhood, to assist them with studying their community's health disparities and health care access. The final, mutually agreed-upon plan used a community-based participatory research approach, wherein university researchers prepared neighborhood volunteers and Coalition members to conduct face-to-face interviews with residents about their health and health care access. Subsequently, the Coalition surveyed 138 residents, and the agency now possesses extensive data about the nature and extent of health problems in their community. Lessons learned from these experiences are offered.

  7. Community Pharmacists’ Views and Practices Regarding Natural Health Products Sold in Community Pharmacies (United States)

    Necyk, Candace


    Background Reports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs). The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are “front-line” health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied. Methods Using Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15) open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies. Results The majority of pharmacists surveyed (276; 68%) recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist’s Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84%) recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31%) recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database. Conclusions The study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists’ practices around NHPs are consistent with

  8. Health Literacy in Rural Areas of China: Hypertension Knowledge Survey

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    Hude Quan


    Full Text Available We conducted this study to determine levels and correlates of hypertension knowledge among rural Chinese adults, and to assess the association between knowledge levels and salty food consumption among hypertensive and non-hypertensive populations. This face-to-face cross sectional survey included 665 hypertensive and 854 non-hypertensive respondents in the rural areas of Heilongjiang province, China. Hypertension knowledge was assessed through a 10-item test; respondents received 10 points for each correct answer. Among respondents, the average hypertension knowledge score was 26 out of a maximum of 100 points for hypertensive and 20 for non-hypertensive respondents. Hypertension knowledge was associated with marital status, education, health status, periodically reading books, newspapers or other materials, history of blood pressure measurement, and attending hypertension educational sessions. Hypertension knowledge is extremely low in rural areas of China. Hypertension education programs should focus on marginal populations, such as individuals who are not married or illiterate to enhance their knowledge levels. Focusing on educational and literacy levels in conjunction with health education is important given illiteracy is still a prominent issue for the Chinese rural population.

  9. Health literacy in rural areas of China: hypertension knowledge survey. (United States)

    Li, Xia; Ning, Ning; Hao, Yanhua; Sun, Hong; Gao, Lijun; Jiao, Mingli; Wu, Qunhong; Quan, Hude


    We conducted this study to determine levels and correlates of hypertension knowledge among rural Chinese adults, and to assess the association between knowledge levels and salty food consumption among hypertensive and non-hypertensive populations. This face-to-face cross sectional survey included 665 hypertensive and 854 non-hypertensive respondents in the rural areas of Heilongjiang province, China. Hypertension knowledge was assessed through a 10-item test; respondents received 10 points for each correct answer. Among respondents, the average hypertension knowledge score was 26 out of a maximum of 100 points for hypertensive and 20 for non-hypertensive respondents. Hypertension knowledge was associated with marital status, education, health status, periodically reading books, newspapers or other materials, history of blood pressure measurement, and attending hypertension educational sessions. Hypertension knowledge is extremely low in rural areas of China. Hypertension education programs should focus on marginal populations, such as individuals who are not married or illiterate to enhance their knowledge levels. Focusing on educational and literacy levels in conjunction with health education is important given illiteracy is still a prominent issue for the Chinese rural population.

  10. The attitude of community health nurses towards integration of traditional healers in primary health care in North-West Province

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    MD Peu


    Full Text Available South Africa is called “the rainbow nation” because it has so many different cultures. These have an impact on the provision of primary health care. The purpose of this research is to foster good relationships between community health nurses and traditional healers and to explore, identify and describe the attitude of community health nurses towards the integration of traditional healers into primary health care. A non-experimental, explorative and descriptive research strategy was designed to explore the working relationship between community health nurses and traditional healers. Data was collected using a structured questionnaire. Quantitative as well as qualitative data analysis techniques were adopted to interpret the findings. The results indicated that respondents demonstrated positive attitudes towards working with traditional healers, especially in the provision of primary health care. Positive opinions, ideas and views were provided about the integration of traditional healers into primary health care. Respect, recognition and sensitivity were emphasized by respondents.

  11. Signals of climate change in butterfly communities in a Mediterranean protected area.

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    Konstantina Zografou

    Full Text Available The European protected-area network will cease to be efficient for biodiversity conservation, particularly in the Mediterranean region, if species are driven out of protected areas by climate warming. Yet, no empirical evidence of how climate change influences ecological communities in Mediterranean nature reserves really exists. Here, we examine long-term (1998-2011/2012 and short-term (2011-2012 changes in the butterfly fauna of Dadia National Park (Greece by revisiting 21 and 18 transects in 2011 and 2012 respectively, that were initially surveyed in 1998. We evaluate the temperature trend for the study area for a 22-year-period (1990-2012 in which all three butterfly surveys are included. We also assess changes in community composition and species richness in butterfly communities using information on (a species' elevational distributions in Greece and (b Community Temperature Index (calculated from the average temperature of species' geographical ranges in Europe, weighted by species' abundance per transect and year. Despite the protected status of Dadia NP and the subsequent stability of land use regimes, we found a marked change in butterfly community composition over a 13 year period, concomitant with an increase of annual average temperature of 0.95°C. Our analysis gave no evidence of significant year-to-year (2011-2012 variability in butterfly community composition, suggesting that the community composition change we recorded is likely the consequence of long-term environmental change, such as climate warming. We observe an increased abundance of low-elevation species whereas species mainly occurring at higher elevations in the region declined. The Community Temperature Index was found to increase in all habitats except agricultural areas. If equivalent changes occur in other protected areas and taxonomic groups across Mediterranean Europe, new conservation options and approaches for increasing species' resilience may have to be

  12. Web-based data warehouse in the osteoporosis community health information management system

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    Wang Qiang


    Full Text Available Objective: To investigate the remote management system of osteoporosis community intervention and design the data warehouse. Materials and Methods: The basic principles and methods of data warehouse were applied to the osteoporosis community intervention to build the MySQL 4.5 relational database using PHP as the development tool. A web-based B/S Model remote management system was established for the high risk population of osteoporosis in the community. Results: The system can be used for data management, data query, online analysis, etc., in community health service center, specialist outpatient for osteoporosis, and health administration sectors. Conclusion: The remote management system and data warehouse can provide guidance for policymaking of health administrators, residents health information, and intervention suggestions for general practitioners in community health service centers, patients follow-up information for osteoporosis specialists in general hospitals, as well as large quantities of original research data and preliminary health statistic results.

  13. Assessment of 'accredited social health activists'-a national community health volunteer scheme in Karnataka State, India. (United States)

    Fathima, Farah N; Raju, Mohan; Varadharajan, Kiruba S; Krishnamurthy, Aditi; Ananthkumar, S R; Mony, Prem K


    About 700,000 Accredited Social Health Activists (ASHA) have been deployed as community health volunteers throughout India over the last few years. The objective of our study was to assess adherence to selection criteria in the recruitment of ASHA workers and to assess their performance against their job descriptions in Karnataka state, India. A cross-sectional survey, using a combination of quantitative and qualitative methods, was undertaken in 2012. Three districts, 12 taluks (subdistricts), and 300 villages were selected through a sequential sampling scheme. For the quantitative survey, 300 ASHAs and 1,800 mothers were interviewed using sets of structured questionnaire. For the qualitative study, programme officers were interviewed via in-depth interviews and focus group discussions. Mean ± SD age of ASHAs was 30.3 ± 5.0 years, and about 90% (261/294) were currently married, with eight years of schooling. ASHAs were predominantly (>80%) involved in certain tasks: home-visits, antenatal counselling, delivery escort services, breastfeeding advice, and immunization advice. Performance was moderate (40-60%) for: drug provision for tuberculosis, caring of children with diarrhoea or pneumonia, and organizing village meetings for health action. Performance was low (<25%) for advice on: contraceptive-use, obstetric danger sign assessment, and neonatal care. This was self-reported by ASHAs and corroborated by mothers. In conclusion, ASHA workers were largely recruited as per preset selection criteria with regard to age, education, family status, income, and residence. The ASHA workers were found to be functional in some areas with scope for improvement in others. The role of an ASHA worker was perceived to be more of a link-worker/facilitator rather than a community health worker or a social activist.

  14. Terrestrial Species in Protected Areas and Community-Managed Lands in Arunachal Pradesh, Northeast India

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    Nandini Velho


    Full Text Available Protected areas (including areas that are nominally fully protected and those managed for multiple uses encompass about a quarter of the total tropical forest estate. Despite growing interest in the relative value of community-managed lands and protected areas, knowledge about the biodiversity value that each sustains remains scarce in the biodiversity-rich tropics. We investigated the species occurrence of a suite of mammal and pheasant species across four protected areas and nearby community-managed lands in a biodiversity hotspot in northeast India. Over 2.5 years we walked 98 transects (half of which were resampled on a second occasion across the four paired sites. In addition, we interviewed 84 key informants to understand their perceptions of species trends in these two management regimes. We found that protected areas had higher overall species richness and were important for species that were apparently declining in occurrence. On a site-specific basis, community-managed lands had species richness and occurrences comparable to those of a protected area, and in one case their relative abundances of mammals were higher. Interviewees indicated declines in the abundances of larger-bodied species in community-managed lands. Their observations agreed with our field surveys for certain key, large-bodied species, such as gaur and sambar, which generally occurred less in community-managed lands. Hence, the degree to which protected areas and community-managed lands protect wildlife species depends upon the species in question, with larger-bodied species usually faring better within protected areas.

  15. Development of a community health inclusion index: an evaluation tool for improving inclusion of people with disabilities in community health initiatives


    Eisenberg, Yochai; Rimmer, James H.; Mehta, Tapan; Fox, Michael H.


    Background Community health initiatives often do not provide enough supports for people with disabilities to fully participate in healthy, active living opportunities. The purpose of this study was to design an instrument that focused on integrating disability-related items into a multi-level survey tool that assessed healthy, active living initiatives. Methods The development and testing of the Community Health Inclusion Index (CHII) involved four components: (a) literature review of studies...

  16. Environmental, Nutrition and Health Issues in a US Refugee Resettlement Community. (United States)

    Sastre, Lauren; Haldeman, Lauren


    INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them. METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants. RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups. CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as

  17. Marginalisation, discrimination and the health of Latino immigrant day labourers in a central North Carolina community. (United States)

    Fleming, Paul J; Villa-Torres, Laura; Taboada, Arianna; Richards, Chelly; Barrington, Clare


    The morbidity and mortality of Latino immigrants in the United States (US) stem from a complex mix of policy, culture, discrimination and economics. Immigrants working as day labourers may be particularly vulnerable to the negative influences of these social factors due to limited access to social, financial and legal resources. We aimed to understand how the health of male Latino day labourers in North Carolina, US is influenced by their experiences interacting with their community and perceptions of their social environment. To respond to our research questions, we conducted three focus groups (n = 9, n = 10, n = 10) and a photovoice project (n = 5) with Latino male immigrants between October 2013 and March 2014. We conducted a thematic analysis of transcripts from the discussions in the focus groups and the group discussions with Photovoice participants. We found that men's health and well-being were primarily shaped by their experiences and feelings of discrimination and marginalisation. We identified three main links between discrimination/marginalisation and poor health: (i) dangerous work resulted in workplace injuries or illnesses; (ii) unsteady employment caused stress, anxiety and insufficient funds for healthcare; and (iii) exclusionary policies and treatment resulted in limited healthcare accessibility. Health promotion with Latino immigrant men in new settlement areas could benefit from community-building activities, addressing discrimination, augmenting the reach of formal healthcare and building upon the informal mechanisms that immigrants rely on to meet their health needs. Reforms to immigration and labour policies are also essential to addressing these structural barriers to health for these men.

  18. Community-Based Management of Diabetes in Nepal: Exploring the Potential Role of Female Community Health Volunteers

    DEFF Research Database (Denmark)

    Gyawali, Bishal


    and treat type 2 diabetes. We suggest that involving Female Community Health Volunteers (FCHVs) of Nepal offering culturally appropriate health promotion may be the blue print for community-based management programmes tackling type 2 diabetes. We aim to explore the potential role of FCHVs of Nepal...... for diabetes management at community level. It is anticipated that the study can give valuable information regarding effectiveness, acceptability, and feasibility of an innovative way to improve diabetes management in low resource settings......., and this is particularly apparent in the South Asian countries, including Nepal. Despite the growing burden and chronic nature of type 2 diabetes, prevention and control of this disease is far from adequate in these settings. One possibility could be through the involvement of community health workers to prevent, diagnose...

  19. Community health workers support community-based participatory research ethics: lessons learned along the research-to-practice-to-community continuum. (United States)

    Smith, Selina A; Blumenthal, Daniel S


    Ethical principles of community-based participatory research (CBPR)--specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability--stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR.

  20. Social and Physical Environments and Self-Rated Health in Urban and Rural Communities in Korea

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    Jung-A Lee


    Full Text Available This study evaluated the associations between social and physical environments and self-rated health (SRH for urban and rural Korean adults, using data from the Korean Community Health Survey (KCHS of 199,790 participants (115,454 urban and 84,336 rural. The main dependent variable was SRH, while the primary independent variables were social and physical characteristics. Urban residents reported better SRH than did rural residents. Five social environmental variables (trust of neighbors, residence in the area for over 20 years, exchanging help with neighbors, friend and fellowship activities, contact with relatives and neighbors over five times per month were more prevalent among rural residents. Satisfaction with physical environment was more common among rural residents, but satisfaction with traffic and healthcare facilities was more common among urban areas. After adjusting for relevant factors, positive associations between SRH and trust of neighbors, exchanging help with neighbors, participation in social activities or organizations, and physical environment existed in both rural and urban populations. Also, in both areas, there was no demonstrated association between SRH and years of residence or frequency of contact with relatives. Our findings suggest the existence of an association between social and physical factors and perceived health status among the general population of Korea.

  1. The University of Washington's Community-Oriented Public Health Practice program and Public Health-Seattle & King County partnership. (United States)

    House, Peter J; Hartfield, Karen; Nicola, Bud; Bogan, Sharon L


    The Community-Oriented Public Health Practice (COPHP) program, a 2-year in-residence MPH degree program in the University of Washington School of Public Health, has partnered with Public Health-Seattle & King County (PHSKC) since 2002 to create a mutually beneficial set of programs to improve teaching and address community-based public health problems in a practice setting. The COPHP program uses a problem-based learning approach that puts students in small groups to work on public health problems. Both University of Washington-based and PHSKC-based faculty facilitate the classroom work. In the first year for students, COPHP, in concert with PHSKC, places students in practicum assignments at PHSKC; in the second year, students undertake a master's project (capstone) in a community or public health agency. The capstone project entails taking on a problem in a community-based agency to improve either the health of a population or the capacity of the agency to improve population health. Both the practicum and the capstone projects emphasize applying classroom learning in actual public health practice work for community-based organizations. This partnership brings PHSKC and COPHP together in every aspect of teaching. In essence, PHSKC acts as the "academic health department" for COPHP. There are detailed agreements and contracts that guide all aspects of the partnership. Both the practicum and capstone projects require written contracts. The arrangements for getting non-University of Washington faculty paid for teaching and advising also include formal contracts.

  2. Factors of collective psychological empowerment of active users in the online health community

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    Petrovčič Andraž


    Full Text Available Objective: This paper investigates the collective psychological empowerment of users of online health communities, which has been often overlooked in literature. Drawing on the theories of empowerment in the context of community psychology, it explores the factors - that are also an important characteristic of online health communities - that are associated with the collective psychological empowerment of online health community users.

  3. Public health and health services development in postconflict communities: a case study of a safe motherhood project in East Timor. (United States)

    Marlowe, Penny; Mahmood, Mohammad Afzal


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

  4. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective (United States)

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.


    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  5. Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial (United States)

    Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.


    The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…

  6. Sample Design and Cohort Selection in the Hispanic Community Health Study/Study of Latinos (United States)

    LaVange, Lisa M.; Kalsbeek, William; Sorlie, Paul D.; Avilés-Santa, Larissa M.; Kaplan, Robert C.; Barnhart, Janice; Liu, Kiang; Giachello, Aida; Lee, David J.; Ryan, John; Criqui, Michael H.; Elder, John P.


    PURPOSE The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a multi-center, community based cohort study of Hispanic/Latino adults in the United States. A diverse participant sample is required that is both representative of the target population and likely to remain engaged throughout follow-up. The choice of sample design, its rationale, and benefits and challenges of design decisions are described in this paper. METHODS The study design calls for recruitment and follow-up of a cohort of 16,000 Hispanics/Latinos aged 18-74 years, with 62.5% (10,000) over 44 years of age and adequate subgroup sample sizes to support inference by Hispanic/Latino background. Participants are recruited in community areas surrounding four field centers in the Bronx, Chicago, Miami, and San Diego. A two-stage area probability sample of households is selected with stratification and over-sampling incorporated at each stage to provide a broadly diverse sample, offer efficiencies in field operations, and ensure that the target age distribution is obtained. CONCLUSIONS Embedding probability sampling within this traditional, multi-site cohort study design enables competing research objectives to be met. However, the use of probability sampling requires developing solutions to some unique challenges in both sample selection and recruitment, as described here. PMID:20609344

  7. Prevention of unintended pregnancy and HIV/STIs among Latinos in rural communities: perspectives of health care providers. (United States)

    Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn


    Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.

  8. Promoting community participation in priority setting in district health systems: experiences from Mbarali district, Tanzania

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    Peter Kamuzora


    Full Text Available Background: Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Design: Key informant interviews were conducted with the Council Health Management Team (CHMT, community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. Results: A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective

  9. Household reporting of childhood respiratory health and air pollution in rural Alaska Native communities

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    Desirae N. Ware


    Full Text Available Background: Air pollution is an important contributor to respiratory disease in children. Objective: To examine associations between household reporting of childhood respiratory conditions and household characteristics related to air pollution in Alaska Native communities. Design: In-home surveys were administered in 2 rural regions of Alaska. The 12-month prevalence of respiratory conditions was summarized by region and age. Odds ratios (ORs were calculated to describe associations between respiratory health and household and air quality characteristics. Results: Household-reported respiratory health data were collected for 561 children in 328 households. In 1 region, 33.6% of children aged <5 years had a recent history of pneumonia and/or bronchitis. Children with these conditions were 2 times more likely to live in a wood-heated home, but these findings were imprecise. Resident concern with mould was associated with elevated prevalence of respiratory infections in children (ORs 1.6–2.5, while reported wheezing was associated with 1 or more smokers living in the household. Reported asthma in 1 region (7.6% was lower than national prevalence estimates. Conclusions: Findings suggest that there may be preventable exposures, including wood smoke and mould that affect childhood respiratory disease in these rural areas. Additional research is needed to quantify particulate matter 2.5 microns in aerodynamic diameter or less and mould exposures in these communities, and to objectively evaluate childhood respiratory health.

  10. An outline of the need for psychology knowledge in health professionals: implications for community development and breast cancer prevention. (United States)

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


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

  11. Promoting and recovering health: meanings produced in community groups within the family health program context

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    Celiane Camargo-Borges


    Full Text Available Public Healthcare in Brazil has tended to reflect major changes in the healthcare model. New tendencies point to the importance of actions being built up from their context and focused on specific communities. The objective of this study is to describe the meanings of health / illness as produced by community groups within the context of a Family Healthcare Program. Five groups had their single-session discussions taped and recorded, under the coordination of the first author. This material was transcribed and, coupled with field notes, formed the database for this study. The analysis described the meanings of the ideas on which new healthcare proposals are being based, providing visibility for the multiplicity of meanings and denaturalizing fixed lines of discourse on healthcare / illness. The final thoughts, developed from the point of view of social constructionism, indicate that healthcare practices based on the process of constant conversation and negotiation between all the social actors involved is a fertile ground.

  12. Lessons from community participation in health programmes: a review of the post Alma-Ata experience. (United States)

    Rifkin, Susan B


    The year 2008 marked the 30 year anniversary of Primary Health Care, the health policy of all member nations of the WHO. Community participation was one of the key principles of this policy. This article reviews the experiences of and lessons learned by policy makers, planners and programme managers in attempting to integrate community participation into their health programmes. The lessons, identified in an earlier article by the author, are still relevant today. They help to identify three reasons why integrating community participation into health programmes is so difficult. These reasons are: (1) the dominance of the bio-medical paradigm as the main planning tool for programmes, leading to the view of community participation as an intervention; (2) the lack of in-depth analysis of the perceptions of community members regarding the use of community health workers; and (3) the propensity to use a framework that limits investigation into what works, why and how in community participation in health programmes. Despite these challenges, evidence suggests that community participation has contributed to health improvements at the local level, particularly in poor communities, and will continue to be relevant to programme professionals.

  13. Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

    DEFF Research Database (Denmark)

    Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian


    Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity...... building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities...

  14. [The social-political-environmental and health reality of families belonging to a vulnerable community]. (United States)

    Marzari, Carla Kowalski; Backes, Dirce Stein; Backes, Marli Stein; Marchiori, Mara Teixeira; Souza, Martha Teixeira de; Carpes, Adriana Dornelles


    The scope of this paper is to ascertain the perception of community leadership, health professionals and users regarding citizenship status and the enhancement of the healthcare conditions of families belonging to a vulnerable community. This is an exploratory study of a qualitative nature, guided by theory based on data. Data were collected between July and December 2009, by means of interviews with four community health leaders, a team of eight family health team professionals and twelve health users. The codification of the data resulted in the following categories: Understanding the social conditions, the political conditions, the environmental conditions and the health conditions of families in a vulnerable community. The conclusions reached were, that if on the one hand the social security and health policies made it possible to reduce poverty and local inequalities, on the other hand they do not ensure the requisite enhancement of citizenship or even the improvement of health conditions.

  15. Community Health Nursing Education: Where We Are Going and How To Get There. (United States)

    Kemp, Charles E.


    Discusses the shift in values needed to provide community health nursing education in partnership with a community. Offers principles for developing programs: refocused purpose, broad practice scope, problem solving as discovery, and family, community, and student empowerment. (Contains 37 references.) (Author/JOW)

  16. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain


    Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

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

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    Arthur Saniotis


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

  18. The Development and Testing of a Community Health Nursing Clinical Evaluation Tool. (United States)

    Hawranik, Pamela


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

  19. Community Participation in Rural Ecuador's School Feeding Programme: A Health Promoting School Perspective (United States)

    Torres, Irene; Simovska, Venka


    Purpose: The purpose of this paper is to contribute to the debate concerning community participation in school-based health education and health promotion, with regard to food and nutrition. Design/methodology/approach: Based on empirical data generated over the course of one year of fieldwork in three rural communities and schools in Ecuador, the…

  20. Continuing Education Needs of Community Nurses, Midwives and Health Visitors for Supervising and Assessing Students. (United States)

    Thomson, Ann M.; Davies, Susan; Shepherd, Bernadette; Whittaker, Karen


    A survey of 314 community nurses, midwives, and health visitors in Britain revealed the practitioners' need for continuing education to help them provide research-based instruction for learners preparing for community-health service. Most practitioners had to study on their own time at their own expense. (SK)

  1. Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill (United States)

    Kliewer, Stephen P.; McNally Melissa; Trippany, Robyn L.


    Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus…

  2. Achieving a shared vision for girls' health in a low-income community. (United States)

    Miller, M Elizabeth; Vaughn, Lisa M


    In response to a lack of information related to girls' health in a low-income community, an initiative was developed to create a community-wide vision for girls' health. A forum was conducted following a photovoice project to generate sustainable action steps. Forty-four participants attended the forum. Key action steps included decreasing barriers to participation in girls' programs, offering leadership roles and interpersonal communication skills for girls in the community, and engaging girls in community organizations. Integral to the forum's success were the initial photos, which provided a bridge from understanding the issues of girls' health to the development of the action steps.

  3. Stakeholders' perceptions of integrated community case management by community health workers: a post-intervention qualitative study.

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    Denise L Buchner

    Full Text Available Integrated community case management (iCCM involves delivery of simple medicines to children with pneumonia, diarrhea and/or malaria by community health workers (CHWs. Between 2010 and 2012, an iCCM intervention trial was implemented by Healthy Child Uganda. This study used qualitative tools to assess whether project stakeholders perceived that iCCM improved access to care for children under five years of age.The intervention involved training and equipping 196 CHWs in 98 study villages in one sub-county in Uganda in iCCM. During the eight-month intervention, CHWs assessed sick children, provided antimalarials (coartem for fever, antibiotics (amoxicillin for cough and fast breathing, oral rehydration salts/zinc for diarrhea, and referred very sick children to health facilities. In order to examine community perceptions and acceptability of iCCM, post-intervention focus groups and key respondent interviews involving caregivers, health workers, CHWs and local leaders were carried out by experienced facilitators using semi-structured interview guides. Data were analyzed using thematic analysis techniques.Respondents reported increased access to health care for children as a result of iCCM. Access was reportedly closer to home, available more hours in a day, and the availability of CHWs was perceived as more reliable. CHW care was reported to be trustworthy and caring. Families reported saving money especially due to reduced transportation costs, and less time away from home. Respondents also perceived better health outcomes. Linkages between health facilities and communities were reportedly improved by the iCCM intervention due to the presence of trained CHWs in the community.iCCM delivered by CHWs may improve access to health care and is acceptable to families. Policymakers should continue to seek opportunities to implement and support iCCM, particularly in remote communities where there are health worker shortages.

  4. Context matters: A community-based study of urban minority parents’ views on child health (United States)

    Bolar, Cassandra L.; Hernandez, Natalie; Akintobi, Tabia Henry; McAllister, Calvin; Ferguson, Aneeqah S.; Rollins, Latrice; Wrenn, Glenda; Okafor, Martha; Collins, David; Clem, Thomas


    Background Among children, there are substantial ethno-racial minority disparities across a broad range of health-related behaviors, experiences, and outcomes. Addressing these disparities is important, as childhood and adolescence establish health trajectories that extend throughout life. Methods The current study employed a community-based participatory research approach to gain community insight on child health priorities and to frame an intervention aimed at improving the health of minority children. Eight focus groups were conducted among seventy-five African American parents in a Southeastern city. The current study was guided by an ecological theoretical framework. Results Although the focus of this investigation was on community identification of child health priorities, participants cited, as root determinants, contextual factors, which included lack of healthy food options, lack of spaces for physical activity, and community violence. These co-occurring factors were related to limited engagement in outdoor activities and physical activity, increased obesity, and poor mental health and coping. Poor parenting was cited as the most substantial barrier to improving child health outcomes, and quality parenting was identified as the most important issue to address for community programs focused on promoting the health and success of children. For improving health outcomes for children in their neighborhoods, establishment of positive social capital and constructive activities were also cited. Conclusions These results reinforce social determinants of health as influences on child health outcomes and describe how community engagement can address potential solutions through interventions that resonate with program participants. PMID:27275021

  5. [Rapid ecological assessment of tropical fish communities in a gold mine area of Costa Rica]. (United States)

    Espinoza Mendiola, Mario


    Gold mining impacts have generated a great concern regarding aquatic systems and habitat fragmentation. Anthropogenic disturbances on the structure and heterogeneity of a system can have an important effect on aquatic community stability. Ecological rapid assessments (1996, 2002, and 2007) were employed to determine the structure, composition and distribution of tropical fish communities in several rivers and smaller creeks from a gold mining area in Cerro Crucitas, Costa Rica. In addition, species composition and relative abundance were related with habitat structure. A total of 35 species were registered, among which sardine Astyanax aeneus (Characidae) and livebearer Alfaro cultratus (Poeciliidae) were the most abundant fish (71%). The highest species richness was observed in Caño Crucitas (s=19) and Minas Creek (s=18). Significant differences in fish communities structure and composition from Infiernillo river and Minas creek were observed (lamda = 0.0, F(132, 66) = 2.24, p fish species and habitat structure was observed. This study reveals a high complexity in tropical fish communities that inhabit a gold mine area. Furthermore, it highlights the importance of habitat heterogeneity in fish community dynamics. The loss and degradation of aquatic systems in Cerro Crucitas can have a strong negative effect on fish community structure and composition of local species. A better understanding of the use of specific habitats that serve as essential fish habitats can improve tropical fish conservation and management strategies, thus increasing local diversity, and thereby, the biological importance of the area.

  6. Assessment of Mobile Health Nursing Intervention Knowledge among Community Health Nurses in Oyo State, Nigeria. (United States)

    Titilayo, Odetola D; Okanlawon, F A


    Maternal mortality is high in Nigeria especially in rural areas due to knowledge deficit about expected care and labour process, socio-cultural belief, health care workers' attitude, physical and financial barriers to quality health care access. Mobile health (m-health) technology which is the use of mobile telecommunication devices in health care delivery reduces costs, improves care access, removes time and distance barriers and facilitates patient-provider communications needed to make appropriate health decisions. Previous studies empowering nurses with m-health knowledge resulted in improved uptake of health care services. There exists a literature dearth about knowledge and perception of nurses in Nigeria. This study became expedient to empower nurses working at the grassroots with the knowledge of m-health and assess the impact of educational training on their perception of its effectiveness. This quasi-experimental study carried out in four randomly selected LGAs across Oyo South Senatorial district involved participants at experimental (20 nurses) and control levels (27 nurses). A validated 25-item questionnaire explored nurses' perception, knowledge and perceived effectiveness of m-health in improving uptake of maternal health services in Nigeria among both groups before intervention. Intervention group nurses had a training equipping them with knowledge of m-health nursing intervention (MNHI) for a period of one week. Their perception, knowledge and perceived effectiveness were re-assessed at three-months and six-months after MHNI. Data were analyzed using Chi-square and repeated measures ANOVA at 5% significance level. In the EG, knowledge score significantly increased from 21.9±4.5 at baseline to 23.6±4.6 and 23.2±5.6 at three-month and six-month respectively while there was no significant difference in knowledge score among CG over the study period. A very significant difference was shown in the knowledge and perception of mobile health and its

  7. Nutritional Status among Rural Community Elderly in the Risk Area of Liver Fluke, Surin Province, Thailand. (United States)

    Kaewpitoon, Soraya J; Namwichaisirikul, Niwatchai; Loyd, Ryan A; Churproong, Seekaow; Ueng-Arporn, Naporn; Matrakool, Likit; Tongtawee, Taweesak; Rujirakul, Ratana; Nimkhuntod, Porntip; Wakhuwathapong, Parichart; Kaewpitoon, Natthawut


    Thailand is becoming an aging society, this presenting as