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Sample records for community-based treatment programs

  1. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  2. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

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

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

    2012-01-01

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

  4. A collaborative community-based treatment program for offenders with mental illness.

    Science.gov (United States)

    Roskes, E; Feldman, R

    1999-12-01

    The paper describes initial results of collaboration between a mental health treatment program at a community mental health center in Baltimore and a probation officer of the U.S. federal prison system to serve the mental health needs of offenders on federal probation, parole, supervised release, or conditional release in the community. A forensic psychiatrist in the treatment program and a licensed social worker in the probation office facilitate the close working relationship between the agencies. Treatment services provided or brokered by the community mental health center staff include psychiatric and medical treatment, intensive case management, addictions treatment, urine toxicology screening, psychosocial or residential rehabilitation services, intensive outpatient care, partial hospitalization, and inpatient treatment. Among the 16 offenders referred for treatment during the first 24 months of the collaborative program, 14 were male and 14 were African American. Three of the 16 violated the terms of their release due to noncompliance with stipulated mental health treatment; only one of the three had been successfully engaged in treatment. One patient died, two completed their terms of supervision, and ten remained in treatment at the time of the report. The major strength of this collaboration is the cooperation of the treatment and monitoring agencies with the overall goal of maintaining the offender in the community. Further research is needed to confirm the effectiveness of the clinical model in reducing recidivism and retaining clients.

  5. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  6. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Directory of Open Access Journals (Sweden)

    Alicia K. Matthews

    2013-01-01

    Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

  7. Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

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    Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

    2017-09-01

    Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional

  8. Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

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    Walter Kipp

    Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a

  9. Perceptions of incentives offered in a community-based malaria diagnosis and treatment program in the Highlands of Papua New Guinea.

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    Burkot, Camilla; Naidi, Laura; Seehofer, Liesel; Miles, Kevin

    2017-10-01

    What motivates community-based health workers to provide care in rural and remote areas, often on a voluntary or casual basis, is a key question for program managers and public health officials. This paper examines how a range of incentives offered as part of the Marasin Stoa Kipa program, a community-based malaria diagnosis and treatment program that has been implemented since 2007 within a major oil and gas development area in Papua New Guinea, are perceived and critiqued by community-based health workers. Nineteen interviews and seven focus group discussions with the workers who deliver services and members of the communities served by the program, conducted between November 4 and 25, 2015, reveal a pattern of mixed motivations and changes in motivation over time. This can be attributed partly to the unique social and economic circumstances in which the program is operating. Changes in the burden of disease as well as in global and national health services policy with implications for local level program operations also had an impact, as did the nature of relationships between program managers, community-based health workers, and program beneficiaries. Overall, the findings suggest that while financial and in-kind incentives can be a useful tool to motivate voluntary or minimally-compensated community-based health workers, they must be carefully structured to align with local social, economic, and epidemiological realities over the long-term. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

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    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Comparing antiretroviral treatment outcomes between a prospective community-based and hospital-based cohort of HIV patients in rural Uganda

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    Alibhai Arif

    2011-11-01

    Full Text Available Abstract Background Improved availability of antiretroviral therapy in sub-Saharan Africa is intended to benefit all eligible HIV-infected patients; however in reality antiretroviral services are mainly offered in urban hospitals. Poor rural patients have difficulty accessing the drugs, making the provision of antiretroviral therapy inequitable. Initial tests of community-based treatment programs in Uganda suggest that home-based treatment of HIV/AIDS may equal hospital-based treatment; however the literature reveals limited experiences with such programs. The research This intervention study aimed to; 1 assess the effectiveness of a rural community-based ART program in a subcounty (Rwimi of Uganda; and 2 compare treatment outcomes and mortality in a rural community-based antiretroviral therapy program with a well-established hospital-based program. Ethics approvals were obtained in Canada and Uganda. Results and outcomes Successful treatment outcomes after two years in both the community and hospital cohorts were high. All-cause mortality was similar in both cohorts. However, community-based patients were more likely to achieve viral suppression and had good adherence to treatment. The community-based program was slightly more cost-effective. Per capita costs in both settings were unsustainable, representing more than Uganda’s Primary Health Care Services current expenditures per person per year for all health services. The unpaid community volunteers showed high participation and low attrition rates for the two years that this program was evaluated. Challenges and successes Key successes of this study include the demonstration that antiretroviral therapy can be provided in a rural setting, the creation of a research infrastructure and culture within Kabarole’s health system, and the establishment of a research collaboration capable of enriching the global health graduate program at the University of Alberta. Challenging questions about the

  12. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

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

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    Boone, Edgar J.

    1992-01-01

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

  14. 75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

    Science.gov (United States)

    2010-11-03

    ...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...

  15. Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

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    Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

    2011-01-01

    This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

  16. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

    Science.gov (United States)

    Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

    2015-05-01

    The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  17. Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

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    Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

    2013-01-01

    A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

  18. Philadelphia's community based drug abuse program: broader medical and social concepts.

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    Schut, J

    1975-06-01

    The rehabilitation of drug dependent people has undergone drastic changes since first attempts were made to curb the abuse of illegal drugs. The isolated law-enforcement model proved to be of no use in this area. So, too, the medical model, the psychological model and the public health model proved disappointingly low in their results. During the last ten years, a so-called "metabolic replacement model" has had its upsurge, creating a controversy still under discussion. The Drug Abuse Rehabilitation Programs of the West Philadelphia Community Mental Health Consortium, Inc. have been in the forefront with its treatment models. Established in 1968 as a purely methadone maintenance program, it has evolved into becoming a model, applying community mental health principles. This paper will explore this model further, describing the mechanics of its changes. From a municipal hospital-based methadone dispensing station, the program has developed into a multi-modality project. Three decentralized drug-free outpatient services are located in the midst of the community where the drug abuse problem is more accute. Outreach is emphasized and case-funding is applied. A possibly unique river-front motel was just acquired for the development of a community-based treatment modality. The 94 rooms were converted into a first-floor alcoholism program which also has a "highway safety program" and an intermediate care facility for alcoholics. The second floor of this facility contains outpatient services for the treatment of drug addicts, including a methadone maintenance program, counselling, family therapy and group therapy. The place where most of the emphasis has been placed is the Work Rehabilitation Center (a novel approach whereby patients will spend up to six hours in "partial hospitalization"). Clients will be tested for vocational aptitude and four workshops will be developed on the premises - carpentry, automotive, electricity and clerical. A huge cafeteria with a semi

  19. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

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    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  20. Community Based Educational Model on Water Conservation Program

    Science.gov (United States)

    Sudiajeng, L.; Parwita, I. G. L.; Wiraga, I. W.; Mudhina, M.

    2018-01-01

    The previous research showed that there were indicators of water crisis in the northern and eastern part of Denpasar city and most of coastal area experienced on seawater intrusion. The recommended water conservation programs were rainwater harvesting and educate the community to develop a water saving and environmentally conscious culture. This research was conducted to built the community based educational model on water conservation program through ergonomics SHIP approach which placed the human aspect as the first consideration, besides the economic and technically aspects. The stakeholders involved in the program started from the problem analyses to the implementation and the maintenance as well. The model was built through three main steps, included determination of accepted design; building the recharge wells by involving local communities; guidance and assistance in developing a water saving and environmentally conscious culture for early childhood, elementary and junior high school students, community and industry. The program was implemented based on the “TRIHITA KARANA” concept, which means the relationship between human to God, human-to-human, and human to environment. Through the development of the model, it is expected to grow a sense of belonging and awareness from the community to maintain the sustainability of the program.

  1. A rural, community-based suicide awareness and intervention program.

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    Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

    2015-01-01

    Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

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

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

    2015-01-01

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

  3. Building Rural Communities through School-Based Agriculture Programs

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    Martin, Michael J.; Henry, Anna

    2012-01-01

    The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…

  4. Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

    Science.gov (United States)

    Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

    2016-08-01

    Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

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

    DEFF Research Database (Denmark)

    Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie

    2017-01-01

    BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

  6. Community-Based Programming: An Opportunity and Imperative for the Community College. Institutes & Workshops.

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    Boone, Edgar J.

    Community-based programming (CBP) is a cooperative process in which a community college serves as the leader and catalyst in effecting collaboration among the people, leaders and community organizations in its service area. This report discusses the changing role of the community college, the nature of CBP, and expected outcomes of the process,…

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

    Science.gov (United States)

    2014-01-01

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

  8. A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings.

    Science.gov (United States)

    Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald

    2013-04-16

    Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

  9. The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities.

    Science.gov (United States)

    Legha, Rupinder Kaur; Novins, Douglas

    2012-07-01

    Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.

  10. An Assessment of Prison-Based Drug Treatment; Texas' In-Prison Therapeutic Community Program.

    Science.gov (United States)

    Knight, Kevin; Simpson, D. Dwayne; Chatham, Lois R.; Camacho, L. Mabel

    1997-01-01

    Provides an overview of a comprehensive, prison-based treatment assessment, including a six-month follow-up study. Results show that 80% of the inmates referred to the program graduated. Graduates demonstrated marked reductions in criminal and drug-use activity and had lower relapse and recidivism rates when compared to other parolees. (RJM)

  11. A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    2013-04-01

    Full Text Available Community-based care (CBC can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

  12. 45 CFR 2517.300 - Who may participate in a community-based service-learning program?

    Science.gov (United States)

    2010-10-01

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

  13. 45 CFR 2517.600 - How are funds for community-based service-learning programs distributed?

    Science.gov (United States)

    2010-10-01

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

  14. Pediatric obesity community programs: barriers & facilitators toward sustainability.

    Science.gov (United States)

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

    2010-08-01

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

  15. Evaluating Community Inclusion: A Novel Treatment Program for Children with Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Natalie J. Webb

    2015-11-01

    Full Text Available A state-funded, non-profit organization developed an innovative inclusion program for children with Autism spectrum disorders and developmental delays, Including Special Kids, which offers activities for children with developmental delays alongside typically developing children in collaboration with well-established local youth programs. This case study examines the ISK intervention program at the original community host sites to determine if the evidence supports a measurable and demonstrable change in behaviors in a real-world setting that may lead to increased quality of life and greater inclusion in the community. Using evidence-based data, we measured the progress of 30 children over 6-24 months. Children participating in the program showed average improvement in all but two function areas and improvement in all composite scores. While these results do not prove program success, they offer an indication that the program helps children learn skills and behaviors to successfully navigate and become part of community-based, after-school recreational programs.

  16. Integrating Faith-based and Community-based Participatory Research Approaches to Adapt the Korean Parent Training Program.

    Science.gov (United States)

    Kim, Eunjung; Boutain, Doris; Kim, Sangho; Chun, Jin-Joo; Im, Hyesang

    Faith and community based inquiry approaches are rarely used to develop research interventions. The purpose of this article is to present how a research team worked with six Korean American Christian churches to revise the prototype Korean Parent Training Program (KPTP), based upon the Bright Futures Parenting Program. The collaboration was sought to better integrate and align the KPTP with Korean culture and faith. The KPTP was developed to promote positive parenting practices and decrease mental health disparities of Korean American children. Sixteen church participants completed a Delphi survey, a workshop series, Community Theaters, and focus groups. The participants suggested adding Korean traditional parenting virtues, Christian parenting principles, and revising the standardized parent training and program philosophy. Revisions made KPTP sensitive to Korean culture and faith, and promoted program acceptability. The process demonstrated the importance of working with church volunteers to develop faith-based and community-based health promotion interventions targeting Korean American faith communities. This research presents significant and meaningful implications for working with other faith communities from minority backgrounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Community Alternatives for Love and Limits (CALL: A community-based family strengthening multi-family intervention program to respond to adolescents at risk

    Directory of Open Access Journals (Sweden)

    David Wilkerson

    2005-12-01

    Full Text Available Family strengthening has become a source of growing interest, research, and program design in the fields of prevention and treatment for problems of youth delinquency, school failure, alcohol, tobacco and other drug abuse (ATOD. Despite many studies that illustrate the positive outcomes of family strengthening programs and family-focused interventions, their use in communities has not advanced commensurate with their promise. This article offers a rationale for why programming efforts should continue to be directed towards family strengthening efforts as opposed to youth-focused only interventions. In addition, a community-based, family-strengthening alternative is described that addresses issues of youth delinquency while reducing barriers associated with availability, accessibility, and cost.

  18. Connect: An Effective Community-Based Youth Suicide Prevention Program

    Science.gov (United States)

    Bean, Gretchen; Baber, Kristine M.

    2011-01-01

    Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in…

  19. Treatment Plans in Psychiatric Community Housing Programs : Do They Reflect Rehabilitation Principles?

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Visser, Ellen; Caro-Nienhuis, Annemarie D.; van Weeghel, Jaap; Sytema, Sjoerd; Wiersma, Durk

    2012-01-01

    Objective: This study examined the extent to which treatment plans of service users of community housing programs measure up to rehabilitation principles according to the Choose-Get-Keep model of psychiatric rehabilitation. The study evaluates whether these plans correspond with service-user and

  20. Recommendations for scale-up of community-based misoprostol distribution programs.

    Science.gov (United States)

    Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

    2014-06-01

    Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa.

    Directory of Open Access Journals (Sweden)

    Arnaud Setondji Amoussouhoui

    2018-03-01

    Full Text Available Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU, is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care.We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds.This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.

  2. An Evaluation of a Community-Based Psycho-Educational Program for Users of Child Sexual Exploitation Material.

    Science.gov (United States)

    Gillespie, Steven M; Bailey, Alexandra; Squire, Tom; Carey, Melissa L; Eldridge, Hilary J; Beech, Anthony R

    2018-03-01

    Online sexual offenders represent an increasingly large proportion of all sexual offenders. Many of these offenders receive noncustodial sentences, and there is a growing need for community-based interventions. The aim of this study was to evaluate a psycho-educational program for community dwelling users of child sexual exploitation material (CSEM). A total of 92 adult male participants completed self-report measures at pre and post. A subset of participants also completed measures after a follow-up period. Results suggested benefits across depression, anxiety, and stress; social competency, including locus of control and self-esteem; and distorted attitudes. Furthermore, these effects remained 8 to 12 weeks following program completion. Our results suggest that CSEM users are amenable to treatment in the community and that there are beneficial outcomes in affective and interpersonal functioning following psycho-education. These factors represent treatment targets for sexual offenders and are recognized risk factors for contact sexual offense recidivism.

  3. A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

    Science.gov (United States)

    Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

    2016-01-01

    Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

  4. Community-Based Psychosocial Treatment Has an Impact on Social Processing and Functional Outcome in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Eszter Varga

    2018-06-01

    Full Text Available Schizophrenic patients have serious impairments in social cognition, which often persists after significant reduction in clinical symptoms. Community-based psychosocial treatments aim to recover social functioning for mentally ill individuals. Our aim was to examine prospective changes in social cognition and functional outcomes in two groups of schizophrenic patients involved in two forms of community-based psychosocial treatments namely case management (CM and community-based club (CC compared to a matched, treatment as usual (TAU group of patients. We hypothesized that CC and CM groups would exhibit better functional and social cognitive outcomes after a 6-month long psychosocial treatment period. Seventy-five patients participated either in CC, CM or TAU. Both CC and CM took part in community-based psychosocial treatment programs including trainings, such as communication and assertiveness trainings. In addition, CC provided group therapeutic treatments and a continuously available day care where patients had the possibility to participate in various social interactions. All participants were in remission, and on maintenance antipsychotic treatment. Participants were assessed on all study variables at two time points: baseline and after 6 months with a battery of questionnaires that examined affective face perception, affective prosody perception, pragmatic language comprehension and ToM. Our results showed that functional outcomes improved significantly in the CC as well as in the CM groups, in contrast to the TAU group. While analyzing summary scores of social cognition, it was found that only the CC group increased its performance in social cognition. In addition, a significant between-group difference in social cognitive function was found after 6 months between the three groups, with the CC group performing best. When investigating associations between changes in social cognition and changes in functional outcomes during a 6-month long

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

    Science.gov (United States)

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

    2015-08-01

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

  6. Impact of a multifaceted community-based falls prevention program on balance-related psychologic factors.

    Science.gov (United States)

    Filiatrault, Johanne; Gauvin, Lise; Richard, Lucie; Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Corriveau, Hélène

    2008-10-01

    To assess the impact of a multifaceted falls prevention program including exercise and educational components on perceived balance and balance confidence among community-dwelling seniors. Quasi-experimental design. Community-based organizations. Two hundred community-dwelling adults aged 60 years and over recruited by community-based organizations. A 12-week multifaceted falls prevention program including 3 components (a 1-hour group exercise class held twice a week, a 30-minute home exercise module to be performed at least once a week, a 30-minute educational class held once a week). Perceived balance and balance confidence. Multivariate analysis showed that the program was successful in increasing perceived balance in experimental participants. However, balance confidence was not improved by program participation. A multifaceted community-based falls prevention program that was successful in improving balance performance among community-dwelling seniors also had a positive impact on perceived balance. However, the program did not improve participants' balance confidence. These results suggest that balance confidence has determinants other than balance and that new components and/or modifications of existing components of the program are required to achieve maximal benefits for seniors in terms of physical and psychologic outcomes.

  7. 76 FR 21372 - Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions...

    Science.gov (United States)

    2011-04-15

    ...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions.... 111-148, enacted on March 23, 2010) (Affordable Care Act) authorized the Medicare Community-based Care...

  8. Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program

    Science.gov (United States)

    Gil, Elizabeth

    2017-01-01

    The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

  9. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program.

    Science.gov (United States)

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo E; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries ("LMICs"). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program ("TEP"), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

  10. The YMCA Healthy, Fit, and Strong Program: a community-based, family-centered, low-cost obesity prevention/treatment pilot study.

    Science.gov (United States)

    Schwartz, Robert P; Vitolins, Mara Z; Case, L Douglas; Armstrong, Sarah C; Perrin, Eliana M; Cialone, Josephine; Bell, Ronny A

    2012-12-01

    Many resources are available for adults, but there are few community-based programs for overweight and obese children. Community engagement may be instrumental in overcoming barriers physicians experience in managing childhood obesity. Our objective was to design and test the feasibility of a community-based (YMCA), family-centered, low-cost intervention for overweight and obese children. Children 6-11 years over the 85th BMI percentile for age and sex were recruited to YMCA sites in four North Carolina communities. The children had physical activity sessions three times weekly for 3 months (one activity session weekly was family night). The parents received a once-weekly nutrition education class conducted by a registered dietitian using the NC Eat Smart Move More curriculum (10 sessions). Changes in BMI were measured at 3, 6, and 12 months and diet and activity behaviors at 3 and 12 months after baseline. Significant reductions were observed in BMI percentile for age and BMI z-scores at 3, 6, and 12 months. Improvements occurred in dietary and physical activity behaviors, including drinking fewer sugar-sweetened beverages, spending more time in physically active behaviors, and spending less time in sedentary behaviors. The program was low-cost, and qualitative comments suggest the parents and children benefited from the experience. This low-cost YMCA-based intervention was associated with BMI reductions and positive nutritional and activity behavior changes, providing an additional strategy for addressing childhood obesity in community settings.

  11. Self-Esteem and Feelings of Community Connectedness of At-Risk Adolescents Attending Community-Based Afterschool Programs

    Directory of Open Access Journals (Sweden)

    Tina Loughlin

    2013-03-01

    Full Text Available This research investigated the relationship between adolescent afterschool program attendance, self-esteem and feelings of community connectedness. Thirty-nine of the 61 at-risk adolescents enrolled in two federally funded, community based afterschool programs participated in the study. Participants completed a 10-item self-esteem questionnaire and a 5-item section of the Youth Involved in Community Issues Survey (YICI to measure perceptions of community connectedness. Attendance records were also collected from the sites. Data were analyzed using Pearson Correlations. Results indicated that there was not a significant relationship between the total variables. The individual item analysis, however, did find a significant relationship between adolescent community connectedness and self esteem items. Findings suggest that there is a relationship to be explored and strengthened through means of community outreach for adolescents. Conclusions from this study have important implications for youth practice. Specifically, program leaders need to help adolescents get involved in the community as contributing members.

  12. Team sponsors in community-based health leadership programs.

    Science.gov (United States)

    Patterson, Tracy Enright; Dinkin, Donna R; Champion, Heather

    2017-05-02

    Purpose The purpose of this article is to share the lessons learned about the role of team sponsors in action-learning teams as part of community-based health leadership development programs. Design/methodology/approach This case study uses program survey results from fellow participants, action learning coaches and team sponsors to understand the value of sponsors to the teams, the roles they most often filled and the challenges they faced as team sponsors. Findings The extent to which the sponsors were perceived as having contributed to the work of the action learning teams varied greatly from team to team. Most sponsors agreed that they were well informed about their role. The roles sponsors most frequently played were to provide the teams with input and support, serve as a liaison to the community and serve as a sounding board, motivator and cheerleader. The most common challenges or barriers team sponsors faced in this role were keeping engaged in the process, adjusting to the role and feeling disconnected from the program. Practical implications This work provides insights for program developers and community foundations who are interested in building the capacity for health leadership by linking community sponsors with emerging leaders engaged in an action learning experience. Originality/value This work begins to fill a gap in the literature. The role of team sponsors has been studied for single organization work teams but there is a void of understanding about the role of sponsors with multi-organizational teams working to improve health while also learning about leadership.

  13. Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

    Science.gov (United States)

    VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

    2014-01-01

    Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

  14. Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged.

    Science.gov (United States)

    Altman, Irwin M; Swick, Shannon; Parrot, Devan; Malec, James F

    2010-11-01

    To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR). Retrospective analysis of program evaluation data for treatment completers and noncompleters. Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities. Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group). PABIR delivered in home and community settings by certified professional staff on an individualized basis. Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact. Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up. Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. The Role of Occupational Therapy in Community-Based Programming: Addressing Childhood Health Promotion

    Directory of Open Access Journals (Sweden)

    Julie Kugel

    2017-01-01

    Full Text Available Background: Obesity and poor health habits impact youth’s health and occupational participation. Occupational therapy’s role in preventing and treating obesity continues to emerge in the research literature. This article explores the impact of a community-based program emphasizing health and wellness for female youth. Methods: Five girls 11 to 13 years of age participated in the healthy occupations program. Before and after the program, the participants engaged in an individual semi-structured interview and completed the Canadian Occupational Performance Measure and the CATCH Kids Club Questionnaire. The youth participated in a focus group midprogram. Results: The participants were receptive to information regarding healthy behaviors and initiated positive health behavior changes after implementation of a 7-week healthy lifestyle community- based program. Conclusion: Occupational therapy can collaborate with community partners to provide programming focused on health promotion and prevention as part of the interprofessional approach to preventing and treating childhood obesity and building healthier communities.

  16. Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

    Science.gov (United States)

    Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

    2010-04-01

    The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

  17. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program

    Science.gov (United States)

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo e; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries (“LMICs”). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (“TEP”), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP’s implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP’s social impact, challenges, and limitations. The program’s goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program’s cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health. PMID

  18. Feasibility of a community-based Functional Power Training program for older adults

    Directory of Open Access Journals (Sweden)

    Tan QLL

    2018-02-01

    Full Text Available Queenie Lin Ling Tan,1 Lilian Min Yen Chye,1 Daniella Hui Min Ng,1 Mei Sian Chong,1 Tze Pin Ng,1,2 Shiou Liang Wee1,3 1Frailty Research Program, Geriatric Education and Research Institute (GERI, Singapore; 2Department of Psychological Medicine, National University of Singapore, Singapore; 3Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore Purpose: Community-based programs can increase and sustain physical activity participation in older adults, even for those who are physically frail. We studied the feasibility and potential effect of a 12-week structured Functional Power Training (FPT program involving high velocities and low loads for older adults conducted in a common area of their housing estate.Patients and methods: The structured FPT program was conducted in collaboration with a health promotion social enterprise and a community service provider based in a public housing site. We recruited nine inactive residents as participants to the single, group-based, twice-weekly program. Attendance and adverse event(s were recorded throughout the program. The Short Physical Performance Battery, Timed Up and Go (TUG, and 30s Sit-to-Stand tests were used to assess functional outcomes pre- and postprogram. The FRAIL Scale was used to assess their frailty status, and a postprogram experience survey was conducted.Results: Eight subjects (aged 74±10 years completed the program with an average overall attendance of 90.3%, with at least five participants present for each session. Changes in functional outcomes showed a moderate-to-large effect with significant improvement in TUG (p<0.01. In addition, participants either reversed or maintained their frailty status (p<0.01. Overall, the program was perceived to be well structured, engaging, as well as providing physical and psychosocial benefits. No exercise-related adverse events occurred during the program, and participants were keen to recommend this program to others

  19. Engaging Street Youth in an Evaluation of a Community-Based Arts Program

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    Robin Wright

    2008-06-01

    Full Text Available Data from the Edmonton Arts & Youth Feasibility Study (EAYFS was used to ascertain the feasibility of engaging street youth in a structured community-based arts program and an outcome-based evaluation. The study engaged 23 street youth in a ten-week multi-media arts program focused on developing prosocial communication, team-building, and problem-solving skills. Results have shown that street youth are highly interested in artistic endeavors; will participate to the best of their circumstances; and will provide reliable data. The youth and staff reported improved art skills, problem-solving capacity, and prosocial communication as well as a decrease in drug use, depression, loneliness, and a greater sense of enjoyment about life. Strengths of the program included the arts media, the non-judgmental environment, and the support from staff. The study suggests that community-based arts programs for street youth could be subjected to a rigorous outcome-based evaluation.

  20. Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS.

    Science.gov (United States)

    Santiago, Catherine Decarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H

    2013-12-01

    This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.

  1. Homogeneity in Community-Based Rape Prevention Programs: Empirical Evidence of Institutional Isomorphism

    Science.gov (United States)

    Townsend, Stephanie M.; Campbell, Rebecca

    2007-01-01

    This study examined the practices of 24 community-based rape prevention programs. Although these programs were geographically dispersed throughout one state, they were remarkably similar in their approach to rape prevention programming. DiMaggio and Powell's (1991) theory of institutional isomorphism was used to explain the underlying causes of…

  2. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program (TEP

    Directory of Open Access Journals (Sweden)

    Andrea Horvath Marques

    2015-07-01

    Full Text Available The maltreatment of children and adolescents is a global public health problem that affects high and low-middle income countries (LMICs. In the United States, around 1.2 million children suffer from abuse, while in LMICs such as Brazil these rates are much higher (an estimated 28 million children. Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders and general clinical conditions such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (TEP, a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP’s implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP’s social impact, challenges and limitations. The program’s goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program’s cost-effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

  3. Community-level Moderators of a School-Based Childhood Sexual Assault Prevention Program

    OpenAIRE

    Morris, Matthew C.; Kouros, Chrystyna D.; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy

    2016-01-01

    Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Last program compared to a waitlist control condition. Knowledge gains from pre- to post-interv...

  4. Planning PR for a Community-Based Program

    Science.gov (United States)

    Keim, William A.

    1977-01-01

    An essential for public relations is a combination of marketing techniques and an understanding of the community in its social, economic, political, and geographic aspects. Reaching disadvantaged clientele requires the use of community agencies and development of specialized programs. (RT)

  5. Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program: Comparison with Hospital-Based and Academic Programs.

    Science.gov (United States)

    Katzenberg, Charles; Silva, Edna; Young, M Jean; Gilles, Greg

    2018-04-13

    The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population. Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program. A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m 2 , P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths). A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Projecting the long-term impact of school- or community-based mass-treatment interventions for control of Schistosoma infection.

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    Xiaoxia Wang

    Full Text Available Schistosomiasis remains a significant health burden in many areas of the world. Morbidity control, focused on limiting infection intensity through periodic delivery of anti-schistosomal medicines, is the thrust of current World Health Organization guidelines (2006 for reduction of Schistosoma-related disease. A new appreciation of the lifetime impact of repeated Schistosoma infection has directed attention toward strategies for greater suppression of parasite infection per se, with the goal of transmission interruption. Variations in drug schedules involving increased population coverage and/or treatment frequency are now undergoing field trials. However, their relative effectiveness in long-term infection suppression is presently unknown.Our study used available field data to calibrate advanced network models of village-level Schistosoma transmission to project outcomes of six different community- or school age-based programs, as compared to the impact of current 2006 W.H.O. recommended control strategies. We then scored the number of years each of 10 typical villages would remain below 10% infection prevalence (a practicable level associated with minimal prevalence of disease. All strategies that included four annual treatments effectively reduced community prevalence to less than 10%, while programs having yearly gaps ('holidays' failed to reach this objective in half of the communities. Effective post-program suppression of infection prevalence persisted in half of the 10 villages for 7-10 years, whereas in five high-risk villages, program effects on prevalence lasted zero to four years only.At typical levels of treatment adherence (60 to 70%, current WHO recommendations will likely not achieve effective suppression of Schistosoma prevalence unless implemented for ≥6 years. Following more aggressive 4 year annual intervention, some communities may be able to continue without further intervention for 8-10 years, while in higher

  7. Youth Perspectives on Meaningful Participation in Community Based Programs: A Qualitative Assessment

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    Sherer W. Royce

    2009-12-01

    Full Text Available Allowing the voiceless to have a voice is a tenet of empowerment. This paper highlights research that employed a participatory action research framework to gain a better understanding of young people’s perceptions about youth empowerment and acquire their perspective (voice about the meaningfulness of participation in out-of-school advocacy and volunteer program activities. Using Photovoice, the research provides a missing point of view in youth empowerment model development. Results indicate that the quality of a youth’s participation in a community-based program is determined by 1 youth expressing themselves without censorship, 2 occasions for youth to expand their social networks with youth and adults, and 3 adults observing and valuing youth contributions. These findings raise implications for community-based, youth empowerment programs including program philosophy, program procedures, youth empowerment content and activities, and adult leadership style. The findings may assist practitioners when designing youth empowering activities and researchers when operationalizing youth empowerment.

  8. Wiisokotaatiwin: development and evaluation of a community-based palliative care program in Naotkamegwanning First Nation.

    Science.gov (United States)

    Nadin, Shevaun; Crow, Maxine; Prince, Holly; Kelley, Mary Lou

    2018-04-01

    Approximately 474 000 Indigenous people live in 617 First Nations communities across Canada; 125 of those communities are located in Ontario, primarily in rural and remote areas. Common rural health challenges, including for palliative care, involve quality and access. The need for culturally relevant palliative care programs in First Nations communities is urgent because the population is aging with a high burden of chronic and terminal disease. Because local palliative care is lacking, most First Nations people now leave their culture, family and community to receive care in distant hospitals or long-term care homes. Due to jurisdictional issues, a policy gap exists where neither federal nor provincial governments takes responsibility for funding palliative care in First Nations communities. Further, no Canadian program models existed for how different levels of government can collaborate to fund and deliver palliative care in First Nations communities. This article describes an innovative, community-based palliative care program (Wiisokotaatiwin) developed in rural Naotkamegwanning, and presents the results of a process evaluation of its pilot implementation. The evaluation aimed to (i) document the program's pilot implementation, (ii) assess progress toward intended program outcomes and (iii) assess the perceived value of the program. The Wiisokotaatiwin Program was developed and implemented over 5 years using participatory action research (http://www.eolfn.lakeheadu.ca). A mixed-method evaluation approach was adopted. Descriptive data were extracted from program documents (eg client registration forms). Client tracking forms documented service provision data for a 4-month sample period. Quantitative and qualitative data were collected through client and family member questionnaires (n=7) and healthcare provider questionnaires (n=22). A focus group was conducted with the program leadership team responsible for program development. Quantitative data were

  9. Perceived Benefits and Barriers of a Community-Based Diabetes Prevention and Management Program.

    Science.gov (United States)

    Shawley-Brzoska, Samantha; Misra, Ranjita

    2018-03-13

    This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants' perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% females; 62% diabetic; 77% had adequate health literacy); 79% of participants completed the benefits and barriers survey. Principal component analysis indicated two components representing benefits (Cronbach's α = 0.83) and barriers (α = 0.65). The majority perceived high benefits and low barriers to program participation; benefits included helpful interaction with health coach or program leader (73%), improved lifestyle modification (65%) due to the program, and satisfaction with the program (75%). Open-ended questions confirmed themes related to benefits of program participation, suggestion for programmatic improvements as well as barriers to participation. Participant feedback could be used to guide interventions and tailor future program implementation.

  10. Development of a community-based diabetes and hypertension preventive program.

    Science.gov (United States)

    Wang, C Y; Abbott, L J

    1998-12-01

    The purpose of this project was to develop rapport with a Chinese Community Association and then establish preventive diabetic and hypertension programs with the Chinese in Chinatown, Hawaii. Subjects were recruited from this Chinese Community Association. Two hundred Chinese responded to the invitation. Among these, 75 individuals had either Type 2 diabetes, hypertension or both. Thirty-six males and 39 females ranging in age from 51 years old to 96 years old (Mean = 71.76, SD = 9.58) participated. Surveys and educational programs were carried out in Chinese. Results were described in terms of quantitative measures (family support and health outcomes) and qualitative experiences (case studies). Eighty percent of participants had decreased their diastolic blood pressure from above 95 mmHg to below 90 mmHg and systolic blood pressure from above 155 mmHg to below 140 mmHg. Ninety-five (n = 71) percent of participants had maintained their glucose level within the 90 mg/dL to 150 mg/dL range with a mean reduction of 57.86 mg/dL in one year. The hardest thing for families was the glucose self-monitoring. Case studies suggested that open-minded active listening and persistence formed the basis for developing a culturally sensitive community-based self management program for chronic diseases. Collaboration among the community, public health nurses, and diabetes nurse educators facilitated the process of community education and health promotion.

  11. Organizational Readiness for Change in Correctional and Community Substance Abuse Programs

    Science.gov (United States)

    Lehman, Wayne E. K.; Greener, Jack M.; Rowan-Szal, Grace A.; Flynn, Patrick M.

    2012-01-01

    Significant needs exist for increased and better substance abuse treatment services in our nation's prisons. The TCU Organizational Readiness for Change (ORC) survey has been widely used in community-based treatment programs and evidence is accumulating for relationships between readiness for change and implementation of new clinical practices.…

  12. Community-level moderators of a school-based childhood sexual assault prevention program.

    Science.gov (United States)

    Morris, Matthew C; Kouros, Chrystyna D; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy

    2017-01-01

    Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. 75 FR 473 - Community Express Pilot Program

    Science.gov (United States)

    2010-01-05

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

  14. Literature Study on Community Participation in Community Based Rural Water Supply and Sanitation Programs

    Science.gov (United States)

    Nurbaiti, Siti Robiah; Bambang, Azis Nur

    2018-02-01

    Clean water and proper sanitation are basic human needs, existing procurement in the Law of the Republic of Indonesia Number 7 of 2004 on Water Resources and Government Regulation of the Republic of Indonesia Number 16 of 2005 on Development of Water Supply System, which the state guarantees the right of everyone water for basic daily minimum needs to meet the needs of a healthy, productive, and clean life. Norms every society has the right to get clean air to meet basic daily needs. One of the points in the goal of sustainable development goals (SDGs) in the environment sector is the guarantee of the community to achieve universal access to clean water and sanitation. The SDG High Level Panel held in 2012 calls on countries around the world to do so in 2030. Fulfillment of clean air and sanitation in Indonesia is conducted through two sectoral approaches, the first through agencies, or related agencies and the second through a Society. In accordance with its community-based principles, the role itself is a key factor in the success of the program. Therefore, the purpose of this paper is to find out the forms of community participation and the factors that influence participation in community-based water supply and sanitation programs in the field of literature studies of previous research such as research journals, theses, theses, dissertations and related books This literature study topic.

  15. Literature Study on Community Participation in Community Based Rural Water Supply and Sanitation Programs

    Directory of Open Access Journals (Sweden)

    Robiah Nurbaiti Siti

    2018-01-01

    Full Text Available Clean water and proper sanitation are basic human needs, existing procurement in the Law of the Republic of Indonesia Number 7 of 2004 on Water Resources and Government Regulation of the Republic of Indonesia Number 16 of 2005 on Development of Water Supply System, which the state guarantees the right of everyone water for basic daily minimum needs to meet the needs of a healthy, productive, and clean life. Norms every society has the right to get clean air to meet basic daily needs. One of the points in the goal of sustainable development goals (SDGs in the environment sector is the guarantee of the community to achieve universal access to clean water and sanitation. The SDG High Level Panel held in 2012 calls on countries around the world to do so in 2030. Fulfillment of clean air and sanitation in Indonesia is conducted through two sectoral approaches, the first through agencies, or related agencies and the second through a Society. In accordance with its community-based principles, the role itself is a key factor in the success of the program. Therefore, the purpose of this paper is to find out the forms of community participation and the factors that influence participation in community-based water supply and sanitation programs in the field of literature studies of previous research such as research journals, theses, theses, dissertations and related books This literature study topic.

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

    Directory of Open Access Journals (Sweden)

    Tali Cassidy

    2016-02-01

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

  17. Impact of a community-based osteoporosis and fall prevention program on fracture incidence.

    Science.gov (United States)

    Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Karlsson, Nadine; Löfman, Owe; Timpka, Toomas; Möller, Margareta

    2005-06-01

    Associations between a 10-year community-based osteoporosis and fall prevention program and fracture incidence amongst middle-aged and elderly residents in an intervention community are studied, and comparisons are made with a control community. A health-education program was provided to all residents in the intervention community, which addressed dietary intake, physical activity, smoking habits and environmental risk factors for osteoporosis and falls. Both communities are small, semi-rural and situated in Ostergotland County in southern Sweden. The analysis is based on incidences of forearm fractures in the population 40 years of age or older, and hip fractures in the population 50 years of age or older. Data for three 5-year periods (pre-, early and late intervention) are accumulated and compared. In the intervention community, forearm fracture incidence decreased in women. There are also tendencies towards decreasing forearm fracture incidence in men, and towards decreasing trochanteric hip fracture incidences in women and in men in the late intervention period. No such changes in fracture incidences are found in the control community. Cervical hip fracture incidence did not change in the intervention and the control communities. Although the reported numbers of fractures are small (a total of 451 forearm and 357 hip fractures), the numbers are based on total community populations and thus represent a true difference. The decrease in forearm fracture incidence among women, and the tendency towards decreasing trochanteric hip fractures, in contrast to the absence of change in cervical hip fractures, might be mainly due to a more rapid effect of fall preventive measures than an increase in bone strength in the population. For the younger age groups an expected time lag between intervention and effect might invalidate the short follow-up period for outcome measurements. Thus, the effect of the 10-year intervention program on fracture incidence should be followed

  18. Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT Team

    Directory of Open Access Journals (Sweden)

    Nicole B. Washington, DO, Assistant Professor

    2012-01-01

    Full Text Available Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI, haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.

  19. A Community-Based Early Intervention Program for Toddlers with Autism Spectrum Disorders

    Science.gov (United States)

    Rollins, Pamela Rosenthal; Campbell, Michelle; Hoffman, Renee Thibodeau; Self, Kayli

    2016-01-01

    This study examined Pathways Early Autism Intervention, a community-based, parent-mediated, intensive behavioral and developmental intervention program for children with autism spectrum disorders that could be used as a model for state-funded early intervention programs. A single-subject, multiple-baseline, across-participants design was used.…

  20. Understanding Program Planning Theory and Practice in a Feminist Community-Based Organization

    Science.gov (United States)

    Bracken, Susan J.

    2011-01-01

    The purpose of this article is to discuss feminist-program-planning issues, drawing from a critical ethnographic study of a Latin American feminist community-based organization. The research findings discuss the centrality of feminist identity to understanding and analyzing day-to-day program-planning process issues within a feminist…

  1. Assessing Clinical Trial-Associated Workload in Community-Based Research Programs Using the ASCO Clinical Trial Workload Assessment Tool.

    Science.gov (United States)

    Good, Marjorie J; Hurley, Patricia; Woo, Kaitlin M; Szczepanek, Connie; Stewart, Teresa; Robert, Nicholas; Lyss, Alan; Gönen, Mithat; Lilenbaum, Rogerio

    2016-05-01

    Clinical research program managers are regularly faced with the quandary of determining how much of a workload research staff members can manage while they balance clinical practice and still achieve clinical trial accrual goals, maintain data quality and protocol compliance, and stay within budget. A tool was developed to measure clinical trial-associated workload, to apply objective metrics toward documentation of work, and to provide clearer insight to better meet clinical research program challenges and aid in balancing staff workloads. A project was conducted to assess the feasibility and utility of using this tool in diverse research settings. Community-based research programs were recruited to collect and enter clinical trial-associated monthly workload data into a web-based tool for 6 consecutive months. Descriptive statistics were computed for self-reported program characteristics and workload data, including staff acuity scores and number of patient encounters. Fifty-one research programs that represented 30 states participated. Median staff acuity scores were highest for staff with patients enrolled in studies and receiving treatment, relative to staff with patients in follow-up status. Treatment trials typically resulted in higher median staff acuity, relative to cancer control, observational/registry, and prevention trials. Industry trials exhibited higher median staff acuity scores than trials sponsored by the National Institutes of Health/National Cancer Institute, academic institutions, or others. The results from this project demonstrate that trial-specific acuity measurement is a better measure of workload than simply counting the number of patients. The tool was shown to be feasible and useable in diverse community-based research settings. Copyright © 2016 by American Society of Clinical Oncology.

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

    Science.gov (United States)

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

    2014-08-01

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

  3. Barriers to community-based drug dependence treatment: implications for police roles, collaborations and performance indicators

    Science.gov (United States)

    Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong

    2016-01-01

    Introduction Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust

  4. Factors related to leader implementation of a nationally disseminated community-based exercise program: a cross-sectional study

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    Economos Christina D

    2008-12-01

    Full Text Available Abstract Background The benefits of community-based health programs are widely recognized. However, research examining factors related to community leaders' characteristics and roles in implementation is limited. Methods The purpose of this cross-sectional study was to use a social ecological framework of variables to explore and describe the relationships between socioeconomic, personal/behavioral, programmatic, leadership, and community-level social and demographic characteristics as they relate to the implementation of an evidence-based strength training program by community leaders. Eight-hundred fifty-four trained program leaders in 43 states were invited to participate in either an online or mail survey. Corresponding community-level characteristics were also collected. Programmatic details were obtained from those who implemented. Four-hundred eighty-seven program leaders responded to the survey (response rate = 57%, 78% online and 22% by mail. Results Of the 487 respondents, 270 implemented the program (55%. One or more factors from each category – professional, socioeconomic, personal/behavioral, and leadership characteristics – were significantly different between implementers and non-implementers, determined by chi square or student's t-tests as appropriate. Implementers reported higher levels of strength training participation, current and lifetime physical activity, perceived support, and leadership competence (all p Conclusion Among this sample of trained leaders, several factors within the professional, socioeconomic, personal/behavioral, and leadership categories were related to whether they implemented a community-based exercise program. It may benefit future community-based physical activity program disseminations to consider these factors when selecting and training leaders.

  5. The Sydney Diabetes Prevention Program: A community-based translational study

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    Farrell Louise

    2010-06-01

    Full Text Available Abstract Background Type 2 diabetes is a major public health problem in Australia with prevalence increasing in parallel with increasing obesity. Prevention is an essential component of strategies to reduce the diabetes burden. There is strong and consistent evidence from randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet, increases physical activity and achieves weight loss in at risk people. The current challenge is to translate this evidence into routine community settings, determine feasible and effective ways of delivering the intervention and providing on-going support to sustain successful behavioural changes. Methods/Design The Sydney Diabetes Prevention Program (SDPP is a translational study which will be conducted in 1,550 participants aged 50-65 years (including 100 indigenous people aged 18 years and older at high risk of future development of diabetes. Participants will be identified through a screening and recruitment program delivered through primary care and will be offered a community-based lifestyle modification intervention. The intervention comprises an initial individual session and three group sessions based on behaviour change principles and focuses on five goals: 5% weight loss, 210 min/week physical activity (aerobic and strength training exercise, limit dietary fat and saturated fat to less than 30% and 10% of energy intake respectively, and at least 15 g/1000 kcal dietary fibre. This is followed by 3-monthly contact with participants to review progress and offer ongoing lifestyle advice for 12 months. The effectiveness and costs of the program on diabetes-related risk factors will be evaluated. Main outcomes include changes in weight, physical activity, and dietary changes (fat, saturated fat and fibre intake. Secondary outcomes include changes in waist circumference, fasting plasma glucose, blood pressure, lipids, quality of life

  6. Planning community-based assessments of HIV educational intervention programs in sub-Saharan Africa.

    Science.gov (United States)

    Kelcey, Ben; Shen, Zuchao

    2017-08-01

    A key consideration in planning studies of community-based HIV education programs is identifying a sample size large enough to ensure a reasonable probability of detecting program effects if they exist. Sufficient sample sizes for community- or group-based designs are proportional to the correlation or similarity of individuals within communities. As a result, efficient and effective design requires reasonable a priori estimates of the correlational structure among individuals within communities. In this study, we investigate the degree of correlation among individuals within communities and regions using samples of sixth-grade adolescents from 609 local area district communities and 122 regions in 15 sub-Saharan African nations. We develop nation-specific and international summaries of these correlations using variance partitioning coefficients from multilevel models and subsequently assess the extent to which different types of background variables delineate key sources of these correlations. The results suggest persistent differences among communities and regions and that the degree of correlation among individuals within communities varied considerably by nation. The findings underscore the importance of empirically derived values of design parameters that are anchored in evidence specific to the outcome, nation and context of the planned study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Shifting the evaluative gaze: Community-based program evaluation in the homeless sector

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    Bruce Wallace

    2015-09-01

    Full Text Available Homelessness is a growing social issue that is a consequence of structural inequities and contributor to the development of health inequities. Community-based research (CBR has been proposed as an effective research strategy for addressing health equities and promoting social justice through participatory processes. The purpose of this article is to examine the application of CBR principles and practices in the homeless sector and the implications for the production of knowledge and social change to address homelessness. Drawing on our experiences as researchers and service providers, we reflect on the significant successes and challenges associated with using CBR in the homelessness sector. In our discussion we emphasise insights, challenges and lessons learned from a community-university partnership that focused on an evaluation of a transitional shelter program in a large urban centre where housing is expensive and often unavailable. Keywords: Homelessness, housing, transitional housing, transitional shelter, program evaluation, community-based research

  8. PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR.

    Science.gov (United States)

    Du Mont, Janice; Mirzaei, Aftab; Macdonald, Sheila; White, Meghan; Kosa, Daisy; Reimer, Linda

    2014-12-01

    Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way. Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada. In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers. We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner. The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

  9. Community health worker programs in India: a rights-based review.

    Science.gov (United States)

    Bhatia, Kavita

    2014-09-01

    This article presents a historical review of national community health worker (CHW) programs in India using a gender- and rights-based lens. The aim is to derive relevant policy implications to stem attrition and enable sustenance of large-scale CHW programs. For the literature review, relevant government policies, minutes of meetings, reports, newspaper articles and statistics were accessed through official websites and a hand search was conducted for studies on the rights-based aspects of large-scale CHW programs. The analysis shows that the CHWs in three successive Indian national CHW programs have consistently asked for reforms in their service conditions, including increased remuneration. Despite an evolution in stakeholder perspectives regarding the rights of CHWs, service reforms are slow. Performance-based payments do not provide the financial security expected by CHWs as demonstrated in the recent Accredited Social Health Activist (ASHA) program. In most countries, CHWs, who are largely women, have never been integrated into the established, salaried team of health system workers. The two hallmark characteristics of CHWs, namely, their volunteer status and the flexibility of their tasks and timings, impede their rights. The consequences of initiating or neglecting standardization should be considered by all countries with large-scale CHW programs like the ASHA program. © Royal Society for Public Health 2014.

  10. Increasing access to evidence-based smoking cessation treatment: effectiveness of a free nicotine patch program among Chinese immigrants.

    Science.gov (United States)

    Shelley, Donna; Nguyen, Nam; Peng, Cha-Hui; Chin, Margaret; Chang, Ming-der; Fahs, Marianne

    2010-04-01

    Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

  11. Integrating community pharmacy into community based anti-retroviral therapy program: A pilot implementation in Abuja, Nigeria.

    Directory of Open Access Journals (Sweden)

    Yohanna Kambai Avong

    Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.

  12. Community-based physical activity as adjunctive smoking cessation treatment: Rationale, design, and baseline data for the Lifestyle Enhancement Program (LEAP randomized controlled trial

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    Mark W. Vander Weg

    2018-03-01

    Full Text Available Despite advances in behavioral and pharmacological treatment for tobacco use and dependence, quit rates remain suboptimal. Increasing physical activity has shown some promise as a strategy for improving cessation outcomes. However, initial efficacy studies focused on intensive, highly structured exercise programs that may not be applicable to the general population of smokers. We describe the rationale and study design and report baseline participant characteristics from the Lifestyle Enhancement Program (LEAP, a two-group, randomized controlled trial. Adult smokers who engaged in low levels of leisure time physical activity were randomly assigned to treatment conditions consisting of an individualized physical activity intervention delivered by health fitness instructors in community-based exercise facilities or an equal contact wellness control. All participants received standard cognitive behavioral smoking cessation counseling combined with nicotine replacement therapy. The primary outcomes are seven-day point prevalence abstinence at seven weeks, six- and 12 months. Secondary outcomes include self-reported physical activity, dietary intake, body mass index, waist circumference, percent body fat, and nicotine withdrawal symptoms. Participants consist of 392 sedentary smokers (mean [standard deviation] age = 44.6 [10.2] = years; 62% female; 31% African American. Results reported here provide information regarding experiences recruiting smokers willing to change multiple health behaviors including smoking and physical activity.

  13. Local Observations, Global Connections: An Educational Program Using Ocean Networks Canada's Community-Based Observatories

    Science.gov (United States)

    Pelz, M.; Hoeberechts, M.; Ewing, N.; Davidson, E.; Riddell, D. J.

    2014-12-01

    Schools on Canada's west coast and in the Canadian Arctic are participating in the pilot year of a novel educational program based on analyzing, understanding and sharing ocean data collected by cabled observatories. The core of the program is "local observations, global connections." First, students develop an understanding of ocean conditions at their doorstep through the analysis of community-based observatory data. Then, they connect that knowledge with the health of the global ocean by engaging with students at other schools participating in the educational program and through supplemental educational resources. Ocean Networks Canada (ONC), an initiative of the University of Victoria, operates cabled ocean observatories which supply continuous power and Internet connectivity to a broad suite of subsea instruments from the coast to the deep sea. This Internet connectivity permits researchers, students and members of the public to download freely available data on their computers anywhere around the globe, in near real-time. In addition to the large NEPTUNE and VENUS cabled observatories off the coast of Vancouver Island, British Columbia, ONC has been installing smaller, community-based cabled observatories. Currently two are installed: one in Cambridge Bay, Nunavut and one at Brentwood College School, on Mill Bay in Saanich Inlet, BC. Several more community-based observatories are scheduled for installation within the next year. The observatories support a variety of subsea instruments, such as a video camera, hydrophone and water quality monitor and shore-based equipment including a weather station and a video camera. Schools in communities hosting an observatory are invited to participate in the program, alongside schools located in other coastal and inland communities. Students and teachers access educational material and data through a web portal, and use video conferencing and social media tools to communicate their findings. A series of lesson plans

  14. Assessing participation in community-based physical activity programs in Brazil.

    Science.gov (United States)

    Reis, Rodrigo S; Yan, Yan; Parra, Diana C; Brownson, Ross C

    2014-01-01

    This study aimed to develop and validate a risk prediction model to examine the characteristics that are associated with participation in community-based physical activity programs in Brazil. We used pooled data from three surveys conducted from 2007 to 2009 in state capitals of Brazil with 6166 adults. A risk prediction model was built considering program participation as an outcome. The predictive accuracy of the model was quantified through discrimination (C statistic) and calibration (Brier score) properties. Bootstrapping methods were used to validate the predictive accuracy of the final model. The final model showed sex (women: odds ratio [OR] = 3.18, 95% confidence interval [CI] = 2.14-4.71), having less than high school degree (OR = 1.71, 95% CI = 1.16-2.53), reporting a good health (OR = 1.58, 95% CI = 1.02-2.24) or very good/excellent health (OR = 1.62, 95% CI = 1.05-2.51), having any comorbidity (OR = 1.74, 95% CI = 1.26-2.39), and perceiving the environment as safe to walk at night (OR = 1.59, 95% CI = 1.18-2.15) as predictors of participation in physical activity programs. Accuracy indices were adequate (C index = 0.778, Brier score = 0.031) and similar to those obtained from bootstrapping (C index = 0.792, Brier score = 0.030). Sociodemographic and health characteristics as well as perceptions of the environment are strong predictors of participation in community-based programs in selected cities of Brazil.

  15. The Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service.

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    Amanda J Wade

    Full Text Available Hepatitis C treatment uptake in Australia is low. To increase access to hepatitis C virus treatment for people who inject drugs, we developed a community-based, nurse-led service that linked a viral hepatitis service in a tertiary hospital to primary care clinics, and resulted in hepatitis C treatment provision in the community.A retrospective cohort study of patients referred to the community hepatitis service was undertaken to determine the cascade of care. Logistic regression analyses were used to identify predictors of hepatitis C treatment uptake.Four hundred and sixty-two patients were referred to the community hepatitis service; 344 attended. Among the 279 attendees with confirmed chronic hepatitis C, 257 (99% reported ever injecting drugs, and 124 (48% injected in the last month. Of 201 (72% patients who had their fibrosis staged, 63 (31% had F3-F4 fibrosis. Fifty-five patients commenced hepatitis C treatment; 26 (47% were current injectors and 25 (45% had F3-F4 fibrosis. Nineteen of the 27 (70% genotype 1 patients and 14 of the 26 (54% genotype 3 patients eligible for assessment achieved a sustained virologic response. Advanced fibrosis was a significant predictor of treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006.Our community hepatitis service produced relatively high rates of fibrosis assessment, hepatitis C treatment uptake and cure, among people who inject drugs. These findings highlight the potential benefits of providing community-based hepatitis C care to people who inject drugs in Australia-benefits that should be realised as direct-acting antiviral agents become available.

  16. Implementing exercise in cancer care: study protocol to evaluate a community-based exercise program for people with cancer

    OpenAIRE

    Cormie, Prue; Lamb, Stephanie; Newton, Robert U.; Valentine, Lani; McKiernan, Sandy; Spry, Nigel; Joseph, David; Taaffe, Dennis R.; Doran, Christopher M.; Galv?o, Daniel A.

    2017-01-01

    Background Clinical research has established the efficacy of exercise in reducing treatment-related side-effects and increasing wellbeing in people with cancer. Major oncology organisations have identified the importance of incorporating exercise in comprehensive cancer care but information regarding effective approaches to translating evidence into practice is lacking. This paper describes the implementation of a community-based exercise program for people with cancer and the protocol for pr...

  17. Healthy Native Community Fellowship: An Indigenous Leadership Program to Enhance Community Wellness

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    Rebecca Rae

    2016-11-01

    Full Text Available The Healthy Native Communities Fellowship (HNCF is a grassroots evidence-based mentorship and leadership program that develops the skills and community-building capacities of leaders and community teams to improve health status through several intermediate social and cultural mechanisms: (a strengthening social participation (also known as social capital or cohesion; (b strengthening cultural connectedness and revitalization of cultural identity; and (c advocating for health-enhancing policies, practices, and programs that strengthen systems of prevention and care, as well as address the structural social determinants of health. This leadership program uses a community-based participatory research (CBPR approach and participatory evaluation to investigate how the work of local American Indian and Alaska Native leaders (fellows and their community coalitions contributes to individual, family, and community level health outcomes.

  18. Principles from history, community psychology and developmental psychology applied to community based programs for deinstitutionalized youth

    OpenAIRE

    Levine, Murray

    2007-01-01

    ABSTRACT: This article analyses the issues of the deinstitutionalization of youth, and the development of community based services, using some historical data and some of the principles of community psychology. The basic premise is that there is no such thing as a social vacuum. All programs are implemented and function in an elaborate social context. RESUMO: Este artigo analisa as questões referentes à desinstitunalização dos jovens e ao desenvolvimento de serviços ...

  19. Strategic Partnerships that Strengthen Extension's Community-Based Entrepreneurship Programs: An Example from Maine

    Science.gov (United States)

    Bassano, Louis V.; McConnon, James C., Jr.

    2011-01-01

    This article explains how Extension can enhance and expand its nationwide community-based entrepreneurship programs by developing strategic partnerships with other organizations to create highly effective educational programs for rural entrepreneurs. The activities and impacts of the Down East Micro-Enterprise Network (DEMN), an alliance of three…

  20. Impact of a community-based osteoporosis and fall prevention program on fracture incidence

    OpenAIRE

    Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Karlsson, Nadine; Löfman, Owe; Timpka, Toomas; Möller, Margareta

    2005-01-01

    Artikkelen rapporterer en studie hvor hensikten var å utforske om kommunebasert intervensjonsprogram for osteoporose og fallforebygging er assosiert med reduksjon av forekomst på overarms- og hoftebrudd eller ikke blant middelaldrende og eldre. Associations between a 10-year community-based osteoporosis and fall prevention program and fracture incidence amongst middle-aged and elderly residents in an intervention community are studied, and comparisons are made with a control community. A h...

  1. CO-CD base management model of Universitas Terbuka community service program

    Science.gov (United States)

    Kridasakti, S. W.; Sudirah; Siregar, H.

    2018-03-01

    These studies were to respond whether the UT social-aid management had been executed under CO-CD principles (Ife J. 1995) and what CO-CD base community service management model can be built. The goals of these evaluational studies were UT social-aid managerial performance profile (2011-2013) and CO-CD management model development. The methods used were Survey and FGD. For data collection were involving the UT officers, the counterparts, and the documents. The analysis used combination between the Performance Analysis (Irawan P., 2003) and the CIPP (Stuffelbeam, D, L., & Shinkfield, A, J., 1985). The findings showed that the quantitative targeting in program completion was credible in achievement (85%). However, the “qulitative targeting” of the management goals was indicating far from a good-stage (≤5.0_Interval-Force: 1-10 Scale). The “Gap” was due to the absent of socialization_needs-analysis_maintenance_release factors on the UT social-service grand-policy. The trial of CO-CD Base Management Model had been imposed to the community that turned out to be very effective to self-help, and the ensuing SOP had been successfully defined. Conclusion, ‘CO-CD Principles’ were not designed in UT community service programs management. However, if efficiency and effectivity likely to be achieved, the SOP of ‘CO-CD Base Management Model has to be adopted.

  2. Evaluation of a Telephone-Delivered, Community-Based Collaborative Care Management Program for Caregivers of Older Adults with Dementia.

    Science.gov (United States)

    Mavandadi, Shahrzad; Wray, Laura O; DiFilippo, Suzanne; Streim, Joel; Oslin, David

    2017-09-01

    To evaluate whether a community-based, telephone-delivered, brief patient/caregiver-centered collaborative dementia care management intervention is associated with improved caregiver and care recipient (CR) outcomes. Longitudinal program evaluation of a clinical intervention; assessments at baseline and 3- and 6-month follow-up. General community. Caregivers (N = 440) of older, community-dwelling, low-income CRs prescribed a psychotropic medication by a primary care provider who met criteria for dementia and were enrolled in the SUpporting Seniors Receiving Treatment And INtervention (SUSTAIN) program for older adults. Dementia care management versus clinical evaluation only. Perceived caregiving burden and caregiver general health (primary outcomes); CR neuropsychiatric symptoms and caregiver distress in response to CRs' challenging dementia-related behaviors (secondary outcomes). Caregivers were, on average, 64.0 (SD: 11.8) years old and 62.6% provided care for the CR for 20 or more hours per week. The majority of the sample was female (73.2%), non-Hispanic White (90.2%), and spousal caregivers (72.5%). Adjusted longitudinal models of baseline and 3- and 6-month data suggest that compared with caregivers receiving clinical evaluation only, caregivers receiving care management reported greater reductions in burden over time. Subgroup analyses also showed statistically significant reductions in caregiver-reported frequency of CR dementia-related behaviors and caregiver distress in response to those symptoms at 3-month follow-up. A community-based, telephone-delivered care management program for caregivers of individuals with dementia is associated with favorable caregiver and CR-related outcomes. Findings support replication and further research in the impact of tailored, collaborative dementia care management programs that address barriers to access and engagement. Published by Elsevier Inc.

  3. Child and Parent Voices on a Community-Based Prevention Program (FAST)

    Science.gov (United States)

    Fearnow-Kenney, Melodie; Hill, Patricia; Gore, Nicole

    2016-01-01

    Families and Schools Together (FAST) is a collaborative program involving schools, families, and community-based partners in efforts to prevent substance use, juvenile delinquency, school failure, child abuse and neglect, mental health problems, and violence. Although evaluated extensively, there remains a dearth of qualitative data on child and…

  4. Preventing Parolees from Returning to Prison through Community-Based Reintegration

    Science.gov (United States)

    Zhang, Sheldon X.; Roberts, Robert E. L.; Callanan, Valerie J.

    2006-01-01

    In the late 1990s, California legislators funded a statewide, community-based correctional program intended to reduce parolee recidivism. Overseen by the California Department of Corrections, the Preventing Parolee Crime Program (PPCP) provided literacy training, employment services, housing assistance, and substance abuse treatment to tens of…

  5. A community-based program evaluation of community competency trainings.

    Science.gov (United States)

    Hanssmann, Christoph; Morrison, Darius; Russian, Ellery; Shiu-Thornton, Sharyne; Bowen, Deborah

    2010-01-01

    Transgender and gender-nonconforming individuals encounter a multitude of barriers to accessing clinically and culturally competent health care. One strategy to increase the quality and competence of care delivery is workplace trainings. This study describes a community-based program for the evaluation of this type of training. Using a mixed-methods approach, the research team assessed the effectiveness of three competency trainings administered by a local nonprofit organization in the Northwest United States. Quantitative data indicated a significant shift in self-assessed knowledge associated with completion of the training. Qualitative data confirmed this result and revealed a number of important themes about the effect of the trainings on providers and their ability to implement knowledge and skills in practice. Clinical considerations are proposed for providers who seek similar trainings and who aim to increase clinical and cultural competency in delivering care to transgender and gender-nonconforming patients and clients.

  6. Community-based rehabilitation offers cost-effective epilepsy treatment in rural Guinea-Bissau

    NARCIS (Netherlands)

    van Diessen, Eric; van der Maas, Frank; Cabral, Vladimir; Otte, Willem M

    Treatment of epilepsy in low-income countries is a challenge considering the lack of resources, availability of antiepileptic drugs, and cultural beliefs. We used a community-based rehabilitation (CBR) service for the detection, monitoring, and treatment of epilepsy. A local network of trained

  7. Small-grants programs: lessons from community-based approaches to changing nutrition environments.

    Science.gov (United States)

    Johnson, Donna B; Smith, Lynne T; Bruemmer, Barbara

    2007-02-01

    Providing small grants to community organizations can be an effective way to encourage changes in the environment that support better nutrition. This is effective because these organizations can provide insights into their communities, ready-made relationships with community members, and the trust of the community. Small-grants programs are more likely to be successful when they are tailored to the needs of individual communities, led by organizations that have established reputations with the community, fully supported by the lead community organization, and engage local partners that complement the skills and resources of the lead organization. An evaluation of a small-grants program, Grants for Healthy Youth, found that grantees developed unique approaches to improving their community nutrition environments, gained experience and skills in program development, built partnerships, and received recognition for their project work. Grantees faced some common barriers, especially with program evaluation. Small-grants programs can be an effective way to improve community nutrition environments, but granting agencies need to provide effective technical assistance to communities throughout the process.

  8. A Community-Supported Clinic-Based Program for Prevention of Violence against Pregnant Women in Rural Kenya

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    Janet M. Turan

    2013-01-01

    Full Text Available Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV. We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya. Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n=2 groups and in-depth interviews (n=25 with healthcare workers and community members. Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37% reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting. Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

  9. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

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    Mercy Abbey

    2017-01-01

    Full Text Available Abstract Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. Results The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. Conclusion We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  10. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach.

    Science.gov (United States)

    Abbey, Mercy; Bartholomew, L Kay; Chinbuah, Margaret A; Gyapong, Margaret; Gyapong, John O; van den Borne, Bart

    2017-01-25

    This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  11. Perspectives on community gardens, community kitchens and the Good Food Box program in a community-based sample of low-income families.

    Science.gov (United States)

    Loopstra, Rachel; Tarasuk, Valerie

    2013-01-08

    Growing recognition of the problem of household food insecurity in Canada has meant public health practitioners are looking for effective ways to ameliorate this problem in their communities. Community gardens, community kitchens, and food box programs can offer nutritious foods for comparably lower costs, however, the uptake and perceptions of these programs in populations at risk of food insecurity have not been evaluated. Building on a previous finding of low program participation among 485 families living in high-poverty neighbourhoods in Toronto, the objective of this study was to understand reasons for non-participation. One year after the baseline study, 371 families were interviewed a second time and were asked to provide their reasons for not participating in community gardens, community kitchens, or the Good Food Box program. Responses were analyzed by inductive content analysis. At follow-up, only 12 families had participated in a community garden, 16 in a community kitchen, and 4 in the Good Food Box program. Reasons for non-participation grouped under two themes. First, families expressed that programs were not accessible because they lacked the knowledge of how or where to participate or because programs were not in their neighbourhoods. Second, programs lacked fit for families, as they were not suited to busy schedules, interests, or needs. This study provides unique perspective on participation in community food programs among food-insecure families and suggests that these programs may not be effective options for these families to improve their food access.

  12. Experiences from a community based substance use treatment centre in an urban resettlement colony in India.

    Science.gov (United States)

    Balhara, Yatan Pal Singh; Ranjan, Rajeev; Dhawan, Anju; Yadav, Deepak

    2014-01-01

    Background. There are limited community based treatment services for drug dependence in India. Rural areas and urban resettlement colonies are in particular deficient in such services. Aims. The current study aimed at preliminary assessment of substance use disorder management services at a community based substance use treatment clinic in an urban resettlement colony. Methods. The study was carried out at community based substance use treatment centre in a resettlement colony in India. The records of the centre were chart reviewed. Results. A total of 754 patients were registered at the clinic during the study period. Heroin was the primary drug of abuse for 63% of the patients. The mean duration of follow-up for the patients with opioid and alcohol dependence was 13.47 (SD ± 10.37; range 0-39) months. A total of 220 patients of opioid dependence were prescribed substation or abstinence directed therapy. Buprenorphine (87), slow release oral morphine (SROM) (16), and dextropropoxyphene (98) were used for opioid substitution. Conclusion. It is possible to deliver substance use disorder treatment services in community setting. There is a need to develop area specific community based treatment services for substance abuse in socially disadvantaged populations such as urban resettlement colonies.

  13. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    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.

  14. Improved physical fitness among older female participants in a nationally disseminated, community-based exercise program.

    Science.gov (United States)

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

    2012-04-01

    Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. The StrongWomen Program is a nationally disseminated, research-based, community ST program active in 40 states. The Senior Fitness Test is used to assess upper and lower body strength, upper and lower body flexibility, aerobic fitness, and agility; data are collected prior to and following program participation. For these analyses, five states provided deidentified data for 367 female participants, mean age 63 (±11) years. Attendance in approximately 10 weeks of twice-weekly classes was 69.4%. Paired t tests were used to analyze pre-post change. Significant improvements were observed (p age-group and compared with published, age-based norms. This study demonstrates that it is feasible for community leaders to conduct pre-post physical fitness evaluations with participants and that participants experienced improvements across several important domains of physical fitness.

  15. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

    Directory of Open Access Journals (Sweden)

    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  16. Best Practices in University-Community Partnerships: Lessons Learned from a Physical-Activity-Based Program

    Science.gov (United States)

    Walsh, David

    2006-01-01

    Universities have the potential to make significant contributions to their neighboring schools and youth agencies through university-community partnerships and the programs they spawn. However, even with proven goals, trained staff, and eager students, collaborative physical-activity-based youth development programs can fail despite the best…

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

    Yuxuan Cai, Stefanie; Shuen Sheng Fung, Daniel

    2016-01-01

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

  19. Yield of community-based tuberculosis targeted testing and treatment in foreign-born populations in the United States: A systematic review.

    Directory of Open Access Journals (Sweden)

    Mohsen Malekinejad

    Full Text Available To synthesize outputs and outcomes of community-based tuberculosis targeted testing and treatment (TTT programs in foreign-born populations (FBP in the United States (US.We systematically searched five bibliographic databases and other key resources. Two reviewers independently applied eligibility criteria to screen citations and extracted data from included studies. We excluded studies that contained 90%. We used random-effects meta-analytic models to calculate pooled proportions and 95% confidence intervals (CI for community-based TTT cascade steps (e.g., recruited, tested and treated, and used them to create two hypothetical cascades for 100 individuals.Fifteen studies conducted in 10 US states met inclusion criteria. Studies were heterogeneous in recruitment strategies and mostly recruited participants born in Latin America. Of 100 hypothetical participants (predominantly FBP reached by community-based TTT, 40.4 (95% CI 28.6 to 50.1 would have valid test results, 15.7 (95% CI 9.9 to 21.8 would test positive, and 3.6 (95% CI 1.4 to 6.0 would complete LTBI treatment. Likewise, of 100 hypothetical participants (majority FBP reached, 77.9 (95% CI 54.0 to 92.1 would have valid test results, 26.5 (95% CI 18.0 to 33.5 would test positive, and 5.4 (95% CI 2.1 to 9.0 would complete LTBI treatment. Of those with valid test results, pooled proportions of LTBI test positive for predominantly FBP and majority FBP were 38.9% (95% CI 28.6 to 49.8 and 34.3% (95% CI 29.3 to 39.5, respectively.We observed high attrition throughout the care cascade in FBP participating in LTBI community-based TTT studies. Few studies included cascade steps prior to LTBI diagnosis, limiting our review findings. Moreover, Asia-born populations in the US are substantially underrepresented in the FBP community-based TTT literature.

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

    Science.gov (United States)

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

    2013-10-01

    The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors. MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire. Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (pexercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Adding evidence-based interventions to assertive community treatment : a feasibility study

    NARCIS (Netherlands)

    Sytema, Sjoerd; Jörg, Frederike; Nieboer, Roeline; Wunderink, Lex

    OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions. METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT

  2. Lessons from a Community-Based Program to Monitor Forest Vertebrates in the Brazilian Amazon

    Science.gov (United States)

    Benchimol, Maíra; von Mühlen, Eduardo M.; Venticinque, Eduardo M.

    2017-09-01

    A large number of sustainable use reserves recently have been titled in the Brazilian Amazonia. These reserves require public participation in the design and implementation of management and monitoring programs. Species-monitoring programs that engage local stakeholders may be useful for assessing wildlife status over the long term. We collaborated on the development of a participatory program to monitor forest vertebrates in the Piagaçu-Purus Sustainable Development Reserve and to build capacity among the local people. We examined relations between the distance to the nearest human community and sighting rates of each species, and evaluated the program overall. Eighteen wildlife monitors received training in line transect and sign surveys and then conducted surveys along a total of ten transects. Sighting rates of most species in the Piagaçu-Purus Sustainable Development Reserve were higher than those reported in other Amazonian forests. Distance to the human community was not associated with the overall vertebrate sighting rate. Use of the trained monitors was successful in terms of data acquisition and engagement. The involvement of local people promoted discussions about regulation of hunting in the reserve. Implementation of community-based programs to monitor forest wildlife in Amazonian sustainable use reserves may empower local communities and assess the status of wildlife through time.

  3. Diabetes connect: African American men's preferences for a community-based diabetes management program.

    Science.gov (United States)

    Crabtree, Krysia; Sherrer, Nathan; Rushton, Tullia; Willig, Amanda; Agne, April; Shelton, Tanya; Cherrington, Andrea

    2015-02-01

    The purpose of the study is to explore African American men's perceptions of how community-based, community-health worker (CHW)-delivered diabetes interventions might best be implemented. Four 90-minute focus groups were guided by a trained moderator with a written guide to facilitate discussion on the topic of diabetes management and preferences for community-based programs. Participants were recruited from the diabetes education database at a safety-net health system in Jefferson County, AL. Two independent reviewers performed content analysis to identify major themes using an iterative, combined deductive and inductive approach. There were 25 male participants. Mean years living with diabetes was 9.6 (range, 1-20). Participants demonstrated knowledge of self-management strategies and identified various hardships including emotional and physical manifestations of diabetes, dietary restrictions, and institutional frustrations with the health system that contributed to self-management barriers. Their preferred CHW responsibilities were to educate, hold support groups, help track daily activities, and help find resources. Potential concerns included the need for confidentiality and fears of being stereotyped. Participants identified critical self-management strategies but endure hardships that present barriers to daily diabetes management. Preferences for community-based programs and suggested CHW responsibilities could help to overcome many of those barriers by increasing access and providing support. © 2014 The Author(s).

  4. Predictors of buprenorphine treatment success of opioid dependence in two Baltimore City grassroots recovery programs.

    Science.gov (United States)

    Damian, April Joy; Mendelson, Tamar; Agus, Deborah

    2017-10-01

    Despite evidence for the efficacy of buprenorphine treatment in primary care, few studies have identified factors associated with treatment success, nor have such factors been evaluated in community settings. Identifying correlates of treatment success can facilitate the development of treatment models tailored for distinct populations, including low-income communities of color. The current study examined client-level socio-demographic factors associated with treatment success in community-based buprenorphine programs serving vulnerable populations. Data were abstracted from client records for participants (N=445) who met DSM-IV criteria for opioid dependence and sought treatment at one of Behavioral Health Leadership Institute's two community-based recovery programs in Baltimore City from 2010 to 2015. Logistic regression estimated the odds ratios of treatment success (defined as retention in treatment for ≥90days) by sociodemographic predictors including age, race, gender, housing, legal issues and incarceration. The odds of being retained in treatment ≥90days increased with age (5% increase with each year of age; pfactors. Clients who reported unstable housing had a 41% decreased odds of remaining in treatment for 90 or more days compared to clients who lived independently at intake. Treatment success did not significantly differ by several other client-level characteristics including gender, race, employment, legal issues and incarceration. In vulnerable populations, the age factor appears sufficiently significant to justify creating models formulated for younger populations. The data also support attention to housing needs for people in treatment. Findings from this paper can inform future research and program development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Sustaining health education research programs in Aboriginal communities.

    Science.gov (United States)

    Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

    2017-09-01

    Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

  6. Scaling-up Community-Based Program for Management of Child Malnutrition in Rural Thailand

    International Nuclear Information System (INIS)

    Winichagoon, Pattanee

    2014-01-01

    Full text: Despite efforts to address child malnutrition at scale since 1970s, management of child illnesses focused on treatment of common infections. In the fifth National Economic and Social Development Plan (NESDP) (1982-1987), effective scaled-up child nutrition policy and program was implemented, through Primary Health Care (PHC) and Poverty Alleviation Plan (PAP). The PAP provided the mechanism to streamline government resources to poverty stricken areas. Almost 300 districts were identified and sectoral programs implemented in the same priority areas. Provincial planning is the key to allocate the government budget, while the district level implemented and supervised actions at the community level. PHC was implemented with the principle of self-help care and nutrition was one of the PHC elements. Community participation was strengthened through manpower mobilization and capacity building, village financing and organization. As a result, there is an alignment of national resource allocations and micro-level actions. Scaling-up of community-based nutrition program was implemented by adopting the PHC principle, using community participation strategy, namely, mobilization and capacity building of village health volunteers, financing and organization. Growth monitoring, promotion of infant and young child feeding and joint financing via a ‘nutrition fund’ was implemented in rural areas, particularly in the poorest areas of the northeast and north. Child malnutrition was strategically managed at the community level, whereby differential actions were taken according to the severity of malnutrition. Management of severe and moderate malnutrition was by monitoring growth monthly, with support of basic health services to manage infections and other curative needs. Food assistance for complementary feeding using appropriate technology for village level processing was an integral part of child malnutrition management. Children with mild malnutrition or normal were

  7. A Community-Based Continuing Care Program for the Elderly Disabled. An Evaluation of Planned Intermittent Hospital Readmission

    Science.gov (United States)

    Robertson, Duncan; And Others

    1977-01-01

    Utilizing flexible community-supporting services integrated with a hospital-based program of planned intermittent relief of the patients' supporters, patients (N=50) were maintained in the community at an average cost of 79.5 hospital bed days per patient per annum. The Continuing Care Program is an alternative to institutionalization. (Author)

  8. [Evaluation of a Two-day Hospital On-site Training Program for Community Pharmacists: Approach to Facilitate Collaboration among Community Healthcare Professionals].

    Science.gov (United States)

    Sumi, Masaki; Hasegawa, Chiaki; Morii, Hiroaki; Hoshino, Nobuo; Okunuki, Yumi; Kanemoto, Kashie; Horie, Miya; Okamoto, Haruka; Yabuta, Naoki; Matsuda, Masashi; Kamiya, Takaki; Sudo, Masatomo; Masuda, Kyouko; Iwashita, Yuri; Matsuda, Kaori; Motooka, Yoshiko; Hira, Daiki; Morita, Shin-Ya; Terada, Tomohiro

    2018-01-01

     The importance of community-based care systems has increased due to the highly aging population and diversity of disease. To enhance the cooperation among healthcare professionals in community-based care systems, a two-day on-site training program for community pharmacists based on a multidisciplinary team approach was conducted at the Medical Science Hospital of Shiga University from April 2015 to March 2017. There were two professional courses in this training program: the palliative care course and nutrition support course. Both courses consisted of common pharmaceutical care training as follows: regional cooperation among healthcare professionals, pharmacist's clinical activities in the ward, pressure ulcer care, infection control, and aseptic technique for parenteral solutions. Each course was limited to 2 participants. A questionnaire was given to participants in the training program. Seventy-five pharmacists participated in the training and all of them answered the questionnaire. According to the questionnaire, 86% of participants felt that 2 days was an appropriate term for the training program. Positive answers regarding the content of each program and overall satisfaction were given by 100% and 99% of the participants, respectively. In the categorical classification of free comments regarding the expected change in pharmacy practice after the training, both "support for patients under nutritional treatment" and "cooperation with other medical staff" were answered by 24 participants. These results suggested that the 2-day on-site training for community pharmacists facilitated cooperation among healthcare professionals in the community.

  9. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

    Science.gov (United States)

    Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

    2016-06-01

    Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

  10. Evaluating community-based public health leadership training.

    Science.gov (United States)

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

    2011-01-01

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

  11. Examining the Feasibility and Effectiveness of a Community-Based Obesity Prevention Program

    Science.gov (United States)

    Cotter, Elizabeth W.; Bera, Victoria; Elsemore, Johanna; Snelling, Anastasia

    2018-01-01

    Background: Latinos in the United States are at heightened risk for obesity and health disparities, yet community-based interventions to promote health are limited. Purpose: This research examined the feasibility and efficacy of a culturally relevant obesity prevention program (Vivir Sano), which included stress reduction and behavioral lifestyle…

  12. Clients' experiences of a community based lifestyle modification program: a qualitative study.

    Science.gov (United States)

    Chan, Ruth S M; Lok, Kris Y W; Sea, Mandy M M; Woo, Jean

    2009-10-01

    There is little information about how clients attending lifestyle modification programs view the outcomes. This qualitative study examined the clients' experience of a community based lifestyle modification program in Hong Kong. Semi-structured interviews were conducted with 25 clients attending the program. Clients perceived the program had positive impacts on their health and nutrition knowledge. They experienced frustration, negative emotion, lack of motivation, and pressure from others during the program. Working environment and lack of healthy food choices in restaurants were the major perceived environmental barriers for lifestyle modification. Clients valued nutritionists' capability of providing professional information and psychological support in the program. Our results suggest that nutritionist's capability of providing quality consultations and patient-centered care are important for empowering clients achieve lifestyle modification.

  13. Community College Program Planning: A Method to Measure and Meet Community Need

    Science.gov (United States)

    Perez-Vergara, Kelly; Lathrop, Rachel; Orlowski, Martin

    2018-01-01

    Offering academic programs that meet community need has long been a core mission of community colleges. However, determining which job skills and credentials are needed for employment in the community is challenging. In order to facilitate a holistic and community-based perspective, our 2-year community college developed a structured curricular…

  14. A community-driven hypertension treatment group in rural Honduras.

    Science.gov (United States)

    Reiger, Sheridan; Harris, Jeffrey R; Chan, Kwun Chuen Gary; Oqueli, Hector Lopez; Kohn, Marlana

    2015-01-01

    We formed a self-funded hypertension treatment group in a resource-poor community in rural Honduras. After training community health workers and creating protocols for standardized treatment, we used group membership fees to maintain the group, purchase generic medications in bulk on the local market, and hire a physician to manage treatment. We then assessed whether participation in the group improved treatment, medication adherence, and hypertension control. This is a program evaluation using quasi-experimental design and no control group. Using data from the 86 members of the hypertension treatment group, we analyzed baseline and follow-up surveys of members, along with 30 months of clinical records of treatment, medication adherence, and blood pressure readings. Our initial hypertension needs assessment revealed that at baseline, community hypertensives relied on the local Ministry of Health clinic as their source of anti-hypertensive medications and reported that irregular supply interfered with medication adherence. At baseline, hypertension group members were mainly female, overweight or obese, physically active, non-smoking, and non-drinking. After 30 months of managing the treatment group, we found a significant increase in medication adherence, from 54.8 to 76.2% (p<0.01), and hypertension control (<140/90 mmHg), from 31.4 to 54.7% (p<0.01). We also found a mean monthly decrease of 0.39 mmHg in systolic blood pressure (p<0.01). At the end of the 30-month observation period, the local Ministry of Health system had increased provision of low-cost anti-hypertensive medications and adopted the hypertension treatment group's treatment protocols. Formation of a self-funded, community-based hypertension treatment group in a rural, resource-poor community is feasible, and group participation may improve treatment, medication adherence, and hypertension control and can serve as a political driver for improving hypertension treatment services provided by the public

  15. Cost of providing injectable contraceptives through a community-based social marketing program in Tigray, Ethiopia.

    Science.gov (United States)

    Prata, Ndola; Downing, Janelle; Bell, Suzanne; Weidert, Karen; Godefay, Hagos; Gessessew, Amanuel

    2016-06-01

    To provide a cost analysis of an injectable contraceptive program combining community-based distribution and social marketing in Tigray, Ethiopia. We conducted a cost analysis, modeling the costs and programmatic outcomes of the program's initial implementation in 3 districts of Tigray, Ethiopia. Costs were estimated from a review of program expense records, invoices, and interviews with health workers. Programmatic outcomes include number of injections and couple-year of protection (CYP) provided. We performed a sensitivity analysis on the average number of injections provided per month by community health workers (CHWs), the cost of the commodity, and the number of CHWs trained. The average programmatic CYP was US $17.91 for all districts with a substantial range from US $15.48-38.09 per CYP across districts. Direct service cost was estimated at US $2.96 per CYP. The cost per CYP was slightly sensitive to the commodity cost of the injectable contraceptives and the number of CHWs. The capacity of each CHW, measured by the number of injections sold, was a key input that drove the cost per CYP of this model. With a direct service cost of US $2.96 per CYP, this study demonstrates the potential cost of community-based social marketing programs of injectable contraceptives. The findings suggest that the cost of social marketing of contraceptives in rural communities is comparable to other delivery mechanisms with regards to CYP, but further research is needed to determine the full impact and cost-effectiveness for women and communities beyond what is measured in CYP. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Impact of drug awareness and treatment camps on attendance at a community outreach de-addiction clinic

    Directory of Open Access Journals (Sweden)

    Om Prakash Giri

    2015-01-01

    Full Text Available Background: Substance misuse is an increasing problem in urban and rural India. The utility of community-based interventions and preventive strategies are increasingly emphasized in this context. The drug de-addiction and treatment center, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, has been running a drug de-addiction and treatment clinic at Kharar Civil Hospital, Kharar, District Mohali, Punjab, since 1998. As part of an effort to enhance this community outreach program, community-based drug awareness and treatment camps have been organized since March 2004 in villages in and around Tehsil Kharar of Mohali. Aim: To study the impact of the drug awareness and treatment camps on the attendance of patients at the community outreach drug de-addiction and treatment clinic at Kharar Civil Hospital. Methods: Sociodemographic and clinical variables, including treatment outcome-related variables, of patients attending the clinic at Kharar Civil Hospital, before and after the camps were compared. Discussion and Conclusion: The study showed a positive impact on drug awareness and treatment camps held in the community on outpatient attendance at a community outreach clinic, with attendance increasing more than 1.8 times.

  17. Clients’ Experiences of a Community Based Lifestyle Modification Program: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Jean Woo

    2009-10-01

    Full Text Available There is little information about how clients attending lifestyle modification programs view the outcomes. This qualitative study examined the clients’ experience of a community based lifestyle modification program in Hong Kong. Semi-structured interviews were conducted with 25 clients attending the program. Clients perceived the program had positive impacts on their health and nutrition knowledge. They experienced frustration, negative emotion, lack of motivation, and pressure from others during the program. Working environment and lack of healthy food choices in restaurants were the major perceived environmental barriers for lifestyle modification. Clients valued nutritionists’ capability of providing professional information and psychological support in the program. Our results suggest that nutritionist’s capability of providing quality consultations and patient-centered care are important for empowering clients achieve lifestyle modification.

  18. Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women.

    Science.gov (United States)

    Koh, Eun; Choi, Ga-Young; Cho, Ji Young

    2016-02-01

    The study evaluates the effectiveness of an ongoing, community-based breast cancer prevention program offered by a local social services agency in the Washington, DC, metropolitan area. Korean American women who participated in this breast cancer prevention program were compared with those who did not participate in their knowledge, attitude, and screening behaviors. The study found that the intervention group was more knowledgeable on breast cancer and related services and reported more positive attitudes toward breast cancer screening services than the comparison group. The participants in the intervention group were also more likely to plan to receive a mammogram than those in the comparison group. However, significant differences were not observed in the two groups in their intention to receive a clinical breast examination. The study findings suggest that an ongoing, community-based breast cancer prevention program can be an effective method of addressing breast cancer prevention disparities observed among Korean American women.

  19. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Directory of Open Access Journals (Sweden)

    Diane McClymont Peace

    2012-05-01

    Full Text Available Objectives: Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design: The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods: Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results: Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions: Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies.

  20. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Science.gov (United States)

    Peace, Diane McClymont; Myers, Erin

    2012-01-01

    Objectives Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies. PMID:22584509

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

    Science.gov (United States)

    2014-01-01

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

  2. Reductions in blood pressure during a community-based overweight and obesity treatment in children and adolescents with prehypertension and hypertension

    DEFF Research Database (Denmark)

    Mollerup, P M; Lausten-Thomsen, U; Fonvig, C E

    2017-01-01

    Due to the pandemic of childhood obesity and thus obesity-related hypertension, improvements in treatment availability are needed. Hence, we investigated whether reductions in blood pressure (BP) would occur in children with overweight and obesity exhibiting prehypertension/hypertension during...... a community-based overweight and obesity treatment program, and if changes in body mass index (BMI) are associated with changes in BP. The study included 663 children aged 3-18 years with a BMI ⩾85th percentile for sex and age that entered treatment from June 2012 to January 2015. Height, weight and BP were....../hypertension developed in 23.3% of the normotensive children despite reductions in BMI SDSs (Pobesity treatment can reduce BP, and thus may help improve treatment availability....

  3. Community-based home-care program for the management of pre-eclampsia: an alternative.

    OpenAIRE

    Helewa, M; Heaman, M; Robinson, M A; Thompson, L

    1993-01-01

    OBJECTIVE: To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia. DESIGN: A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989. SETTING: St. Boniface General Hospital, Winnipeg. PATIENTS: Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program. INTERVENTION...

  4. Brighter Smiles Africa--translation of a Canadian community-based health-promoting school program to Uganda.

    Science.gov (United States)

    Macnab, A J; Radziminski, N; Budden, H; Kasangaki, A; Zavuga, R; Gagnon, F A; Mbabali, M

    2010-08-01

    PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership. Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students. MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules. Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care

  5. Accountability for Community-Based Programs for the Seriously Ill.

    Science.gov (United States)

    Teno, Joan M; Montgomery, Russ; Valuck, Tom; Corrigan, Janet; Meier, Diane E; Kelley, Amy; Curtis, J Randall; Engelberg, Ruth

    2018-03-01

    Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.

  6. 77 FR 26827 - Medicaid Program; Community First Choice Option

    Science.gov (United States)

    2012-05-07

    ... Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option; Final Rule #0... [CMS-2337-F] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for Medicare... Affordable Care Act, which establishes a new State option to provide home and community-based attendant...

  7. Pasos Adelante: the effectiveness of a community-based chronic disease prevention program.

    Science.gov (United States)

    Staten, Lisa K; Scheu, Linda L; Bronson, Dan; Peña, Veronica; Elenes, JoJean

    2005-01-01

    Implementing programs that target primary prevention of chronic diseases is critical for at-risk populations. Pasos Adelante, or "Steps Forward," is a curriculum aimed at preventing diabetes, cardiovascular disease, and other chronic diseases in Hispanic populations. Pasos Adelante is adapted from the National Heart, Lung, and Blood Institute's cardiovascular disease prevention curriculum, Su Corazon, Su Vida, and includes sessions on diabetes and community advocacy and incorporates walking clubs. The Pasos Adelante curriculum was implemented in two Arizona, United States-Sonora, Mexico border counties. Key issues in these communities are safety, access to recreational facilities, climate, and cultural beliefs. Pasos Adelante is a 12-week program facilitated by community health workers. The program includes interactive sessions on chronic disease prevention, nutrition, and physical activity. Evaluation of the program included precurriculum and postcurriculum questionnaires with self-reported measures of physical activity and dietary patterns. Approximately 250 people participated in the program in Yuma and Santa Cruz counties. Postprogram evaluation results demonstrate a significant increase in moderate to vigorous walking among participants and shifts in nutritional patterns. The Pasos Adelante program demonstrates that an educational curriculum in conjunction with the support of community health workers can motivate people in Arizona/Sonora border communities to adopt healthy lifestyle behaviors.

  8. The Role of School and Community-Based Programs in Aiding Latina/o High School Persistence

    Science.gov (United States)

    Harris, Donna M.; Kiyama, Judy Marquez

    2015-01-01

    This study documents the important role school and community-based programs have for sustaining the persistence of Latina/o high school students in an urban, low achieving school district. Consensus among student participants revealed these programs provided a safe space where students were able to develop "confianza" (mutual trust) with…

  9. A Census of Prison-Based Drug Treatment Programs: Implications for Programming, Policy, and Evaluation

    Science.gov (United States)

    Welsh, Wayne N.; Zajac, Gary

    2004-01-01

    Despite a growing realization that unmeasured programmatic differences influence prison-based drug treatment effectiveness, few attempts to systematically measure such differences have been made. To improve program planning and evaluation in this area, we developed a census instrument to collect descriptive information about 118 prison-based drug…

  10. Confronting barriers and recognizing opportunities: Developing effective community-based environmental monitoring programs to meet the needs of Aboriginal communities

    International Nuclear Information System (INIS)

    McKay, Ariana J.; Johnson, Chris J.

    2017-01-01

    Aboriginal communities can be negatively affected by resource development, but often they do not have a full opportunity to participate in project review and the resulting monitoring and mitigation activities. Cumulative impacts of resource development are also typically neglected in monitoring protocols that focus on a limited number of environmental values, rather than adopting a long-term, holistic view of development over time and space. Community-based environmental monitoring (CBEM) is emerging as a way to meaningfully include local Aboriginal citizens in the decision-making process as well as the assessment of the long-term impacts of the development of natural resources. We explored opportunities and barriers for developing CBEM programs that meet the needs of small and rural Aboriginal communities that are faced with the rapid and wide-spread development of natural resources. We conducted interviews with a local Aboriginal community, and natural resource management practitioners who could provide perspectives on the application of CBEM to resource management in north-central British Columbia, Canada. Results demonstrate that CBEM offers a locally adapted and culturally appropriate approach to facilitate the participation of Aboriginal communities in natural resource decision making and management. The interpretation of the specific role and purpose of CBEM differed among participants, depending on their objectives for and concerns about natural resource development. However, all parties were consistent in viewing CBEM as an effective method for engaging in dialogue, cooperation, and tracking environmental change. The development or improvement of CBEM programs should consider the efficacy of monitoring protocols, social cohesion and relationships, ability to inform decision-making, and effectiveness of CBEM for the members of the community. - Highlights: • We explored how to develop effective CBEM with a focus on Aboriginal communities. • We identified

  11. Confronting barriers and recognizing opportunities: Developing effective community-based environmental monitoring programs to meet the needs of Aboriginal communities

    Energy Technology Data Exchange (ETDEWEB)

    McKay, Ariana J., E-mail: ariana.mckay@outlook.com; Johnson, Chris J., E-mail: chris.johnson@unbc.ca

    2017-05-15

    Aboriginal communities can be negatively affected by resource development, but often they do not have a full opportunity to participate in project review and the resulting monitoring and mitigation activities. Cumulative impacts of resource development are also typically neglected in monitoring protocols that focus on a limited number of environmental values, rather than adopting a long-term, holistic view of development over time and space. Community-based environmental monitoring (CBEM) is emerging as a way to meaningfully include local Aboriginal citizens in the decision-making process as well as the assessment of the long-term impacts of the development of natural resources. We explored opportunities and barriers for developing CBEM programs that meet the needs of small and rural Aboriginal communities that are faced with the rapid and wide-spread development of natural resources. We conducted interviews with a local Aboriginal community, and natural resource management practitioners who could provide perspectives on the application of CBEM to resource management in north-central British Columbia, Canada. Results demonstrate that CBEM offers a locally adapted and culturally appropriate approach to facilitate the participation of Aboriginal communities in natural resource decision making and management. The interpretation of the specific role and purpose of CBEM differed among participants, depending on their objectives for and concerns about natural resource development. However, all parties were consistent in viewing CBEM as an effective method for engaging in dialogue, cooperation, and tracking environmental change. The development or improvement of CBEM programs should consider the efficacy of monitoring protocols, social cohesion and relationships, ability to inform decision-making, and effectiveness of CBEM for the members of the community. - Highlights: • We explored how to develop effective CBEM with a focus on Aboriginal communities. • We identified

  12. Building a community-based culture of evaluation.

    Science.gov (United States)

    Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

    2017-12-01

    In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Evaluation of a Community-Based Parenting Program with the Parents of Young Children.

    Science.gov (United States)

    Brenner, Viktor; Nicholson, Bonnie C.; Fox, Robert A.

    1999-01-01

    Evaluated effectiveness of a cognitive-behavioral parenting program for parents of children ages 1 to 5 years offered through community-based family resource centers. Found that participants showed significant decreases in use of verbal and corporal punishment, and increases in nurturing behaviors as measured by the Parent Behavior Checklist.…

  14. Effects of an Aerobic Exercise Program on Community-Based Adults with Mental Retardation.

    Science.gov (United States)

    Pommering, Thomas L.; And Others

    1994-01-01

    Evaluation of a 10-week aerobic exercise program on 14 community-based adults with mental retardation found a 91.3% attendance rate and significant increases in maximal oxygen consumption, oxygen pulse, maximum ventilation, exercise stress test duration, and flexibility. However, no significant changes were observed in weight or body composition.…

  15. Medicaid program; state plan home and community-based services, 5-year period for waivers, provider payment reassignment, and home and community-based setting requirements for Community First Choice and home and community-based services (HCBS) waivers. Final rule.

    Science.gov (United States)

    2014-01-16

    This final rule amends the Medicaid regulations to define and describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations. This rule describes Medicaid coverage of the optional state plan benefit to furnish home and community based-services and draw federal matching funds. This rule also provides for a 5-year duration for certain demonstration projects or waivers at the discretion of the Secretary, when they provide medical assistance for individuals dually eligible for Medicaid and Medicare benefits, includes payment reassignment provisions because state Medicaid programs often operate as the primary or only payer for the class of practitioners that includes HCBS providers, and amends Medicaid regulations to provide home and community-based setting requirements related to the Affordable Care Act for Community First Choice State plan option. This final rule also makes several important changes to the regulations implementing Medicaid 1915(c) HCBS waivers.

  16. Building an evidence base for community health: a review of the quality of program evaluations.

    Science.gov (United States)

    Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

    2007-11-01

    An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

  17. Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

    Science.gov (United States)

    Trotman, Adria J.; Taxman, Faye S.

    2011-01-01

    A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

  18. Cost Effective Community Based Dementia Screening: A Markov Model Simulation

    Directory of Open Access Journals (Sweden)

    Erin Saito

    2014-01-01

    Full Text Available Background. Given the dementia epidemic and the increasing cost of healthcare, there is a need to assess the economic benefit of community based dementia screening programs. Materials and Methods. Markov model simulations were generated using data obtained from a community based dementia screening program over a one-year period. The models simulated yearly costs of caring for patients based on clinical transitions beginning in pre dementia and extending for 10 years. Results. A total of 93 individuals (74 female, 19 male were screened for dementia and 12 meeting clinical criteria for either mild cognitive impairment (n=7 or dementia (n=5 were identified. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Discussion. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages.

  19. Quality of life improves in children and adolescents during a community-based overweight and obesity treatment.

    Science.gov (United States)

    Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine; Kloppenborg, Julie T; Baker, Jennifer L; Holm, Jens-Christian

    2017-06-01

    The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree of obesity. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys) completed another PedsQL after a median of 13 months of treatment. Quality of life improved (p quality of life (p ≤ 0.047). However, improvements also occurred in children and adolescents with low socioeconomic status or who increased their BMI SDS (p quality of life occurred in children and adolescents during a community-based overweight and obesity treatment, even in children and adolescents who increased their BMI SDS. Thus, improvements may be due to the treatment itself and not exclusively to reductions in BMI SDS. Clinicaltrials.gov, ID-no.: NCT02013843.

  20. Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach.

    Science.gov (United States)

    Leyva, Bryan; Allen, Jennifer D; Ospino, Hosffman; Tom, Laura S; Negrón, Rosalyn; Buesa, Richard; Torres, Maria Idalí

    2017-09-01

    Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.

  1. ISFAHAN HEALTHY HEART PROGRAM:A COMPREHENSIVE INTEGRATED COMMUNITY-BASED PROGRAM FOR CARDIOVASCULAR DISEASE PREVENTION AND CONTROL. DESIGN, METHODS AND INITIAL EXPERIENCE 2000-2001

    Directory of Open Access Journals (Sweden)

    N MOHAMMADI FARD

    2002-03-01

    Full Text Available Isfahan Healthy Heart Program (IHHP is a five to six year comprehensive integrated community based program for preventing and controlling of cardiovascular diseases (CVD via reducing CVD risk factors and improvement of cardiovascular healthy behavior in target population. IHHP has been started in 1999 and will be last since 2004. Primary survey was done to collect baseline data from interventional (Isfahan and Najafabad Cities and reference (Arak communities. In a multistage sampling method, we select randomly 5 to 10 percent of households in clusters. Then individuals aged equal or higher than 19 years old were selected for entering to survey. In this way, data from 12600 individuals (6300 in interventional counties and 6300 in reference county was collected and stratified due to their living area (urban vs. rural and different age and sex groups. Cardiovascular risk factors (Hypercholesterolemia, Smoking, Hypertension, Diabetes Mellitus, Obesity were investigated by laboratory tests (Lipid profile, FBS, OGTT, physical exam and standard questionnaires, in all ones. Nutritional habits, socioeconomic states, physical activity profiles and other healthy behaviors regarding to cardiovascular disease were assessed by validated questionnaires via interviewing to all individuals. Twelve leads electrocardiogram was done in all persons older than 35 years old. The prevalence of CVDs and distribution of CVD risk factors were estimated in this phase. In the 2nd phase, based on primary survey findings, we arranged a series of teams (worksite, children, women, health personnel, high risk patients, nutrition for planning and implementation of program through interventional community for a 5-year period. Every team has its own target population and objectives and monitors its process during the study. At intervals (annually, some local and small surveys with a random sampling will be conducted to assess and monitor the program and its potency to cope with

  2. Recruitment strategies and costs for a community-based physical activity program.

    Science.gov (United States)

    Peck, Lara E; Sharpe, Patricia A; Burroughs, Ericka L; Granner, Michelle L

    2008-04-01

    A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

  3. Exploring impacts of multi-year, community-based care programs for orphans and vulnerable children: a case study from Kenya.

    Science.gov (United States)

    Larson, Bruce A; Wambua, Nancy; Masila, Juliana; Wangai, Susan; Rohr, Julia; Brooks, Mohamad; Bryant, Malcolm

    2013-01-01

    The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006-2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n=500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n=300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n=700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18-22 year olds who were "children" during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities

  4. Survey of a community-based infusion program for Australian patients with rheumatoid arthritis requiring treatment with tocilizumab: patient characteristics and drivers of patient satisfaction and patient-perceived benefits and concerns

    Directory of Open Access Journals (Sweden)

    Voight L

    2012-04-01

    Full Text Available Louisa VoightCoast Joint Care, Maroochydore, Queensland, AustraliaBackground: Tocilizumab is an effective therapy for patients with moderate to severe rheumatoid arthritis that is administered by infusion over one hour every 4 weeks. The community-based infusion (ACTiv program was introduced to Australia in August 2010 to provide accessible and convenient treatment for patients with rheumatoid arthritis who require tocilizumab. The primary objectives of this study were to determine the characteristics of patients in the ACTiv program, patient satisfaction, and patient-perceived benefits and concerns with the ACTiv program, and drivers of patient satisfaction and patient-perceived benefits and concerns.Methods: A voluntary self-administered survey was given to all 608 patients in the ACTiv program between January 27, 2011 and March 31, 2011.Results: A total of 351 surveys were returned completed, giving a response rate of 58% (351/608. Most patients in the ACTiv program were women aged 40–64 years, with a mean disease duration of 13.7 years and moderate disability, who had been in the ACTiv program for ≥5 months. Most patients (88%, 302/342 were either very satisfied or satisfied with the ACTiv program and believed that they were very unlikely or somewhat unlikely to switch from the ACTiv program (64%, 214/335. The most important benefit was the reassurance of receiving treatment from a trained nurse in a professional medical environment (33%, 102/309. The most important concern was the fear of side effects (48%, 134/280. The main drivers of patient satisfaction and patient-perceived benefits and concerns of patients were health profile, previous medication experience, and length of treatment time in the program.Conclusion: The ACTiv program is used by patients of various ages, family life situations, and locations. Patient satisfaction with the program is high, which enables patients to benefit from long-term use of tocilizumab

  5. Community-based management versus traditional hospitalization in treatment of drug-resistant tuberculosis: a systematic review and meta-analysis.

    Science.gov (United States)

    Williams, Abimbola Onigbanjo; Makinde, Olusesan Ayodeji; Ojo, Mojisola

    2016-01-01

    Multidrug drug resistant Tuberculosis (MDR-TB) and extensively drug resistant Tuberculosis (XDR-TB) have emerged as significant public health threats worldwide. This systematic review and meta-analysis aimed to investigate the effects of community-based treatment to traditional hospitalization in improving treatment success rates among MDR-TB and XDR-TB patients in the 27 MDR-TB High burden countries (HBC). We searched PubMed, Cochrane, Lancet, Web of Science, International Journal of Tuberculosis and Lung Disease, and Centre for Reviews and Dissemination (CRD) for studies on community-based treatment and traditional hospitalization and MDR-TB and XDR-TB from the 27 MDR-TB HBC. Data on treatment success and failure rates were extracted from retrospective and prospective cohort studies, and a case control study. Sensitivity analysis, subgroup analyses, and meta-regression analysis were used to explore bias and potential sources of heterogeneity. The final sample included 16 studies involving 3344 patients from nine countries; Bangladesh, China, Ethiopia, Kenya, India, South Africa, Philippines, Russia, and Uzbekistan. Based on a random-effects model, we observed a higher treatment success rate in community-based treatment (Point estimate = 0.68, 95 % CI: 0.59 to 0.76, p   18 months, and regimen with drugs >5 reported higher treatment success rate. In the meta-regression model, age of patients, adverse events, treatment duration, and lost to follow up explains some of the heterogeneity of treatment effects between studies. Community-based management improved treatment outcomes. A mix of interventions with DOTS-Plus throughout therapy and treatment duration > 18 months as well as strategies in place for lost to follow up and adverse events should be considered in MDR-TB and XDR-TB interventions, as they influenced positively, treatment success.

  6. Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

    Science.gov (United States)

    Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

    2009-01-01

    This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

  7. Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

    Science.gov (United States)

    DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

    2012-01-01

    Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

  8. Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

    Science.gov (United States)

    Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

    2017-07-01

    The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P rehabilitation (P 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

  9. Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

    Science.gov (United States)

    Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

    2018-01-01

    The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

  10. Creating a "culture of research" in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program.

    Science.gov (United States)

    Dimond, Eileen P; St Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

    2015-06-01

    The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute's Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important component yet often challenging to

  11. Revisiting the concept of growth monitoring and its possible role in community-based nutrition programs.

    Science.gov (United States)

    Mangasaryan, Nuné; Arabi, Mandana; Schultink, Werner

    2011-03-01

    Community-based growth monitoring (GM) and growth monitoring and promotion (GMP) have been implemented worldwide. The literature provides controversial messages regarding their effectiveness. Numerous countries have GM as their main community-based activity and need guidance for future programming. The notion of GM is usually clear, but the follow-up actions include a range of activities and interventions, all under the heading of "promotion." We suggested definitions, objectives, and outcomes of the GM and GMP. By providing some clarity on these conceptual issues we attempted to provide a basis for consensus building and development of recommendations on when this activity should be promoted or discouraged. We reviewed basic concepts and global experience of GM and GMP using publications about GM and GMP, UNICEF country reports and other publications, field observations, and reports of recent expert consultations. Realistic added benefits are suggested as compared with general counseling that could also be delivered outside the GM session. We provide a narrow definition of "promotion" in GMP, in which actions are tailored to the results of monitoring, as well as suggest quality implementation criteria. GM, even if complemented by a promotional package, can have only a limited impact if it is not part of a comprehensive program. GMP cannot be viewed as a competitor to highly effective interventions, but may serve as a possible platform for their delivery. The decision to build community-based programs on a GMP platform should be based on consideration of benefits, feasibility of quality implementation, and capacity of human resources.

  12. Making daddies into fathers: community-based fatherhood programs and the construction of masculinities for low-income African American men.

    Science.gov (United States)

    Roy, Kevin M; Dyson, Omari

    2010-03-01

    In this analysis, we explore how low-income African American fathers build understandings of successful manhood in the context of community-based responsible fatherhood programs. Drawing on life history interviews with 75 men in Illinois and Indiana, we explore men's attempts to fulfill normative expectations of fatherhood while living in communities with limited resources. We examine the efforts of community-based fatherhood programs to shape alternative African American masculinities through facilitation of personal turning points and "breaks with the past," use of social support and institutional interventions, and the reframing of provision as a priority of successful fatherhood. We refer to Connell's hegemonic masculinity framework (Connell in Masculinities, Polity Press, Cambridge, 1995) and discuss how both men and programs borrow from hegemonic and street masculinities to develop alternative approaches to paternal involvement for marginalized men.

  13. Quality of life improves in children and adolescents during a community-based overweight and obesity treatment

    DEFF Research Database (Denmark)

    Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine

    2017-01-01

    PURPOSE: The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree...... of obesity. METHODS: Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based...... upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). RESULTS: Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys...

  14. Inuit women's stories of strength: informing Inuit community-based HIV and STI prevention and sexual health promotion programming.

    Science.gov (United States)

    Rand, Jenny R

    2016-01-01

    There is a dearth of literature to guide the development of community-based HIV and sexually transmitted infection (STI) prevention and sexual health promotion programs within Inuit communities. The aim of this study was to create a dialogue with Inuit women to address the lack of information available to inform programming to improve the sexual health of Inuit women, their families, and their communities in the Canadian Arctic. This study used Indigenous methodologies and methods by drawing from Inuit Qaujimajatuqangit and postcolonial research theory in a framework of Two-Eyed Seeing, and using storytelling sessions to gather data. Community-based participatory research principles informed the design of the study, ensuring participants were involved in all stages of the project. Nine storytelling sessions took place with 21 Inuit women aged 18-61 years. Storytelling sessions were audio recorded and transcribed verbatim, and Atlas.ti aided in the organization of the data for collaborative thematic analysis within three participatory analysis sessions with 13 of the participating women. From the storytelling and analysis sessions, five major themes emerged: (a) the way it used to be, (b) change, (c) family, (d) intimate relationships and (e) holistic strategies. Participating women emphasized that HIV and STI prevention and sexual health promotion programming needs to take a holistic, community-wide, family-focused and youth-centred approach within their communities. Participants identified several important determinants of sexual health and shared ideas for innovative approaches they believe will work as prevention efforts within their communities. This article specifically focuses on key characteristics of programming aimed at STI and HIV prevention and sexual health promotion that were identified throughout participants' stories. This study has provided a narrative to complement the epidemiological data that highlight the urgent need for prevention programming.

  15. Performance Assessment of Full-Scale Wastewater Treatment Plants Based on Seasonal Variability of Microbial Communities via High-Throughput Sequencing.

    Directory of Open Access Journals (Sweden)

    Tang Liu

    Full Text Available Microbial communities of activated sludge (AS play a key role in the performance of wastewater treatment processes. However, seasonal variability of microbial population in varying AS-based processes has been poorly correlated with operation of full-scale wastewater treatment systems (WWTSs. In this paper, significant seasonal variability of AS microbial communities in eight WWTSs located in the city of Guangzhou were revealed in terms of 16S rRNA-based Miseq sequencing. Furthermore, variation redundancy analysis (RDA demonstrated that the microbial community compositions closely correlated with WWTS operation parameters such as temperature, BOD, NH4+-N and TN. Consequently, support vector regression models which reasonably predicted effluent BOD, SS and TN in WWTSs were established based on microbial community compositions. This work provided an alternative tool for rapid assessment on performance of full-scale wastewater treatment plants.

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

    Science.gov (United States)

    McAndrew, Maureen

    2010-09-01

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

  17. Capacity Enhancement of Hepatitis C Virus Treatment through Integrated, Community-Based Care

    Directory of Open Access Journals (Sweden)

    Warren D Hill

    2008-01-01

    Full Text Available BACKGROUND: An estimated 250,000 Canadians are infected with the hepatitis C virus (HCV. The present study describes a cohort of individuals with HCV referred to community-based, integrated prevention and care projects developed in British Columbia. Treatment outcomes are reported for a subset of individuals undergoing antiviral therapy at four project sites.

  18. A community-based hip-hop dance program for youth in a disadvantaged community in Ottawa: implementation findings.

    Science.gov (United States)

    Beaulac, Julie; Olavarria, Marcela; Kristjansson, Elizabeth

    2010-05-01

    Participation in physical activity is important for the positive development and well-being of youth. A community- academic partnership was formed to improve access to physical activity for youth in one disadvantaged community in Ottawa, Canada. After consulting this community, a new hip-hop dance intervention was implemented. Adolescents aged 11 to 16 years participated in one of two 3-month sessions. A girls-only and a boys-and-girls format were offered both sessions. This article investigates the implementation of the intervention from the perspective of the youth participants, parents, staff, and researchers. Multiple methods were used, including document review, observation, questionnaire, focus groups, and interviews. Overall, the consistency and quality of program implementation were moderately satisfactory; however, important concerns were noted and this program appeared to be only partially delivered as planned. These findings will be discussed in terms of suggestions for improving the implementation of this intervention and similar recreation programs prioritizing disadvantaged communities.

  19. A Decentralized Group Treatment Program.

    Science.gov (United States)

    Conrow, Douglas C.

    Old style and new style mental hospitals are criticized for not dealing directly with a person's inability to live within his community and relate effectively with significant people. The comprehensive mental health programs, which arose in reaction to the deficits of previous facilities and treatment, are viewed as frequently following a similar,…

  20. Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: a longitudinal process evaluation

    Directory of Open Access Journals (Sweden)

    Maypilama Elaine

    2011-05-01

    Full Text Available Abstract Background Public health promotes an ecological approach to chronic disease prevention, however, little research has been conducted to assess the integration of an ecological approach in community-based prevention programs. This study sought to contribute to the evidence base by assessing the extent to which an ecological approach was integrated into an Aboriginal community-based cardiovascular disease (CVD and type 2 diabetes prevention program, across three-intervention years. Methods Activity implementation forms were completed by interview with implementers and participant observation across three intervention years. A standardised ecological coding procedure was applied to assess participant recruitment settings, intervention targets, intervention strategy types, extent of ecologicalness and organisational partnering. Inter-rater reliability for two coders was assessed at Kappa = 0.76 (p Results 215 activities were implemented across three intervention years by the health program (HP with some activities implemented in multiple years. Participants were recruited most frequently through organisational settings in years 1 and 2, and organisational and community settings in year 3. The most commonly utilised intervention targets were the individual (IND as a direct target, and interpersonal (INT and organisational (ORG environments as indirect targets; policy (POL, and community (COM were targeted least. Direct (HP→ IND and indirect intervention strategies (i.e., HP→ INT→ IND, HP→ POL → IND were used most often; networking strategies, which link at least two targets (i.e., HP→[ORG-ORG]→IND, were used the least. The program did not become more ecological over time. Conclusions The quantity of activities with IND, INT and ORG targets and the proportion of participants recruited through informal cultural networking demonstrate community commitment to prevention. Integration of an ecological approach would have been

  1. Adaptation and implementation of family-based treatment enhanced with dialectical behavior therapy skills for anorexia nervosa in community-based specialist clinics.

    Science.gov (United States)

    Accurso, Erin C; Astrachan-Fletcher, Ellen; O'Brien, Setareh; McClanahan, Susan F; Le Grange, Daniel

    2018-01-01

    Although family-based therapy (FBT) is a well-established treatment for anorexia nervosa, its implementation and effectiveness in clinical settings has been neglected. A group of seven therapists at a community-based eating disorders clinic were trained in skills-enhanced FBT and provided treatment to 11 youth with anorexia nervosa. Family-based skills training, which borrowed heavily from dialectical behavior therapy, was introduced in four additional sessions and then integrated throughout the remainder of FBT. FBT was perceived as appropriate and acceptable by all participants. Therapists reported high treatment fidelity. There was a large improvement in weight and moderate improvement in caregiver-reported eating disorder psychopathology but no clinically significant change by youth report. This study provides preliminary data on the implementation and effectiveness of FBT in the community.

  2. Considerations for community-based mHealth initiatives: insights from three Beacon Communities.

    Science.gov (United States)

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

    2013-10-15

    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.

  3. Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

    Science.gov (United States)

    2013-01-01

    Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

  4. Community-Based Native Teacher Education Programs.

    Science.gov (United States)

    Heimbecker, Connie; Minner, Sam; Prater, Greg

    This paper describes two exemplary school-based Native teacher education programs offered by Northern Arizona University (NAU) to serve Navajo students and by Lakehead University (Ontario) to serve members of the Nishnabe Nation of northern Ontario. The Reaching American Indian Special/Elementary Educators (RAISE) program is located in Kayenta,…

  5. GateWay Community College Water Resources Program Partnerships: An Opportunity for Program Success and Collaboration

    Science.gov (United States)

    Castaneda, M.

    2012-12-01

    GateWay Community College Water Resources Technologies (WRT) Program offers Certificate of Completions and Associate Degrees on Hydrologic Studies, Water Treatment and Wastewater Treatment. The program has been in existence since 1998 and has gone through several updates to meet the demand for professionals in those areas. The program includes theoretical and practical hands-on training in the monitoring of water quality and quantity as well as in water and industrial wastewater treatment. The WRT program offers online, face-to-face, and hybrid courses to address different student's needs for training. The program only Full-time faculty is supported by 15 adjunct- faculty professionals. Adjunct faculty is usually hired from a wide variety of professional people already working in the industry that have shown interest on teaching. Adjunct faculty also provide free tutoring to the WRT students when they are not teaching courses. The college Learning Center provides funding to support these tutoring activities. The program has an active Advisory Committee that provides guidance and recommends program changes to meet their training needs. This Advisory Committee is made of professionals from different federal, state, county agencies, and municipalities, private industry and consulting companies in the area. The Advisory Committee meets every year to provide feedback to GateWay on curriculum changes and commit to potential internship opportunities for the WRT students. Those internships (or voluntary work) are paid directly by the municipalities or agencies or can be paid by the GateWay WRT program. These internship jobs provides with an opportunity to actively promote the WRT program throughout the valley. The GateWay WRT program considers the Advisory Committee an essential component for the program success: the committee supports the program in recommending and acquiring the latest field equipment needed for the hands-on training. One of the main WRT program

  6. Treatment Readiness as a Determinant of Treatment Participation in a Prison-Based Rehabilitation Program: An Exploratory Study.

    Science.gov (United States)

    Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul

    2017-06-01

    The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.

  7. Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

    Science.gov (United States)

    Hartzler, Bryan; Rabun, Carl

    2014-01-01

    Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge

  8. Counting the cost: estimating the economic benefit of pedophile treatment programs.

    Science.gov (United States)

    Shanahan, M; Donato, R

    2001-04-01

    The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.

  9. Community-based radon education programs

    International Nuclear Information System (INIS)

    Laquatra, J.

    1990-01-01

    This paper reports that in the United States, educational programs about radon gas have been developed and implemented by federal and state government entities and other organizations, including the Cooperative Extension Service and affiliated land grant universities. Approaches have included the production of brochures, pamphlets, workshops for targeted audiences, and consumer telephone hotlines. In a free market for radon mitigation products and services, these efforts can be appropriate for their credibility, lack of bias, and individualized approaches. The purpose of this paper is to report on an educational program about radon undertaken by Cornell Cooperative Extension, including county-based workshops targeted to homeowners, housing professionals, high school teachers, and others. An analysis of survey data from program participants forms the basis for a discussion of the effectiveness of the Cooperative Extension Service in reaching the public about this topic

  10. ASSESSMENT OF PERDA, E-COMMUNITY PROGRAM, PULAU PINANG

    OpenAIRE

    Cheah Fee Lian; Musa Abu Hassan; Jusang Bolong

    2011-01-01

    The purpose of this paper is to assess the e-community program launched by Penang Regional Development Authority (PERDA) based on participants. 276 survey forms were distributed randomly throughout four zones Multimedia Training Centers in Penang. Generally, the respondents admitted that PERDA’s e-community program had positive elements towards them. It was found that interpersonal source such as peers, neighbours and family members were main sources to provided information regarding PE...

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

    Science.gov (United States)

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

    2016-12-01

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

  12. (SWASH-D for Worms: A pilot study investigating the differential impact of school- versus community-based integrated control programs for soil-transmitted helminths.

    Directory of Open Access Journals (Sweden)

    Naomi E Clarke

    2018-05-01

    Full Text Available Soil-transmitted helminths (STH infect nearly 1.5 billion individuals globally, and contribute to poor physical and cognitive development in children. STH control programs typically consist of regular delivery of anthelminthic drugs, targeting school-aged children. Expanding STH control programs community-wide may improve STH control among school-aged children, and combining deworming with improvements to water, sanitation and hygiene (WASH may further reduce transmission. The (SWASH-D for Worms pilot study aims to compare the differential impact of integrated WASH and deworming programs when implemented at primary schools only versus when additionally implemented community-wide.A two-arm, non-randomized cluster intervention study was conducted. Six communities were identified by partner WASH agencies and enrolled in the study. All communities received a school-based WASH and deworming program, while three additionally received a community-based WASH and deworming program. STH infections were measured in school-aged children at baseline and six months after deworming. Over 90% of eligible children were recruited for the study, of whom 92.3% provided stool samples at baseline and 88.9% at follow-up. The school WASH intervention improved school sanitation, while the community WASH intervention reduced open defecation from 50.4% (95% CI 41.8-59.0 to 23.5% (95% CI 16.7-32.0. There was a trend towards reduced odds of N. americanus infection among children who received the community-wide intervention (OR 0.42, 95% CI 0.07-2.36, p = 0.32.This pilot study provides proof of principle for testing the hypothesis that community-wide STH control programs have a greater impact on STH infections among children than school-based programs, and supports the rationale for conducting a full-scale cluster randomized controlled trial. High recruitment and participation rates and successful implementation of school WASH programs demonstrate study feasibility and

  13. ASSESSMENT OF PERDA, E-COMMUNITY PROGRAM, PULAU PINANG

    Directory of Open Access Journals (Sweden)

    Cheah Fee Lian

    2011-12-01

    Full Text Available The purpose of this paper is to assess the e-community program launched by Penang Regional Development Authority (PERDA based on participants. 276 survey forms were distributed randomly throughout four zones Multimedia Training Centers in Penang. Generally, the respondents admitted that PERDA’s e-community program had positive elements towards them. It was found that interpersonal source such as peers, neighbours and family members were main sources to provided information regarding PERDA’s e-community program to the respondents. The results showed that most respondents had positive attitude towards competence, ability to try and complexity of computer and the Internet after going through the program. However, there were respondents which had negative attitudes towards their ability to try using the computer and Internet after involving in this program. The results also found that features in PERDA’s ecommunity program become the core into such involvement. Therefore, efforts are needed now and then in order to enhance the quality of this program thus encouraging more participation in the future.

  14. Journey to Healthy Aging: Impact of Community Based Education Programs on Knowledge and Health Behavior in Older Adults

    Science.gov (United States)

    McLarry, Sue

    2007-01-01

    The objective of this study was to determine if community based health education programs increased knowledge and health behavior in older adults. The study was a pretest-posttest design with a convenience sample of 111 independent community dwelling older adults. Participants received two disease prevention education presentations: type 2…

  15. Quantitative Evaluation of the Community Research Fellows Training Program

    Directory of Open Access Journals (Sweden)

    Lucy eD'Agostino McGowan

    2015-07-01

    Full Text Available Context: The Community Research Fellows Training (CRFT program is a community-based participatory research (CBPR initiative for the St. Louis area. This fifteen week program, based on a Master in Public Health curriculum, was implemented by the Division of Public Health Sciences at Washington University School of Medicine in partnership with the Siteman Cancer Center. Objectives: We measure the knowledge gained by participants and evaluate participant and faculty satisfaction of the CRFT program both in terms of meeting learning objectives and actively engaging the community in the research process.Participants: We conducted analyses on 44 community members who participated in the CRFT program and completed the baseline and follow-up knowledge assessments.Main Outcome Measures: Knowledge gain is measured by a baseline and follow-up assessment given at the first and final session. Additionally, pre- and post-tests are given after the first 12 sessions. To measure satisfaction, program evaluations are completed by both the participants and faculty after each topic. Mid-way through the program, a mid-term assessment was administered to assess the program’s community engagement. We analyzed the results from the assessments, pre- and post-tests, and evaluations.Results: The CRFT participants’ knowledge increased at follow-up as compared with baseline on average by a 16.5 point difference (p<0.0001. Post-test scores were higher than pre-test scores for 11 of the 12 sessions. Both participants and faculty enjoyed the training and rated all session well.Conclusions: The CRFT program was successful in increasing community knowledge, in participant satisfaction, and in faculty satisfaction. This success has enhanced the infrastructure for CBPR as well as led to CBPR pilot projects that address health disparities in the St. Louis Greater Metropolitan Area.

  16. Finding needles in a haystack: a methodology for identifying and sampling community-based youth smoking cessation programs.

    Science.gov (United States)

    Emery, Sherry; Lee, Jungwha; Curry, Susan J; Johnson, Tim; Sporer, Amy K; Mermelstein, Robin; Flay, Brian; Warnecke, Richard

    2010-02-01

    Surveys of community-based programs are difficult to conduct when there is virtually no information about the number or locations of the programs of interest. This article describes the methodology used by the Helping Young Smokers Quit (HYSQ) initiative to identify and profile community-based youth smoking cessation programs in the absence of a defined sample frame. We developed a two-stage sampling design, with counties as the first-stage probability sampling units. The second stage used snowball sampling to saturation, to identify individuals who administered youth smoking cessation programs across three economic sectors in each county. Multivariate analyses modeled the relationship between program screening, eligibility, and response rates and economic sector and stratification criteria. Cumulative logit models analyzed the relationship between the number of contacts in a county and the number of programs screened, eligible, or profiled in a county. The snowball process yielded 9,983 unique and traceable contacts. Urban and high-income counties yielded significantly more screened program administrators; urban counties produced significantly more eligible programs, but there was no significant association between the county characteristics and program response rate. There is a positive relationship between the number of informants initially located and the number of programs screened, eligible, and profiled in a county. Our strategy to identify youth tobacco cessation programs could be used to create a sample frame for other nonprofit organizations that are difficult to identify due to a lack of existing directories, lists, or other traditional sample frames.

  17. Effective recruitment and retention strategies in community health programs.

    Science.gov (United States)

    McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

    2013-08-01

    The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

  18. The "10 Keys" to Healthy Aging: 24-Month Follow-Up Results from an Innovative Community-Based Prevention Program

    Science.gov (United States)

    Robare, Joseph F.; Bayles, Constance M.; Newman, Anne B.; Williams, Kathy; Milas, Carole; Boudreau, Robert; McTigue, Kathleen; Albert, Steven M.; Taylor, Christopher; Kuller, Lewis H.

    2011-01-01

    The purpose of this report was to evaluate a prevention program to reduce risk factors for common diseases among older individuals in a lower income community. This randomized community-based study enrolled older adults into a Brief Education and Counseling Intervention or a Brief Education and Counseling Intervention plus a physical activity and…

  19. Comparing Effectiveness of New Training Program of Local Trainers of Community-Based Rehabilitation Program with the Current Program: A Knowledge, Attitude and Skills Study

    Directory of Open Access Journals (Sweden)

    Mohsen Iravani

    2011-10-01

    Full Text Available Objective: This research aimed at comparison effects of a new and current "training program for community rehabilitation workers of Community Based Rehabilitation", in enhancing their knowledge, attitude and skills. Materials & Methods: In this experimental field trial, a total number of 34 newly engaged local trainers in Lorestan province were divided randomly in two (16 and 18 peoplesinterventional groups based on geographical location of their work places Teaching methods were roll playing, problem solving, and learning by doing in new program and the booklets were revised in terms of fluency and a guideline booklet for trainers were added in this program but the teaching method was reading booklets and demonstration of the skills in current program. Knowledge, Attitude and Skills of trainees assessed just before and after the training course based on the material which were used for the training course. K.A.P. changes of two groups were compared by independent t-test, Mann Whitney, Wilcoxon & Chi square. Results: Mean knowledge and skills scores increments were remarkably more significant after attending new course than after passing the current course (P<0.001 and more rehabilitation workers who attending new course use practical guides in addition to verbal instructions to train disabled people and their families (P=0.028. There were no significant differences in attitude changes among the two groups. Conclusion: As trainees learned more by means of the new training course and the two courses were not so different in the resource allocation, substituting the new method to the current one should get consideration.

  20. Community College Employee Wellness Programs

    Science.gov (United States)

    Thornton, L. Jay; Johnson, Sharon

    2010-01-01

    This paper describes the prevalence and characteristics of employee wellness programs in public community colleges accredited by the Southern Association of Colleges and Schools (SACS). A random sample of 250 public community colleges accredited by SACS was mailed a 46-item employee-wellness program survey. The survey solicited program information…

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

    Science.gov (United States)

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

    2010-05-01

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

  2. International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

    Science.gov (United States)

    Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

    2017-03-24

    National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

  3. Social support and education groups for single mothers: a randomized controlled trial of a community-based program.

    Science.gov (United States)

    Lipman, Ellen L; Boyle, Michael H

    2005-12-06

    Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting. We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting. Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood (p effect = 0.55) and self-esteem (p effect = 0.29) compared with mothers in the control group; scores for the other 2 measures did not differ between the groups. Growth curve analysis of program effects over the follow-up period showed improvement in all 4 outcomes, with no significant difference between the intervention and control groups. This community-based program of group sessions offering social support and education to low-income single mothers had positive short-term effects on mood and self-esteem but not on social support and parenting. Longer follow-up showed attenuation of these effects.

  4. Community translation of the Math Interactive Learning Experience Program for children with FASD.

    Science.gov (United States)

    Kable, Julie A; Taddeo, Elles; Strickland, Dorothy; Coles, Claire D

    2015-04-01

    The Math Interactive Learning Experience (MILE), a program designed to address academic and behavioral problems found in children with Fetal Alcohol Spectrum Disorders (FASD), was found to be effective in a randomized clinical trials with results that persisted at a 6-month follow-up. The current study evaluated the effectiveness of a community translation, in partnership with several community sites in the metropolitan Atlanta area. A total of 60 participants were randomly assigned to one of the three treatment groups: the MILE program administered at a specialty care center (Center MILE) or in the community (Community MILE), or to parent math instruction only (Parent Instruction). This study evaluated instructor satisfaction with the training program, knowledge related to FASD and the MILE program, adherence to the MILE teaching methodology, participant math outcomes, and parents' satisfaction with their treatment experience. Instructors reported a high degree of satisfaction with the overall training and mean site fidelity ratings were positively correlated with change in math performance. Those in the MILE intervention groups demonstrated more positive gains in math skills than those in the Parent Instruction group but did not differ from each other. Parents in the Parent Instruction group reported less satisfaction with their intervention than those assigned to the Center MILE group but satisfaction ratings did not differ between those in the MILE intervention groups. These results indicate that the community translation and the MILE instructor training program developed as part of this process were well-received and effective in producing positive treatment outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

    Science.gov (United States)

    Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

    2015-01-01

    Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

  6. [Reflections on community-based rehabilitation strategy (CBR): the experience of a CBR program in Bolivia].

    Science.gov (United States)

    Díaz-Aristizabal, Urko; Sanz-Victoria, Silvia; Sahonero-Daza, Milton; Ledesma-Ocampo, Sandra; Cachimuel-Vinueza, Mesías; Torrico, Marisabel

    2012-01-01

    Community-Based Rehabilitation (CBR) is a strategy for community development endorsed by the World Health Organization (WHO), the International Labor Office (ILO) and the United Nations Educational, Scientific and Cultural Organization (UNESCO). It is designed to promote rehabilitation, equal opportunity and social inclusion of Disabled Persons (DP) in their home communities by fostering cooperation among disabled individuals, their families, and other concerned social actors, it encourages community leadership and full social participation by DP through multi-sector cooperation. This article explores the historical antecedents and basic features of CBR strategy through an analysis of a directed culture change initiative developed by a foundation in the Cochabamba administrative region of Bolivia. Especially in intercultural environments, certain aspects of the socio-cultural context may determine whether CBR programs succeed or fail.

  7. Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

    Science.gov (United States)

    Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

    2003-01-01

    Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

  8. Responsible Adult Culture (RAC): Cognitive and Behavioral Changes at a Community-Based Correctional Facility

    Science.gov (United States)

    Devlin, Renee S.; Gibbs, John C.

    2010-01-01

    This article examined cognitive and behavioral changes among participants in Responsible Adult Culture (RAC), a cognitive-behavioral (especially, cognitive restructuring) treatment program in use at the Franklin County Community-Based Correctional Facility (CBCF). Participants were adult felony offenders (approximately three-fourths male). A…

  9. Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

    Science.gov (United States)

    Crowley, Max; Jones, Damon

    2017-12-01

    Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed. © Society for Community Research and Action 2017.

  10. Factors associated with the implementation of community-based peer-led health promotion programs: A scoping review.

    Science.gov (United States)

    Lorthios-Guilledroit, Agathe; Richard, Lucie; Filiatrault, Johanne

    2018-06-01

    Peer education is growing in popularity as a useful health promotion strategy. However, optimal conditions for implementing peer-led health promotion programs (HPPs) remain unclear. This scoping review aimed to describe factors that can influence implementation of peer-led HPPs targeting adult populations. Five databases were searched using the keywords "health promotion/prevention", "implementation", "peers", and related terms. Studies were included if they reported at least one factor associated with the implementation of community-based peer-led HPPs. Fifty-five studies were selected for the analysis. The method known as "best fit framework synthesis" was used to analyze the factors identified in the selected papers. Many factors included in existing implementation conceptual frameworks were deemed applicable to peer-led HPPs. However, other factors related to individuals, programs, and implementation context also emerged from the analysis. Based on this synthesis, an adapted theoretical framework was elaborated, grounded in a complex adaptive system perspective and specifying potential mechanisms through which factors may influence implementation of community-based peer-led HPPs. Further research is needed to test the theoretical framework against empirical data. Findings from this scoping review increase our knowledge of the optimal conditions for implementing peer-led HPPs and thereby maximizing the benefits of such programs. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies

    Science.gov (United States)

    Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce

    2015-01-01

    Many community-based sport and physical activity programs take a positive youth development approach when operating in underserved communities around the world (Forneris, Whitley, & Barker, 2013). However, one of the biggest challenges for these programs is sustainability (Lindsey, 2008). The purpose of this article is to present the 3…

  12. Abundance and composition of indigenous bacterial communities in a multi-step biofiltration-based drinking water treatment plant.

    Science.gov (United States)

    Lautenschlager, Karin; Hwang, Chiachi; Ling, Fangqiong; Liu, Wen-Tso; Boon, Nico; Köster, Oliver; Egli, Thomas; Hammes, Frederik

    2014-10-01

    Indigenous bacterial communities are essential for biofiltration processes in drinking water treatment systems. In this study, we examined the microbial community composition and abundance of three different biofilter types (rapid sand, granular activated carbon, and slow sand filters) and their respective effluents in a full-scale, multi-step treatment plant (Zürich, CH). Detailed analysis of organic carbon degradation underpinned biodegradation as the primary function of the biofilter biomass. The biomass was present in concentrations ranging between 2-5 × 10(15) cells/m(3) in all filters but was phylogenetically, enzymatically and metabolically diverse. Based on 16S rRNA gene-based 454 pyrosequencing analysis for microbial community composition, similar microbial taxa (predominantly Proteobacteria, Planctomycetes, Acidobacteria, Bacteriodetes, Nitrospira and Chloroflexi) were present in all biofilters and in their respective effluents, but the ratio of microbial taxa was different in each filter type. This change was also reflected in the cluster analysis, which revealed a change of 50-60% in microbial community composition between the different filter types. This study documents the direct influence of the filter biomass on the microbial community composition of the final drinking water, particularly when the water is distributed without post-disinfection. The results provide new insights on the complexity of indigenous bacteria colonizing drinking water systems, especially in different biofilters of a multi-step treatment plant. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Enhancing community based health programs in Iran: a multi-objective location-allocation model.

    Science.gov (United States)

    Khodaparasti, S; Maleki, H R; Jahedi, S; Bruni, M E; Beraldi, P

    2017-12-01

    Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.

  14. Community Radiation Monitoring Program

    International Nuclear Information System (INIS)

    Cooper, E.N.

    1993-05-01

    The Community Radiation Monitoring Program (CRMP) is a cooperative effort between the US Department of Energy (DOE); the US Environmental Protection Agency (EPA); the Desert Research Institute (DRI), a division of the University and Community College System of Nevada and the Nuclear Engineering Laboratory of the University of Utah (UNEL). The twelfth year of the program began in the fall of 1991, and the work continues as an integral part of the DOE-sponsored long-term offsite radiological monitoring effort that has been conducted by EPA and its predecessors since the inception of nuclear testing at the Nevada Test Site (NTS). The program began as an outgrowth of activities that occurred during the Three Mile Island incident in 1979. The local interest and public participation that took place there were thought to be transferrable to the situation at the NTS, so, with adaptations, that methodology was implemented for this program. The CRMP began by enhancing and centralizing environmental monitoring and sampling equipment at 15 communities in the existing EPA monitoring network, and has since expanded to 19 locations in Nevada, Utah and California. The primary objectives of this program are still to increase the understanding by the people who live in the area surrounding the NTS of the activities for which DOE is responsible, to enhance the performance of radiological sampling and monitoring, and to inform all concerned of the results of these efforts. One of the primary methods used to improve the communication link with people in the potentially impacted area has been the hiring and training of local citizens as station managers and program representatives in those selected communities in the offsite area. These managers, active science teachers wherever possible, have succeeded, through their training, experience, community standing, and effort, in becoming a very visible, able and valuable asset in this link

  15. Lessons learned from community-based approaches to sodium reduction.

    Science.gov (United States)

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

    2015-01-01

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

  16. Assessing Community Needs for Expanding Environmental Education Programming

    Science.gov (United States)

    Hintz, Carly J.; Lackey, Brenda K.

    2017-01-01

    Based on increased demand for educational programming, leadership at Schmeeckle Reserve, a campus natural area in Stevens Point, WI explored the needs for expanded environmental education efforts. In 2014, a three-phased needs assessment framework was employed to explore educational programming offered in the community. Results from interviews and…

  17. Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers.

    Science.gov (United States)

    Guerrero, Erick G; Padwa, Howard; Lengnick-Hall, Rebecca; Kong, Yinfei; Perrigo, Judith L

    2015-07-01

    Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = -0.235, p = 0.041, 95 % CI -0.460, -0.010) and COD supervision and training (β = -0.195, p = 0.049, 95 % CI -0.389, -0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

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

    Science.gov (United States)

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

    2016-06-21

    Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens. The objective of this study is to investigate the effectiveness of 4 weeks of a Web-based psychoeducational intervention program for depressive and anxiety symptoms in the community of Selangor, Malaysia. A two-arm randomized controlled trial of a single-blind study will be conducted to meet the objective of this study. We aim to recruit 84 participants each for the intervention and control groups. The recruitment will be from participants who participated in the first phase of this research. The primary outcomes of this study are depressive and anxiety scores, which will be assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7, respectively. The secondary outcome includes mental health literacy of the participants, which will be assessed using the self-developed and adapted Mental Health Literacy Questionnaire. The psychoeducational intervention program consists of four sessions, which will be accessed each week. The depressive and anxiety symptoms will be compared between participants who participated in the psychoeducational program compared with the control group. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at follow-ups at week 5 and week 12, respectively. The psychoeducational intervention program consists of four sessions, which will be accessed at each week. The depressive and anxiety symptoms will be compared between the intervention and control groups using a series of mixed ANOVAs. Depressive and anxiety scores and mental health literacy will be assessed at week 1 and at two follow-ups at week 5 and week 12, respectively. To our knowledge, this study will be the first randomized

  19. Engagement processes in model programs for community reentry from prison for people with serious mental illness.

    Science.gov (United States)

    Angell, Beth; Matthews, Elizabeth; Barrenger, Stacey; Watson, Amy C; Draine, Jeffrey

    2014-01-01

    Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

    Science.gov (United States)

    Evans, Steven W; Randy Koch, J; Brady, Christine; Meszaros, Peggy; Sadler, Joanna

    2013-07-01

    Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

  1. Children's Readiness Gains in Publically Funded, Community-Based Pre-Kindergarten Programs for 4 Year Olds and Preschool for 3 Year Olds

    Science.gov (United States)

    Goldstein, Peggy; Warde, Beverly; Peluso, Paul

    2013-01-01

    Background: Many states provide public funding to facilitate school readiness for community-based pre-K and preschool programs for 4 year old children and "at risk" 3 year old children. Little research exists on the school readiness gains of children participating in these "garden variety" community-based programs. Objective:…

  2. Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival.

    Science.gov (United States)

    Miller, Daniel L; Mayfield, William R; Luu, Theresa D; Helms, Gerald A; Muster, Alan R; Beckler, Vickie J; Cann, Aaron

    2016-05-01

    Lung cancer is the most common cause of cancer deaths in the United States. Overall survival is less than 20%, with the majority of patients presenting with advanced disease. The National Lung Screening Trial, performed mainly in academic medical centers, showed that cancer mortality can be reduced with computed tomography (CT) screening compared with chest radiography in high-risk patients. To determine whether this survival advantage can be duplicated in a community-based multidisciplinary thoracic oncology program, we initiated a CT scan screening program for lung cancer within an established health care system. In 2008, we launched a lung cancer CT screening program within the WellStar Health System (WHS) consisting of five hospitals, three health parks, 140 outpatient medical offices, and 12 imaging centers that provide care in a five-county area of approximately 1.4 million people in Metro-Atlanta. Screening criteria incorporated were the International Early Lung Cancer Action Program (2008 to 2010) and National Comprehensive Cancer Network guidelines (2011 to 2013) for moderate- and high-risk patients. A total of 1,267 persons underwent CT lung cancer screening in WHS from 2008 through 2013; 53% were men, 87% were 50 years of age or older, and 83% were current or former smokers. Noncalcified indeterminate pulmonary nodules were found in 518 patients (41%). Thirty-six patients (2.8%) underwent a diagnostic procedure for positive findings on their CT scan; 30 proved to have cancer, 28 (2.2%) primary lung cancer and 2 metastatic cancer, and 6 had benign disease. Fourteen patients (50%) had their lung cancer discovered on their initial CT scan, 11 on subsequent scans associated with indeterminate pulmonary nodules growth and 3 patients who had a new indeterminate pulmonary nodules. Only 15 (54%) of these 28 patients would have qualified as a National Lung Screening Trial high-risk patient; 75% had stage I or II disease. Overall 5-year survival was 64% and 5-year

  3. Frontline over ivory tower: key competencies in community-based curricula

    Directory of Open Access Journals (Sweden)

    Adam Millar

    2015-04-01

    Full Text Available Background: The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties.  Presently there is wide variability in community endocrine experiences across Canadian training programs.  This is complicated by the paucity of literature providing guidance on what constitutes a ‘community’ rotation. Method: A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round.  The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates. Results: Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum.  The experts considered the “Manager” role best taught in the community, while they considered the community least suitable to learn the “Medical Expert” competency. Conclusions: To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada.  These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role.  The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs.

  4. Virtual reality-based prospective memory training program for people with acquired brain injury.

    Science.gov (United States)

    Yip, Ben C B; Man, David W K

    2013-01-01

    Acquired brain injuries (ABI) may display cognitive impairments and lead to long-term disabilities including prospective memory (PM) failure. Prospective memory serves to remember to execute an intended action in the future. PM problems would be a challenge to an ABI patient's successful community reintegration. While retrospective memory (RM) has been extensively studied, treatment programs for prospective memory are rarely reported. The development of a treatment program for PM, which is considered timely, can be cost-effective and appropriate to the patient's environment. A 12-session virtual reality (VR)-based cognitive rehabilitation program was developed using everyday PM activities as training content. 37 subjects were recruited to participate in a pretest-posttest control experimental study to evaluate its treatment effectiveness. Results suggest that significantly better changes were seen in both VR-based and real-life PM outcome measures, related cognitive attributes such as frontal lobe functions and semantic fluency. VR-based training may be well accepted by ABI patients as encouraging improvement has been shown. Large-scale studies of a virtual reality-based prospective memory (VRPM) training program are indicated.

  5. A pilot study of community-based self-sampling for HPV testing among non-attenders of cervical cancer screening programs in El Salvador.

    Science.gov (United States)

    Laskow, Bari; Figueroa, Ruben; Alfaro, Karla M; Scarinci, Isabel C; Conlisk, Elizabeth; Maza, Mauricio; Chang, Judy C; Cremer, Miriam

    2017-08-01

    To establish the feasibility and acceptability of home-based HPV self-sampling among women who did not attend screening appointments in rural El Salvador. In a cross-sectional study, data were collected from May 2015 to January 2016 among 60 women aged 30-59 years who were not pregnant, provided informed consent, had not been screened in 2 years, had no history of pre-cancer treatment, and did not attend a scheduled HPV screening. Participants completed questionnaires and received educational information before being given an opportunity to self-sample with the Hybrid Capture 2 High Risk HPV DNA Test. Self-sampling was accepted by 41 (68%) participants. Almost all women chose to self-sample because the process was easy (40/41, 98%), could be performed at home (40/41, 98%), and saved time (38/41, 93%), and because they felt less embarrassed (33/41, 80%). The most common reason for declining the test was not wanting to be screened (8/19, 42%). The prevalence of high-risk HPV types among women who accepted self-sampling was 17% (7/41). For most women, community-based self-sampling was an acceptable way to participate in a cervical cancer screening program. In low-resource countries, incorporating community-based self-sampling into screening programs might improve coverage of high-risk women. © 2017 International Federation of Gynecology and Obstetrics.

  6. 75 FR 80561 - Community Express Pilot Program

    Science.gov (United States)

    2010-12-22

    ... SMALL BUSINESS ADMINISTRATION Community Express Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Notice of short-term extension and termination of the Community Express Pilot Program. SUMMARY: This notice announces the termination of the Community Express Pilot Program following a...

  7. Relationship power and sexual risk among women in community-based substance abuse treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Tross, Susan; Dworkin, Shari L; Hu, Mei-Chen; Manuel, Jennifer; Pavlicova, Martina; Nunes, Edward V

    2009-11-01

    Relationship power has been highlighted as a major factor influencing women's safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women's HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

  8. Individualization of a Manualized Pressure Ulcer Prevention Program: Targeting Risky Life Circumstances Through a Community-Based Intervention for People with Spinal Cord Injury

    Science.gov (United States)

    Vaishampayan, Ashwini; Clark, Florence; Carlson, Mike; Blanche, Erna Imperatore

    2012-01-01

    Purpose To sensitize practitioners working with individuals with spinal cord injury to the complex life circumstances that are implicated in the development of pressure ulcers, and to document the ways that interventions can be adapted to target individual needs. Methods Content analysis of weekly fidelity/ quality control meetings that were undertaken as part of a lifestyle intervention for pressure ulcer prevention in community-dwelling adults with spinal cord injury. Results Four types of lifestyle-relevant challenges to ulcer prevention were identified: risk-elevating life circumstances, communication difficulties, equipment problems, and individual personality issues. Intervention flexibility was achieved by changing the order of treatment modules, altering the intervention content or delivery approach, or going beyond the stipulated content. Conclusion Attention to recurrent types of individual needs, along with explicit strategies for tailoring manualized interventions, has potential to enhance pressure ulcer prevention efforts for adults with spinal cord injury. Target audience This continuing education article is intended for practitioners interested in learning about a comprehensive, context-sensitive, community-based pressure ulcer prevention program for people with spinal cord injury. Objectives After reading this article, the reader should be able to: Describe some of the contextual factors that increase pressure ulcer risk in people with spinal cord injury living in the community.Distinguish between tailored and individualized intervention approaches.Identify the issues that must be taken into account to design context-sensitive, community-based pressure ulcer prevention programs for people with spinal cord injury.Describe approaches that can be used to individualize manualized interventions. PMID:21586911

  9. Lessons Learned From Community-Based Approaches to Sodium Reduction

    Science.gov (United States)

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

    2017-01-01

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

  10. Flexibility in competency-based workplace transition programs: an exploratory study of community child and family health nursing.

    Science.gov (United States)

    Cusack, Lynette; Gilbert, Sandra; Fereday, Jennifer

    2013-03-01

    Successful transition to practice programs that use competency-based assessment require the involvement of all staff, especially those undertaking the preceptor role. Qualitative data were collected using interview methods. Participants were 14 newly employed nurses and 7 preceptors in the child and family community health service in South Australia. Participant narratives were recorded electronically, transcribed, and thematically analyzed using the paradigm of critical social science. Five themes were identified that describe enablers as well as barriers to applying a flexible transition to practice program using competency-based assessment. These included flexibility in the program design, flexibility on the part of preceptors, flexibility to enable recognition of previous learning, flexibility in the assessment of competencies, and flexibility in workload. To ensure successful application of a transition to practice program using competency-based assessment, preceptors must understand the flexible arrangements built into the program design and have the confidence and competence to apply them. Copyright 2013, SLACK Incorporated.

  11. Assertive community treatment: facilitators and barriers to implementation in routine mental health settings.

    Science.gov (United States)

    Mancini, Anthony D; Moser, Lorna L; Whitley, Rob; McHugo, Gregory J; Bond, Gary R; Finnerty, Molly T; Burns, Barbara J

    2009-02-01

    This study identified barriers and facilitators to the high-fidelity implementation of assertive community treatment. As part of a multistate implementation project for evidence-based practices, training and consultation were provided to 13 newly implemented assertive community treatment teams in two states. Model fidelity was assessed at baseline and at six, 12, 18, and 24 months. Key informant interviews, surveys, and monthly on-site visits were used to monitor implementation processes related to barriers and facilitators. Licensing processes of the state mental health authority provided critical structural supports for implementation. These supports included a dedicated Medicaid billing structure, start-up funds, ongoing fidelity monitoring, training in the model, and technical assistance. Higher-fidelity sites had effective administrative and program leadership, low staff turnover, sound personnel practices, and skilled staff, and they allocated sufficient resources in terms of staffing, office space, and cars. Lower-fidelity sites were associated with insufficient resources, prioritization of fiscal concerns in implementation, lack of change culture, poor morale, conflict among staff, and high staff turnover. In cross-state comparisons, the specific nature of fiscal policies, licensing processes, and technical assistance appeared to influence implementation. State mental health authorities can play a critical role in assertive community treatment implementation but should carefully design billing mechanisms, promote technical assistance centers, link program requirements to fidelity models, and limit bureaucratic requirements. Successful implementation at the organizational level requires committed leadership, allocation of sufficient resources, and careful hiring procedures.

  12. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects

    NARCIS (Netherlands)

    Koekkoek, B.; van Meijel, B.; Schene, A.; Smit, A.; Kaasenbrood, A.; Hutschemaekers, G.

    2012-01-01

    Background: In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the

  13. Increasing Research Capacity in Underserved Communities: Formative and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1

    Directory of Open Access Journals (Sweden)

    Danielle Fastring

    2018-02-01

    Full Text Available BackgroundThe Mississippi Community Research Fellows Training Program (MSCRFTP is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants’ community, increase individual and community capacity, and to engage community members as equal partners in the research process.MethodsA comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants’ attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members’ involvement in research, satisfaction with the program, and the program’s impact on the participants’ daily practice and community work.ResultsTwenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p < 0.05. Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as “very high” (76.2%, n = 16 or

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

    Science.gov (United States)

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

    2014-12-01

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

  15. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects

    NARCIS (Netherlands)

    B. Koekkoek; G. Hutschemaekers; A. Smit; A. Schene; A. Kaasenbrood; prof Berno van Meijel

    2011-01-01

    In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It

  16. Community-Based Mental Health and Behavioral Programs for Low-Income Urban Youth: A Meta-Analytic Review

    Science.gov (United States)

    Farahmand, Farahnaz K.; Duffy, Sophia N.; Tailor, Megha A.; Dubois, David L.; Lyon, Aaron L.; Grant, Kathryn E.; Zarlinski, Jennifer C.; Masini, Olivia; Zander, Keith J.; Nathanson, Alison M.

    2012-01-01

    A meta-analytic review of 33 studies and 41 independent samples was conducted of the effectiveness of community-based mental health and behavioral programs for low-income urban youth. Findings indicated positive effects, with an overall mean effect of 0.25 at post-test. While this is comparable to previous meta-analytic intervention research with…

  17. Community intervention to promote rational treatment of acute respiratory infection in rural Nepal.

    Science.gov (United States)

    Holloway, Kathleen A; Karkee, Shiba B; Tamang, Ashalal; Gurung, Yam Bahadur; Kafle, Kumud K; Pradhan, Ramesh; Reeves, Barnaby C

    2009-01-01

    To evaluate a community education program about treatment of acute respiratory infection (ARI). First, community case definitions for severe and mild ARI were developed. The intervention was then evaluated using a controlled before-and-after design. Household surveys collected data about ARI treatment in 20 clusters, each based around a school and health facility. Treatment indicators included percentages of cases attending health facilities and receiving antibiotics. The intervention consisted of an education program in schools culminating in street theater performances, discussions with mothers after performances and training for community leaders and drug retailers by paramedics. The intervention was conducted in mid-2003. Indicators were measured before the intervention in Nov/Dec 2002 and again in Dec 2003/Jan 2004. Two thousand and seven hundred and nineteen households were surveyed and 3654 under-fives were identified, of whom 377 had severe ARI. After implementing the intervention, health post (HP) attendance rose by 13% in under-fives with severe ARI and fell by 9% in under-fives with mild ARI (test of interaction, P = 0.01). Use of prescribed antibiotics increased in under-fives with severe ARI by 21% but only by 1% in under-fives with mild ARI (test of interaction, P = 0.38). Irrespective of ARI severity, the use of non-prescribed antibiotics dropped by 5% (P = 0.002), and consultation with female community health volunteers (FCHVs)and use of safe home remedies increased by 6.7% (P not estimated) and 5.7% (P = 0.008) respectively. The intervention was implemented using local structures and in difficult circumstances, yet had a moderate impact. Thus it has the potential to effect large scale changes in behaviour and merits replication elsewhere.

  18. Building an Educational Program together health community agents

    Directory of Open Access Journals (Sweden)

    Lúcia Rondelo Duarte

    2007-01-01

    Full Text Available Aiming at contributing inputs to the learning process of community health agents from Family Health Strategy, this study has sought to devise an Educational Program to qualify seven community agents from the Family Health Unit on Habiteto, a neighborhood in the Brazilian city of Sorocaba. Speeches on the perception these agents have of their work, their difficulties and proposals were captured and analyzed within the framework of the "Collective Subject Speech". Results showed the group's learning needs, and guided the devising and implementation of the Educational Program, which adopted the "Problem-Based Education" model. This knowledge was built by the agents through a problem-focused reality, debating, searching for solutions, and implementing intervention projects. They noticed that being a community health agent means, above all, to struggle and harness community forces for purposes of defending health & education public services and for improving social health determinants.

  19. IMPLEMENTATION OF AN EVIDENCED-BASED PARENTING PROGRAM IN A COMMUNITY MENTAL HEALTH SETTING.

    Science.gov (United States)

    Roosa Ordway, Monica; McMahon, Thomas J; De Las Heras Kuhn, Lourdes; Suchman, Nancy E

    2018-01-01

    The process of mental health intervention implementation with vulnerable populations is not well-described in the literature. The authors worked as a community-partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low-income community. We used qualitative ethnographic methods to document the adaption of an evidence-based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0- to 84-month-old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings. © 2017 Michigan Association for Infant Mental Health.

  20. Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

    Science.gov (United States)

    Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

    2017-07-01

    Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

  1. Community energy auditing: experience with the comprehensive community energy management program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, J.L.; Berger, D.A.; Rubin, C.B.; Hutchinson, P.A. Sr.; Griggs, H.M.

    1980-09-01

    The report provides local officials and staff with information on lessons from the audit, projection, and general planning experiences of the Comprehensive Community Energy Management Program (CCEMP) communities and provides ANL and US DOE with information useful to the further development of local energy management planning methods. In keeping with the objectives, the report is organized into the following sections: Section II presents the evaluation issues and key findings based on the communities' experiences from Spring of 1979 to approximately March of 1980; Section III gives an organized review of experience of communities in applying the detailed audit methodology for estimating current community energy consumption and projecting future consumption and supply; Section IV provides a preliminary assessment of how audit information is being used in other CCEMP tasks; Section V presents an organized review of preliminary lessons from development of the community planning processes; and Section VI provides preliminary conclusions on the audit and planning methodology. (MCW)

  2. Community-based peer-led diabetes self-management: a randomized trial.

    Science.gov (United States)

    Lorig, Kate; Ritter, Philip L; Villa, Frank J; Armas, Jean

    2009-01-01

    The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months. A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires. At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures. These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.

  3. HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

    Science.gov (United States)

    Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian; Hausler, Harry; Van Damme, Wim

    2016-01-01

    members. In this respect, a household with a high level of HIV/AIDS competence will be more receptive to treatment adherence support, as the patient is more likely to allow interaction between the CHW and the household. In contrast, in a household which exhibits limited characteristics of HIV/AIDS competence, interaction with the treatment adherence supporter may be difficult in the beginning. In such a situation, visits from the CHW threaten the hybrid identity management. If the CHW handles this situation cautiously and the patient-acting as a gate keeper-allows interaction, the CHW may be able to help the household develop towards HIV/AIDS competence. This would have a more added value compared to a household which was more HIV/AIDS competent from the outset. This study indicates that pre-existing dynamics in a patient's social environment, such as the HIV/AIDS competence of the household, should be taken into account when designing community-based treatment adherence programs in order to provide long-term quality care, treatment and support in the context of human resource shortages.

  4. HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

    Directory of Open Access Journals (Sweden)

    Caroline Masquillier

    /her household members. In this respect, a household with a high level of HIV/AIDS competence will be more receptive to treatment adherence support, as the patient is more likely to allow interaction between the CHW and the household. In contrast, in a household which exhibits limited characteristics of HIV/AIDS competence, interaction with the treatment adherence supporter may be difficult in the beginning. In such a situation, visits from the CHW threaten the hybrid identity management. If the CHW handles this situation cautiously and the patient-acting as a gate keeper-allows interaction, the CHW may be able to help the household develop towards HIV/AIDS competence. This would have a more added value compared to a household which was more HIV/AIDS competent from the outset. This study indicates that pre-existing dynamics in a patient's social environment, such as the HIV/AIDS competence of the household, should be taken into account when designing community-based treatment adherence programs in order to provide long-term quality care, treatment and support in the context of human resource shortages.

  5. Organizational capacity for service integration in community-based addiction health services.

    Science.gov (United States)

    Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

    2014-04-01

    We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

  6. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

    Directory of Open Access Journals (Sweden)

    Yoshito Kawakatsu

    2017-02-01

    Full Text Available Abstract Background The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW. The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. Methods The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS. In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Results Factors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Conclusions Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate

  7. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  8. A Model for Community-Based Pediatric Oral Heath: Implementation of an Infant Oral Care Program

    Directory of Open Access Journals (Sweden)

    Francisco J. Ramos-Gomez

    2014-01-01

    Full Text Available The Affordable Care Act (ACA mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0–5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC, and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance “in health” not in “disease modality”. IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the “age-one visit”. This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.

  9. A model for community-based pediatric oral heath: implementation of an infant oral care program.

    Science.gov (United States)

    Ramos-Gomez, Francisco J

    2014-01-01

    The Affordable Care Act (ACA) mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP) in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0-5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC), and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance "in health" not in "disease modality". IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the "age-one visit". This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.

  10. Assertive Community Treatment in the Netherlands

    NARCIS (Netherlands)

    M.D. van Vugt (Maaike)

    2015-01-01

    markdownabstract__Abstract__ __Introduction: __ Assertive Community Treatment is a model for care and treatment of patients with the most severe mental illness in the community. Key principles of Assertive Community Treatment (ACT) are: integration of services, low patient–staff ratio, locus of

  11. Participation of pregnant women in a community-based nutrition program in Mumbai's informal settlements: Effect on exclusive breastfeeding practices.

    Science.gov (United States)

    Chanani, Sheila; Waingankar, Anagha; Shah More, Neena; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

    2018-01-01

    In urban Maharashtra, India, approximately half of mothers exclusively breastfeed. For children residing in informal settlements of Mumbai, this study examines factors associated with exclusive breastfeeding, and whether exclusive breastfeeding, in a community-based nutrition program to prevent and treat wasting among children under age three, is associated with enrolment during the mother's pregnancy. The nutrition program conducted a cross-sectional endline survey (October-December 2015) of caregivers in intervention areas. Factors associated with exclusive breastfeeding for infants under six months of age were explored using multi-level logistic regressions. Additionally, program surveillance data collected during home-based counselling visits documented breastfeeding practices for children under six months of age. Using the surveillance data (January 2014-March 2016), exclusive breastfeeding status was regressed adjusting for child, maternal and socioeconomic characteristics, and whether the child was enrolled in the program in utero or after birth. The community-based endline survey included 888 mothers of infants. Mothers who received the nutrition program home visits or attended group counselling sessions were more likely to exclusively breastfeed (adjusted odds ratio 1.67, 95% CI 1.16, 2.41). Having a normal weight-for-height z-score (adjusted odds ratio 1.57, 95% CI 1.00, 2.45) was associated positively with exclusive breastfeeding. As expected, being an older infant aged three to five months (adjusted odds ratio 0.34, 95% CI 0.25, 0.48) and receiving a prelacteal feed after birth (adjusted odds ratio 0.57, 95% CI 0.41, 0.80) were associated with lower odds of exclusively breastfeeding. Surveillance data (N = 3420) indicate that infants enrolled in utero have significantly higher odds of being exclusively breastfed (adjusted odds ratio 1.55, 95% CI 1.30, 1.84) than infants enrolled after birth. Prenatal enrolment in community-based programs working on

  12. Consumer preferences in format and type of community-based weight control programs.

    Science.gov (United States)

    Sherwood, N E; Morton, N; Jeffery, R W; French, S A; Neumark-Sztainer, D; Falkner, N H

    1998-01-01

    The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. The study was conducted at a university and three local health department sites. Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain. The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offering ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offering attracted health-conscious participants with higher education and income levels. These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.

  13. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Ahead of the game protocol: a multi-component, community sport-based program targeting prevention, promotion and early intervention for mental health among adolescent males.

    Science.gov (United States)

    Vella, Stewart A; Swann, Christian; Batterham, Marijka; Boydell, Katherine M; Eckermann, Simon; Fogarty, Andrea; Hurley, Diarmuid; Liddle, Sarah K; Lonsdale, Chris; Miller, Andrew; Noetel, Michael; Okely, Anthony D; Sanders, Taren; Telenta, Joanne; Deane, Frank P

    2018-03-21

    There is a recognised need for targeted community-wide mental health strategies and interventions aimed specifically at prevention and early intervention in promoting mental health. Young males are a high need group who hold particularly negative attitudes towards mental health services, and these views are detrimental for early intervention and help-seeking. Organised sports provide a promising context to deliver community-wide mental health strategies and interventions to adolescent males. The aim of the Ahead of the Game program is to test the effectiveness of a multi-component, community-sport based program targeting prevention, promotion and early intervention for mental health among adolescent males. The Ahead of the Game program will be implemented within a sample drawn from community sporting clubs and evaluated using a sample drawn from a matched control community. Four programs are proposed, including two targeting adolescents, one for parents, and one for sports coaches. One adolescent program aims to increase mental health literacy, intentions to seek and/or provide help for mental health, and to decrease stigmatising attitudes. The second adolescent program aims to increase resilience. The goal of the parent program is to increase parental mental health literacy and confidence to provide help. The coach program is intended to increase coaches' supportive behaviours (e.g., autonomy supportive behaviours), and in turn facilitate high-quality motivation and wellbeing among adolescents. Programs will be complemented by a messaging campaign aimed at adolescents to enhance mental health literacy. The effects of the program on adolescent males' psychological distress and wellbeing will also be explored. Organised sports represent a potentially engaging avenue to promote mental health and prevent the onset of mental health problems among adolescent males. The community-based design, with samples drawn from an intervention and a matched control community

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

    Science.gov (United States)

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

    2008-09-15

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

  16. Reflective learning in community-based dental education.

    Science.gov (United States)

    Deogade, Suryakant C; Naitam, Dinesh

    2016-01-01

    Community-based dental education (CBDE) is the implementation of dental education in a specific social context, which shifts a substantial part of dental clinical education from dental teaching institutional clinics to mainly public health settings. Dental students gain additional value from CBDE when they are guided through a reflective process of learning. We propose some key elements to the existing CBDE program that support meaningful personal learning experiences. Dental rotations of 'externships' in community-based clinical settings (CBCS) are year-long community-based placements and have proven to be strong learning environments where students develop good communication skills and better clinical reasoning and management skills. We look at the characteristics of CBDE and how the social and personal context provided in communities enhances dental education. Meaningfulness is created by the authentic context, which develops over a period of time. Structured reflection assignments and methods are suggested as key elements in the existing CBDE program. Strategies to enrich community-based learning experiences for dental students include: Photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. A directed process of reflection is suggested as a way to increase the impact of the community learning experiences. We suggest key elements to the existing CBDE module so that the context-rich environment of CBDE allows for meaningful relations and experiences for dental students and enhanced learning.

  17. Essential elements for community engagement in evidence-based youth violence prevention.

    Science.gov (United States)

    Miao, Tai-An; Umemoto, Karen; Gonda, Deanna; Hishinuma, Earl S

    2011-09-01

    In the field of youth violence prevention, there has been increasing emphasis on "evidence based" programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence-based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence-based youth violence prevention based on their work in a university-community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self-reflection. The authors propose placing greater emphasis on "evaluative thinking" and organizational capacity for evaluation as we pursue evidence-based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.

  18. Evaluation of a Home-Based Hospice and Palliative Care Program in a Community Health Center in Korea

    Directory of Open Access Journals (Sweden)

    Su Hyun Kim

    2009-03-01

    Conclusions: A home-based palliative service program delivered by the community health center appears to be an appropriate care model for managing physical symptoms. Reinforcing services for psychosocial and spiritual counseling and encouraging affiliation with free-standing inpatient healthcare providers are warranted. [Asian Nursing Research 2009;3(1:24–30

  19. Strengthening community leadership: evaluation findings from the california healthy cities and communities program.

    Science.gov (United States)

    Kegler, Michelle C; Norton, Barbara L; Aronson, Robert E

    2008-04-01

    Collaborative approaches to community health improvement such as healthy cities and communities have the potential to strengthen community capacity through leadership development. The healthy cities and communities process orients existing local leadership to new community problem-solving strategies and draws out leadership abilities among residents not previously engaged in civic life. In an evaluation of the California Healthy Cities and Communities (CHCC) Program, leadership development was one of several outcomes assessed at the civic-participation level of the social ecology. Data collection methods included focus groups and surveys, semistructured interviews with coordinators and community leaders, and review of program documents. Findings suggest that the CHCC program enhanced capacity by expanding new leadership opportunities through coalition participation, program implementation, and civic leadership roles related to spin-off organizations and broader collaborative structures. Communities in rural regions were particularly successful in achieving significant leadership outcomes.

  20. An empirical approach to selecting community-based alcohol interventions: combining research evidence, rural community views and professional opinion

    Directory of Open Access Journals (Sweden)

    Shakeshaft Anthony

    2012-01-01

    Full Text Available Abstract Background Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Method Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The preferences of alcohol professionals were identified by a survey of randomly selected members of the Australasian Professional Society on Alcohol and Other Drugs. To identify preferred interventions and the extent of support for them, a budget allocation exercise was embedded in both surveys, asking respondents to allocate a given budget to different interventions. Tobit regression models were estimated to identify the characteristics that explain differences in intervention preferences. Results Community respondents selected school programs most often (88.0% and allocated it the largest proportion of funds, followed by promotion of safer drinking (71.3%, community programs (61.4% and police enforcement of alcohol laws (60.4%. Professionals selected GP training most often (61.0% and allocated it the largest proportion of funds, followed by school programs (36.6%, community programs (33.8% and promotion of safer drinking (31.7%. Community views were susceptible to response bias. There were no significant predictors of professionals' preferences. Conclusions In the absence of sufficient research evidence for effective community-based alcohol interventions, rural communities and professionals both strongly support school programs, promotion of safer drinking and community programs. Rural communities also supported police enforcement of alcohol laws and professionals supported GP training. The impact of a combination of these strategies needs to be rigorously evaluated.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  2. Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

    Science.gov (United States)

    Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

    2011-06-01

    This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

  3. Evaluation of a fissure sealant program as part of community-based teaching and training.

    Science.gov (United States)

    van Wyk, Philippus J; Kroon, Jeroen; White, John G

    2004-01-01

    Since 1995 the Department of Community Dentistry of the University of Pretoria has been involved in the rendering of mobile primary oral health care services to children in the Hammanskraal area of Gauteng, South Africa, as part of their students' community-based training. Mokonyama Primary School was identified as the first school where a primary oral health care service could be rendered. The objective of this study was to evaluate the impact (outcomes) of a fissure sealant program on the dentition status of the school children. Seven years after the implementation of the program, the dentition status of children at Mokonyama was compared with that of a comparable group of children from the same area who were not exposed to the program. The results showed that the decayed, missing, and filled teeth in the primary dentition (dmft) in the six-year-old group in Mokonyama (1.74) did not differ significantly from the dmft (1.43) of the control group (p = 0.49). The decayed, missing, and filled teeth in the permanent dentition (DMFT) of 0.59 for the fifteen-year-old group in Mokonyama, however, differed significantly (p = 0.0001) from the DMFT of the control group (2.38). Fifteen-year-old children in Mokonyama had 75.2 percent fewer caries than their counterparts in the control group.

  4. Treatment of hyperthyroidism in community hospital

    International Nuclear Information System (INIS)

    Gossain, V.V.; Heath, R.C.; Rovner, D.R.

    1989-01-01

    The preferred treatment of hyperthyroidism remains controversial. Most of this data is derived from large, university-based medical centers. We report here our experience with treatment of hyperthyroidism in a community setting. This involves 144 patients with hyperthyroidism who were seen over a 10 year period at Michigan State University Clinical Center and were treated in the community hospitals and private physicians' offices, and by community surgeons. Follow-up data were available on 119 of these patients; 105 of them were hyperthyroid because of Graves' disease and multinodular goiter. Patients were encouraged to make their own decisions regarding choice of therapy, as independently as possible. Sixty-five percent of these patients were treated by 131I, 18% by antithyroid drugs, and 17% by surgery. The mean follow-up period was 2.5 years (range 2 months to 19 years). Hyperthyroidism was controlled in 84% of the patients treated by 131I and 83% of the patients treated by surgery. Forty percent of the patients treated by 131I and 33% treated by surgery became hypothyroid. Fifty percent of the patients achieved remission when treated by antithyroid drugs alone. Our results indicate that when patients are encouraged to make their own decisions regarding the treatment of hyperthyroidism, their choices are similar to those of the thyroidologists. Secondly, the results obtained with different modalities of treatment for hyperthyroidism in a community setting are similar to those obtained in university medical centers

  5. An Australian Indigenous community-led suicide intervention skills training program: community consultation findings.

    Science.gov (United States)

    Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree

    2017-06-13

    Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.

  6. 76 FR 56262 - Community Advantage Pilot Program

    Science.gov (United States)

    2011-09-12

    ... SMALL BUSINESS ADMINISTRATION [Docket No. SBA 2011-0003] Community Advantage Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Notice of change to Community Advantage Pilot... Community Advantage Pilot Program. In that notice, SBA modified or waived as appropriate certain regulations...

  7. Exploring Community Radio Programming Practices to Inform ...

    African Journals Online (AJOL)

    A collective case study (multi-site) design was used to probe educational programming practices used in community radio. The paper explores how community radio station programming engages listeners in community generated education programmes that are produced through collaborative work with radio listener clubs.

  8. The effect of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation.

    Science.gov (United States)

    Miller, Carol A; Williams, Jennifer E; Durham, Katey L; Hom, Selena C; Smith, Julie L

    2017-10-01

    Many individuals with lower limb loss report concern with walking ability after completing structured traditional rehabilitation. The purpose of this study was to explore the impact of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation. Repeated measures. The supervised exercise program was offered biweekly for 6 weeks. The GAITRite System by CIR Systems, Inc., the Figure-of-8 Walk Test, and Activity-specific Balance Confidence Scale were used to measure clinical outcomes pre- and post-intervention. In total, 16 participants with lower limb amputation (mean age: 50.8 years) completed the study. A multivariate, repeated measures analysis of variance indicated a statistically significant effect of training across six clinical outcome measures ( F(6, 10) = 4.514, p = .018). Moderate effect sizes were found for the Figure-of-8 Walk Test ( η 2 = .586), Activity-specific Balance Confidence Scale ( η 2 = .504), and gait velocity at comfortable walking speed ( η 2 = .574). The average increase in gait speed was clinically meaningful at .14 m/s. The supervised community-based exercise program implemented in this study was designed to address specific functional needs for individuals with lower limb loss. Each participant experienced clinically meaningful improvements in balance, balance confidence, and walking ability. Clinical relevance The provision of a supervised community-based exercise program, after traditional rehabilitation, provides opportunity to offer a continuum of care that may enhance prosthetic functional ability and active participation in the community for individuals with lower limb amputation.

  9. Implementing community-based education in basic nursing education programs in South Africa.

    Science.gov (United States)

    Mtshali, N G

    2009-03-01

    Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE) programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin's (1990) grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

  10. Implementing community-based education in basic nursing education programs in South Africa

    Directory of Open Access Journals (Sweden)

    N.G. Mtshali

    2009-09-01

    Full Text Available Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin’s (1990 grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

  11. Community Radiation Monitoring Program

    International Nuclear Information System (INIS)

    Lucas, R.P. Jr.; Cooper, E.N.; McArthur, R.D.

    1990-05-01

    The Community Radiation Monitoring Program began its ninth year in the summer of 1989, continuing as an essential portion of the Environmental Protection Agency's long-standing off-site monitoring effort. It is a cooperative venture between the Department of Energy (DOE), the Environmental Protection Agency (EPA), the University of Utah (U of U), and the Desert Research Institute (DRI) of the University of Nevada System. The objectives of the program include enhancing and augmenting the collection of environmental radiation data at selected sites around the Nevada Test Site (NTS), increasing public awareness of that effort, and involving, in as many ways as possible, the residents of the off-site area in these and other areas related to testing nuclear weapons. This understanding and improved communication is fostered by hiring residents of the communities where the monitoring stations are located as program representatives, presenting public education forums in those and other communities, disseminating information on radiation monitoring and related subjects, and developing and maintaining contacts with local citizens and elected officials in the off-site areas. 8 refs., 4 figs., 4 tabs

  12. The relationship between the quality of drug user treatment and program completion: understanding the perceptions of women in a prison-based program.

    Science.gov (United States)

    Strauss, S M; Falkin, G P

    2000-01-01

    To determine why some women offenders complete prison-based drug user treatment and others leave early, clients' (N = 101) perceptions of various aspects of the quality of the treatment experience were compared. Analyses of both quantitative and qualitative data indicate that clients who completed the program had a more favorable perception of staff and felt empowered by the experience in treatment. Most of the clients who left early did so because of conflicts or disagreements with the program's rules. We discuss how a supportive approach to personal development may enhance client perceptions of program quality and increase retention rates.

  13. Measurement of Community Empowerment in Three Community Programs in Rapla (Estonia)

    Science.gov (United States)

    Kasmel, Anu; Andersen, Pernille Tanggaard

    2011-01-01

    Community empowerment approaches have been proven to be powerful tools for solving local health problems. However, the methods for measuring empowerment in the community remain unclear and open to dispute. This study aims to describe how a context-specific community empowerment measurement tool was developed and changes made to three health promotion programs in Rapla, Estonia. An empowerment expansion model was compiled and applied to three existing programs: Safe Community, Drug/HIV Prevention and Elderly Quality of Life. The consensus workshop method was used to create the measurement tool and collect data on the Organizational Domains of Community Empowerment (ODCE). The study demonstrated considerable increases in the ODCE among the community workgroup, which was initiated by community members and the municipality’s decision-makers. The increase was within the workgroup, which had strong political and financial support on a national level but was not the community’s priority. The program was initiated and implemented by the local community members, and continuous development still occurred, though at a reduced pace. The use of the empowerment expansion model has proven to be an applicable, relevant, simple and inexpensive tool for the evaluation of community empowerment. PMID:21556179

  14. Measurement of Community Empowerment in Three Community Programs in Rapla (Estonia

    Directory of Open Access Journals (Sweden)

    Pernille Tanggaard Andersen

    2011-03-01

    Full Text Available Community empowerment approaches have been proven to be powerful tools for solving local health problems. However, the methods for measuring empowerment in the community remain unclear and open to dispute. This study aims to describe how a context-specific community empowerment measurement tool was developed and changes made to three health promotion programs in Rapla, Estonia. An empowerment expansion model was compiled and applied to three existing programs: Safe Community, Drug/HIV Prevention and Elderly Quality of Life. The consensus workshop method was used to create the measurement tool and collect data on the Organizational Domains of Community Empowerment (ODCE. The study demonstrated considerable increases in the ODCE among the community workgroup, which was initiated by community members and the municipality’s decision-makers. The increase was within the workgroup, which had strong political and financial support on a national level but was not the community’s priority. The program was initiated and implemented by the local community members, and continuous development still occurred, though at a reduced pace. The use of the empowerment expansion model has proven to be an applicable, relevant, simple and inexpensive tool for the evaluation of community empowerment.

  15. Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

    Directory of Open Access Journals (Sweden)

    Arfiza Ridwan

    2012-08-01

    Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

  16. SPECAL ISSUE The Inclusion of Community-Based Education in to ...

    African Journals Online (AJOL)

    implementing a community-oriented education program. However, no comprehensive ... implementation of the program . Key Words: Community-Based Education, Curriculum, syllabus design, inclusion .... obvious to many instructors, Rubin (as cited in Diamond, 1989) found that, in practice, course syllabi frequently lack ...

  17. Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program.

    Science.gov (United States)

    Gutierrez, Jaime; Devia, Carlos; Weiss, Linda; Chantarat, Tongtan; Ruddock, Charmaine; Linnell, Jill; Golub, Maxine; Godfrey, Loyce; Rosen, Rosa; Calman, Neil

    2014-01-01

    The purpose of this study was to evaluate Fine, Fit, and Fabulous (FFF), a faith-based diabetes prevention program for black and Latino congregants at churches in low-income New York City neighborhoods. FFF includes nutrition education and fitness activities while incorporating Bible-based teachings that encourage healthy lifestyles. FFF is a 12-week, bilingual program developed by the Bronx Health REACH coalition, a Centers for Disease Control and Prevention-funded Center of Excellence for the Elimination of Disparities. This program has been implemented in 15 Bronx and Harlem churches, engaging a primarily black and Latino overweight and obese urban population. Pre-post surveys, nutrition tests, and weight logs were collected to assess knowledge, attitudes, and behaviors regarding healthy eating and physical activity. Participants (n = 183) reported statistically significant improvements in knowledge and healthy behaviors from baseline. Increased numbers of participants reported exercising in the past 30 days, eating fruit daily, being able to judge portion sizes, and reading food labels. Statistically significant numbers reported that they ate less fast food and were less likely to overeat at follow-up. The average weight loss across churches was 4.38 lbs or 2% of participants' initial body weight. Significant differences were observed when stratifying by race/ethnicity. Evaluation results show FFF's success at engaging overweight adults in behavior changes related to healthy eating and exercise. FFF demonstrates the potential of faith-based health interventions to address obesity and diabetes risk in high-need communities of color.

  18. [Community Service Program, Westmont College.

    Science.gov (United States)

    Kistler, Christina

    This report describes a 2-year project at Westmont College, California, which established a Community Service Program with the purposes of decreasing student debt and increasing student participation in community organizations. Eligible students worked 8-10 hours per week for a qualified community agency and received credit towards tuition for the…

  19. Evaluating a School-Based Day Treatment Program for Students with Challenging Behaviors

    Science.gov (United States)

    Hickman, Antoine Lewis

    2014-01-01

    Jade County Public Schools has provided school-based therapeutic day treatment in its public schools for more than 10 years. This program was adopted by the school system to provide an intervention in the school and classroom to address the challenging behaviors of students with emotional and behavioral disorders. Currently, three human services…

  20. Community-Based Promotional Campaign to Improve Uptake of Intermittent Preventive Antimalarial Treatment in Pregnancy in Burkina Faso

    NARCIS (Netherlands)

    Gies, Sabine; Coulibaly, Sheick O.; Ky, Clotilde; Ouattara, Florence T.; Brabin, Bernard J.; d'Alessandro, Umberto

    2009-01-01

    Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae

  1. 77 FR 38015 - Community Programs Guaranteed Loans

    Science.gov (United States)

    2012-06-26

    ... section. This is based upon the Agency's experience to date in financing this type of project and the... sections, in order to clarify the types of projects that are eligible for a Community Facilities Guaranteed... Program by limiting the risk to the guaranteed loan portfolio. RHS is seeking to prohibit the financing of...

  2. Factor Analysis of the HEW National Strategy for Youth Development Model's Community Program Impact Scales.

    Science.gov (United States)

    Truckenmiller, James L.

    The former HEW (Health, Education, and Welfare) National Strategy for Youth Development Model proposed a community-based program to promote positive youth development and to prevent delinquency through a sequence of youth needs assessments, needs-targeted programs, and program impact evaluation. HEW Community Program Impact Scales data obtained…

  3. Improving Urban Minority Girls' Health Via Community Summer Programming.

    Science.gov (United States)

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

    2017-12-01

    Summertime has emerged as a high-risk period for weight gain among low-income minority youth who often experience a lack of resources when not attending school. Structured programming may be an effective means of reducing risk for obesity by improving obesogenic behaviors among these youth. The current multi-method study examined sedentary time, physical activity, and dietary intake among low-income urban minority girls in two contexts: an unstructured summertime setting and in the context of a structured 4-week community-based summer day camp program promoting physical activity. Data were analyzed using paired-sample t tests and repeated-measure analyses of variance with significance at the p time of over 2 h/day and dairy consumption when engaged in structured summer programming. All improvements were independent of weight status and age, and African-American participants evidenced greater changes in physical activity during programming. The study concludes that structured, community-based summertime programming may be associated with fewer obesogenic behaviors in low-income urban youth and may be a powerful tool to address disparities in weight gain and obesity among high-risk samples.

  4. A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

    Directory of Open Access Journals (Sweden)

    Suzuki Yuriko

    2008-09-01

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

  5. Resource-stratified implementation of a community-based breast cancer management programme in Peru.

    Science.gov (United States)

    Duggan, Catherine; Dvaladze, Allison L; Tsu, Vivien; Jeronimo, Jose; Constant, Tara K Hayes; Romanoff, Anya; Scheel, John R; Patel, Shilpen; Gralow, Julie R; Anderson, Benjamin O

    2017-10-01

    Breast cancer incidence and mortality rates continue to rise in Peru, with related deaths projected to increase from 1208 in 2012, to 2054 in 2030. Despite improvements in national cancer control plans, various barriers to positive breast cancer outcomes remain. Multiorganisational stakeholder collaboration is needed for the development of functional, sustainable early diagnosis, treatment and supportive care programmes with the potential to achieve measurable outcomes. In 2011, PATH, the Peruvian Ministry of Health, the National Cancer Institute in Lima, and the Regional Cancer Institute in Trujillo collaborated to establish the Community-based Program for Breast Health, the aim of which was to improve breast health-care delivery in Peru. A four-step, resource-stratified implementation strategy was used to establish an effective community-based triage programme and a practical early diagnosis scheme within existing multilevel health-care infrastructure. The phased implementation model was initially developed by the Breast Cancer Initiative 2·5: a group of health and non-governmental organisations who collaborate to improve breast cancer outcomes. To date, the Community-based Program for Breast Health has successfully implemented steps 1, 2, and 3 of the Breast Cancer Initiative 2·5 model in Peru, with reports of increased awareness of breast cancer among women, improved capacity for early diagnosis among health workers, and the creation of stronger and more functional linkages between the primary levels (ie, local or community) and higher levels (ie, district, region, and national) of health care. The Community-based Program for Breast Health is a successful example of stakeholder and collaborator involvement-both internal and external to Peru-in the design and implementation of resource-appropriate interventions to increase breast health-care capacity in a middle-income Latin American country. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Effectiveness of group cognitive–behavioral treatment for childhood anxiety disorders in community clinics: benchmarking against an efficacy trial at a university clinic

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Arendt, Kristian Bech; Jørgensen, Lisbeth

    in Denmark (Arendt & Thastum, 2013). Objective: To evaluate the outcomes of evidence based, manualized group cognitive-behavioural treatment (CBT) for children and adolescent with anxiety disorders, when delivered in an outpatient Child and Adolescent Psychiatry or in a community based School Counselling...... Service in Denmark. Method: Psychologists and psychiatrists from three Child and Adolescent Psychiatry clinics and four community bases School Counselling Services are trained and supervised in a manualized group CBT treatment program (Cool Kids) for Childhood anxiety. Ninety-six children with anxiety...... disorders aged between 7 - 14 are expected to be included, equally divided between Psychiatric clinics (n = 48) and School Counselling services (n =48). The treatment consists of 10 2-hour group sessions with 5-6 children and their parents. Results are measured by independent diagnostic interviews...

  7. A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia

    Directory of Open Access Journals (Sweden)

    Adrian Miller

    2018-05-01

    Full Text Available This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven ‘treat-and-test’ mass drug administration (MDA intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested that resulted in increased morbidity and at least one death in the community. Between 2004–2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the ‘treat-and-test’ intervention was 16.6% [95% confidence interval 14.2–19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis

  8. The Effect of a Long-Term, Community-Based Exercise Program on Bone Mineral Density in Postmenopausal Women with Pre-Diabetes and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Bello Marieni

    2014-12-01

    Full Text Available The aim of this study was to evaluate the impact of a community-based exercise program on bone mineral density and body composition in postmenopausal women with pre-diabetes and type 2 diabetes. Twenty postmenopausal women (aged 61.3 ± 6.0 years with pre-diabetes and type 2 diabetes were randomly assigned to a community-based exercise program group (n=10 or a control group (n=10. The community-based exercise program was multicomponent, three days per week for 32 weeks, and included walking, resistance and aquatic exercises. Body composition and bone mineral density were measured pre and post-training by dual X-ray absorptiometry. In the exercise group significant increases were found in the ward’s triangle bone mineral density (+7.8%, p=0.043, and in fat-free mass (+2.4%, p=0.018. The findings suggest that regular multicomponent training is effective in preventing osteoporosis and sarcopenia among postmenopausal women with pre-diabetes and type 2 diabetes.

  9. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

    Science.gov (United States)

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

    2015-01-01

    We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

  10. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2009-01-01

    Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

  11. Community based monitoring: engaging and empowering Alberta ranchers

    Science.gov (United States)

    Michael S. Quinn; Jennifer E. Dubois

    2005-01-01

    Community based monitoring (CBM), a form of citizen science, is presented as a potential contributor to ecosystem management and sustainable development. A conceptual model for CBM and lessons learned from a Canadian national pilot program, the Canadian Community Monitoring Network, are summarized along with a description of the European university-based “science shop...

  12. Evaluation of a Community-Based Program That Integrates Joyful Movement Into Fall Prevention for Older Adults

    Science.gov (United States)

    Carlucci, Celeste; Kardachi, Julie; Bradley, Sara M.; Prager, Jason; Wyka, Katarzyna

    2018-01-01

    Background: Despite the development of evidence-based fall-prevention programs, there remains a need for programming that will engage older adults in real-world settings. Objective: This study aimed to evaluate a community-based group program that integrates joyful movement into fall prevention. The curriculum emphasizes a positive experience of movement, cultivating a healthy body image, and retraining of biomechanics. Design: Program evaluation was conducted using a one-group pre–post test study design. Key outcomes were functional balance and confidence. Qualitative feedback was gathered at the final class sessions. Results: Two hundred fifteen older adults enrolled at four sites over the period from 2010 to 2014. Among 86 participants who provided feedback, most credited the program for an increased sense of optimism and/or confidence (70%), and better walking ability (50%). Among 102 participants who completed both initial and final assessments, there was evidence of significant improvements on the Functional Reach Test (d = .60, p Falls Efficacy Scale (d = .17, p balance and confidence. Future research should examine whether the positive changes encouraged by joyful movement lead to lasting reductions in fall risk and additional health benefits. PMID:29796405

  13. Intelligence Community Programs, Management, and Enduring Issues

    Science.gov (United States)

    2016-11-08

    books, journal papers, conference presentations, working papers, and other electronic and print publications. Intelligence Community Programs... Intelligence Community Programs, Management, and Enduring Issues Anne Daugherty Miles Analyst in Intelligence and National Security Policy...

  14. Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).

    Science.gov (United States)

    Jones, Charlotte A; Nanji, Alykhan; Mawani, Shefina; Davachi, Shahnaz; Ross, Leanne; Vollman, Ardene; Aggarwal, Sandeep; King-Shier, Kathryn; Campbell, Norman

    2013-02-21

    South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population. South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures). Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing

  15. The Latino Migrant Worker HIV Prevention Program: building a community partnership through a community health worker training program.

    Science.gov (United States)

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

    2012-01-01

    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.

  16. A University-Community Partnership in Teacher Education from the Perspectives of Community-Based Teacher Educators

    Science.gov (United States)

    Guillen, Lorena; Zeichner, Ken

    2018-01-01

    This article examines the experiences of a group of nine community-based mentors of teacher candidates who partnered for several years through a local, community-based organization with the graduate elementary and secondary teacher education programs at a research university in the Pacific Northwest. Following a brief discussion of the history of…

  17. A behavior setting assessment for community programs and residences.

    Science.gov (United States)

    Perkins, D V; Baker, F

    1991-10-01

    Using the concept of person-environment fit to determine the effectiveness of residential and program placements for chronic psychiatric clients requires systematic and concrete information about these community environments in addition to information about the clients themselves. The conceptual and empirical development of the Behavior Setting Assessment (BSA), a measure based on Barker's behavior setting theory, is described. Use of the BSA with 28 residences (117 settings) and 11 programs (176 settings) from two community support systems demonstrated that all 293 settings assessed could be described and analyzed in terms of differences in their demands for self-care skills, food preparation and consumption, verbal/cognitive responses, and solitary or group activities. The BSA is an efficient measure for obtaining specific, concrete information about the behavioral demands of important community environments.

  18. A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability

    Science.gov (United States)

    Hakim, Renée M.; Ross, Michael D.; Runco, Wendy; Kane, Michael T.

    2017-01-01

    The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants’ measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance (P<0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility. PMID:28349039

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

    Science.gov (United States)

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

    2015-12-01

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

  20. Perceived impact of an interprofessional education program on community resilience: an exploratory study.

    Science.gov (United States)

    Slack, Marion Kimball; McEwen, Marylyn Morris

    2013-09-01

    The purpose of this study was to explore the perceived impact of an interprofessional education (IPE) program for health sciences students on two culturally diverse, underserved communities. A community resilience/capacity framework, consisting of catalysts (primarily the creation of awareness) and capital components: human (workforce development), social (networking and empowerment) and economic (volunteer labor and money spent by the program), provided the conceptual underpinnings for the study. Focus groups with stakeholders in two communities, one rural and one metropolitan, were audio-recorded, transcribed and analyzed by categorizing data according to each capital component. In addition to the concepts contained in the capacity framework a new category, informational capital (data specific to the community) emerged during the analysis. We suggest that by acting as a catalyst a community based interprofessional program can affect components of community resilience/capacity, primarily human, social, and informational capital. Using the community resilience/capacity framework facilitated exploration of the perceived impact of an educational program on one rural and one urban underserved community beyond assessing student outcomes or number of clients served.

  1. Feasibility and quality of cardiovascular disease prevention within a community-based health insurance program in rural Nigeria: an operational cohort study

    NARCIS (Netherlands)

    Hendriks, Marleen E.; Bolarinwa, Oladimeji A.; Wit, Ferdinand W. N. W.; Brewster, Lizzy M.; Odusola, Aina O.; Rosendaal, Nicole T. A.; Bindraban, Navin R.; Adenusi, Peju; Agbede, Kayode; Lange, Joep M. A.; Akande, Tanimola M.; Schultsz, Constance

    2015-01-01

    To assess the feasibility of providing guideline-based cardiovascular disease (CVD) prevention care within the context of a community-based health insurance program (CBHI) in rural Nigeria. A prospective operational cohort study was conducted in a primary healthcare clinic in rural Nigeria,

  2. Effects of a Community-Based, Post-Rehabilitation Exercise Program in COPD: Protocol for a Randomized Controlled Trial With Embedded Process Evaluation.

    Science.gov (United States)

    Desveaux, Laura; Beauchamp, Marla K; Lee, Annemarie; Ivers, Noah; Goldstein, Roger; Brooks, Dina

    2016-05-11

    This manuscript (1) outlines the intervention, (2) describes how its effectiveness is being evaluated in a pragmatic randomized controlled trial, and (3) summarizes the embedded process evaluation aiming to understand key barriers and facilitators for implementation in new environments. Participating centers refer eligible individuals with COPD following discharge from their local PR program. Consenting patients are assigned to a year-long community exercise program or usual care using block randomization and stratifying for supplemental oxygen use. Patients in the intervention arm are asked to attend an exercise session at least twice per week at their local community facility where their progress is supervised by a case manager. Each exercise session includes a component of aerobic exercise, and activities designed to optimize balance, flexibility, and strength. All study participants will have access to routine follow-up appointments with their respiratory physician, and additional health care providers as part of their usual care. Assessments will be completed at baseline (post-PR), 6, and 12 months, and include measures of functional exercise capacity, quality of life, self-efficacy, and health care usage. Intervention effectiveness will be assessed by comparing functional exercise capacity between intervention and control groups. A mixed-methods process evaluation will be conducted to better understand intervention implementation, guided by Normalization Process Theory and the Consolidated Framework for Implementation Research. Based on results from our pilot work, we anticipate a maintenance of exercise capacity and improved health-related quality of life in the intervention group, compared with a decline in exercise capacity in the usual care group. Findings from this study will improve our understanding of the effectiveness of community-based exercise programs for maintaining benefits following PR in patients with COPD and provide information on how best

  3. Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle program.

    Science.gov (United States)

    Kostadinov, Iordan; Daniel, Mark; Jones, Michelle; Cargo, Margaret

    2016-02-01

    Issue addressed The context of community-based childhood obesity prevention programs can influence the effects of these intervention programs. Leadership readiness for community mobilisation for childhood obesity prevention is one such contextual factor. This study assessed perceived community leadership readiness (PCLR) at two time points in a state-wide, multisite community-based childhood obesity prevention program. Methods PCLR was assessed across 168 suburbs of 20 intervention communities participating in South Australia's Obesity Prevention and Lifestyle (OPAL) program. Using a validated online PCLR tool, four key respondents from each community rated each suburb within their respective community on a nine-point scale for baseline and 2015. Average PCLR and change scores were calculated using the general linear model with suburbs nested in communities. Relationships between demographic variables and change in PCLR were evaluated using multiple regression. Ease of survey use was also assessed. Results Average PCLR increased between baseline (3.51, s.d.=0.82) and 2015 (5.23, s.d.=0.89). PCLR rose in 18 of 20 intervention communities. PCLR was inversely associated with suburb population size (r 2 =0.03, P=0.03, β=-0.25) and positively associated with intervention duration (r 2 change=0.08, P=0.00, β=0.29). Only 8% of survey respondents considered the online assessment tool difficult to use. Conclusions PCLR increased over the course of the OPAL intervention. PCLR varied between and within communities. Online assessment of PCLR has utility for multisite program evaluations. So what? Use of a novel, resource-efficient online tool to measure the key contextual factors of PCLR has enabled a better understanding of the success and generalisability of the OPAL program.

  4. Scaling up a community-based program for maternal and child nutrition in Thailand.

    Science.gov (United States)

    Winichagoon, Pattanee

    2014-06-01

    The first national nutrition survey of Thailand in 1960 revealed that malnutrition among children and women in this rice-exporting country was highly prevalent. Malnutrition received national-level attention in the 1970s, when a national multisectoral nutrition plan was included in the Fourth National Economic and Social Development Plan (NESDP) (1977-81), followed by effective implementation through Thailand's primary healthcare system and poverty alleviation plan in the 1982-87 NESDP. Nutrition was embedded into primary healthcare, and a community-based nutrition program was successfully implemented through community participation via manpower mobilization and capacity-building, financing, and organization. Growth-monitoring, promotion of infant and young child feeding, and joint financing (government and community) of a nutrition fund were implemented. The poverty alleviation plan made it possible to streamline resource allocations at the national level down to priority poverty areas, which also facilitated microlevel planning. Effective, integrated actions were undertaken using the basic minimum needs approach, wherein community people identified problems and participated in actions with inputs from government personnel. This effective process took about 5 years to put in place. In response, child undernutrition declined significantly. Severe malnutrition was practically eradicated, and it remains resilient despite social and economic challenges, such as the Asian economic crisis in 1977. Currently, stunting and subclinical micronutrient deficiencies remain, while overweight and obesity among children are rising rapidly. A different paradigm and strategy will be essential to address the nation's current nutrition challenges.

  5. A community based intervention program to enhance neighborhood cohesion: The Learning Families Project in Hong Kong.

    Science.gov (United States)

    Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia S

    2017-01-01

    Neighborhood cohesion, which refers to the extent of the connectedness and solidarity among residents in a community or neighborhood, is an important determinant of human health. To enhance neighborhood cohesion, the "Learning Families Project" was developed with a series of intervention programs in Kwun Tong in Hong Kong, a district with low neighborhood cohesion. This project, based on the social ecological model, provided a platform for neighbors to learn, communicate and interact with each other. This quasi-experimental study included two nearby government subsidized low rent housing estates separated by busy main roads. One served as the intervention (Tsui Ping (South) Estate) and one as the control (Shun Tin Estate) estate. The intervention included promotion, resident training and learning programs, embodied by a series of community activities such as talks, day camp, thematic activities and horticulture class. Baseline (before the programs) and follow-up (one year after the programs) surveys were conducted both in the intervention and control estate to assess the impact of the programs on neighborhood cohesion. The number of residents who completed both the baseline and follow-up surveys was 502 in the intervention estate and 476 in the control estate. Neighborhood cohesion significantly improved in the intervention group after the programs (Cohen effect size d: 0.15). Compared with the control group, the improvements in closeness of the neighborhood and trust in neighbors were significantly greater in the intervention group (Cohen effect size d: 0.13 and 0.14, respectively). This brief intervention program using a quasi-experimental study design increased neighborhood cohesion in a low rent housing estate. ClinicalTrials.gov NCT02851667.

  6. CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

    Science.gov (United States)

    Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

    2018-05-01

    The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

  7. A Community-based Healthy Living Promotion Program Improved Self-esteem Among Minority Children.

    Science.gov (United States)

    Wong, William W; Ortiz, Christina L; Stuff, Janice E; Mikhail, Carmen; Lathan, Debra; Moore, Louis A; Alejandro, Mercedes E; Butte, Nancy F; Smith, Elliot O'Brian

    2016-07-01

    Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority children. The after-school program was implemented at community centers in low-income neighborhoods with close proximity to public schools. The program consisted of 3 6-week sessions. Each week, children attended 2 2-hour sessions. Each 2-hour session in the intervention included 90 minutes of structured physical activities and 30 minutes of nutrition and healthy habit lessons. The control group received typical enrichment programs. Outcomes were measured before the intervention and at the end of each 6-week session. We enrolled 877 children (age 10.2 ± 0.1 years (mean ± SE); body mass index z score: 1.49 ± 0.1; 52.0% boys; 72.6% Hispanic) in the program with 524 children received the intervention at 14 community centers and 353 children served as control at 10 community centers. The intervention led to no improvements in BMI z score (P = 0.78) and dietary habits (P = 0.46). Significant improvements (P ≤ 0.02) were detected in the amount of exercise that a child perceived to be required to offset a large meal and in several key self-esteem scores. No improvements were detected in physical activities (P ≥ 0.21). The improvement in some key self-esteem scores and nutrition knowledge may act as a mediator to motivate these children to adopt a healthier lifestyle in the future.

  8. Puerto Rico NCI Community Oncology Research Program Minority/Underserved | Division of Cancer Prevention

    Science.gov (United States)

    The Puerto Rico NCI Community Oncology Research Program (PRNCORP) will be the principal organization in the island that promotes cancer prevention, control and screening/post-treatment surveillance clinical trials. It will conduct cancer care delivery research and will provide access to treatment and imaging clinical trials conducted under the reorganization of the National

  9. The impact of student diversity on interest, design, and promotion of Web-based tailored nutrition and physical activity programs for community colleges.

    Science.gov (United States)

    Quintiliani, Lisa M; De Jesus, Maria; Wallington, Sherrie Flynt

    2011-01-01

    To examine an organizational level perspective of the process of adopting Web-based tailored nutrition and physical activity programs for community college students. In this qualitative study, 21 individual key informant interviews of community college student services and health center administrators were used to examine organizational-level perceptions of interest in, design characteristics of, and ways to promote health programs. A cross-classification matrix of a priori and emergent themes related to student diversity was created to describe cross-cutting patterns. Findings revealed 5 emergent themes for consideration in program development related to student diversity: (1) multiple roles played by students, (2) limited access to financial resources, (3) varied student demographics, (4) different levels of understanding, and (5) commuting to campus. Nutrition and physical activity programs for community colleges need to specifically address the diverse nature of their students to increase the potential of adoption. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  10. "Just Say It Like It Is!" Use of a Community-Based Participatory Approach to Develop a Technology-Driven Food Literacy Program for Adolescents.

    Science.gov (United States)

    Wickham, Catherine A; Carbone, Elena T

    2018-01-01

    FuelUp&Go! is a technology-driven food literacy program consisting of six in-person skill building sessions as well as fitness trackers, text messages, and a companion website. A community-based participatory research approach was used with adolescents who were recruited to participate in a Kid Council. Qualitative data were collected about the use of surveys, program activities, recipes, technology and text messages, and music and incentives. Changes suggested by Kid Councilmembers informed the design and development of a pilot program. Participants were recruited for the pilot program and completed pre- and postintervention surveys. The results indicated food-related knowledge remained low but increased from baseline to follow-up. Attitudes toward vegetables and physical activity increased slightly. Self-reported participation in physical activity and consumption of sugar-added beverages moved in positive directions. These findings suggest that community-based participatory research approach is an effective approach to engage adolescents in the development of a technology-driven food literacy program.

  11. Use of partnership strategies to build radiation oncology disparities research programs in five Western Pennsylvania communities: an organizational case study.

    Science.gov (United States)

    Morgenlander, Keith H; Heron, Dwight E; Schenken, Larry L

    2009-01-01

    Many cancer treatment and prevention trials as well as surveillance programs suffer from a disproportionately low rate of accrual and a high rate of noncompliance or dropouts of racial minorities and the poor. One suggested strategy to help remediate this trend is to directly involve those targeted populations within the development, implementation, and evaluation of these services. The Radiation Oncology Community Outreach Group (ROCOG) and Neighborhood Cancer Care Cooperative (NCCC) are designed based upon this type of highly collaborative organizational structure, consistent with the general principles of community-based participatory research. Funded by the National Cancer Institute Cancer Disparities Research Partnership program, ROCOG/NCCC provide oncology-focused, community hospital-based initiatives intended to help close the cancer disparities gap. This article presents a descriptive case study of the organizational and political process that preceded our grant proposal submission, the potential benefits and difficulties associated with our extensive collaborative model, and an example of how highly competitive health care organizations can become partners in narrowly focused initiatives aimed at a greater social good.

  12. Growing healthy kids: a community garden-based obesity prevention program.

    Science.gov (United States)

    Castro, Dina C; Samuels, Margaret; Harman, Ann E

    2013-03-01

    Childhood obesity has increased dramatically in the past 3 decades, particularly among children aged 2-5 years. In this group, Latino children are among those with the highest prevalence of obesity. This paper describes a pilot study to evaluate a community intervention, known as the Growing Healthy Kids Program (GHK), to prevent childhood obesity among low-income families in a Southern state. The intervention included a weekly gardening session, a 7-week cooking and nutrition workshop, and social events for parents and children. Matched pre- and post-program height and weight data were collected for 95 children aged 2-15 years. Children's BMI was determined. Also, families reported on the availability and consumption of fruits and vegetables at the beginning and the end of the family's participation in the GHK program. Data were collected in 2008-2010 and analyzed in 2011. About 60% of participants who enrolled in the program were Latino families (n=60 families/120 children). By the end of their participation in the program, 17% (n=6, pcommunity gardens. Although there are limitations because this is a pilot study, this strategy seems to be promising for addressing childhood obesity, particularly among low-income Latino immigrant families. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Predicting the performance of a strategic alliance: an analysis of the Community Clinical Oncology Program.

    Science.gov (United States)

    Kaluzny, A D; Lacey, L M; Warnecke, R; Hynes, D M; Morrissey, J; Ford, L; Sondik, E

    1993-06-01

    This study is designed to examine the effects of environment and structure of the Community Clinical Oncology Program (CCOP) on performance as measured by patient accrual to National Cancer Institute (NCI)-approved treatment protocols. Data and analysis are part of a larger evaluation of the NCI Community Clinical Oncology Program during its second funding cycle, June 1987-May 1990. Data, taken from primary and secondary sources, included a survey of selected informants in CCOPs and research bases, CCOP grant applications, CCOP annual progress reports, and site visits to a subsample of CCOPs (N = 20) and research bases (N = 5). Accrual data were obtained from NCI records. Analysis involved three complementary sets of factors: the local health care resources environment available to the CCOP, the larger policy environment as reflected by the relationship of the CCOP to selected research bases and the NCI, and the operational structure of the CCOP itself. A hierarchical model examined the separate and cumulative effects of local and policy environment and structure on performance. Other things equal, the primary predictors of treatment accrual were: (1) the larger policy environment, as measured by the attendance of nurses at research base meetings; and (2) operational structure, as measured by the number and character of components within participating CCOPs and the number of hours per week worked by data managers. These factors explained 73 percent of the total variance in accrual performance. Findings suggest criteria for selecting the types of organizations to participate in the alliance, as well as for establishing guidelines for managing such alliances. A future challenge is to determine the extent to which factors predicting accrual to cancer treatment clinical trials are equally important as predictors of accrual to cancer prevention and control trials.

  14. Process Evaluation and Continuous Improvement in Community Youth Programs

    Directory of Open Access Journals (Sweden)

    Jennifer V. Trachtenberg

    2008-06-01

    Full Text Available A method of using process evaluation to provide improvement plans in order to promote community youth programs is described. The core elements of this method include the following: (1 collection and analysis of baseline data, (2 feedback provided to programs describing their strengths and limitations, (3 programs provided with assistance in preparing improvement plans in regard to their baseline data, and (4 follow-up evaluation assessed program changes based on their improvement plans and baseline data. A case study of an inner-city neighborhood youth center is used to demonstrate this method.

  15. Implementation cost analysis of a community-based exercise program for seniors in South Florida.

    Science.gov (United States)

    Page, Timothy F; Batra, Anamica; Ghouse, Muddasir M; Palmer, Richard C

    2014-07-01

    The objective of the study was to measure the costs of implementing the EnhanceFitness program to elderly residents of South Florida. The Health Foundation of South Florida's Healthy Aging Regional Collaborative implemented EnhanceFitness as part of their initiative to make evidence-based healthy aging programs available to South Florida seniors. Cost data were collected from agencies participating in the delivery of EnhanceFitness classes in South Florida. Cost questionnaires were e-mailed to program coordinators from agencies participating in the delivery of EnhanceFitness classes. Program coordinators worked with accounting staff to complete the questionnaires. Questionnaires were returned via e-mail. Costs were presented from the perspective of participating agencies. Total costs were divided by the number of classes being offered by each agency to determine cost per class per month. Average monthly costs per class were $1,713 during the first year of implementation and $873 during the second year of implementation. The cost measurements, combined with information from the literature on cost savings attributable to EnhanceFitness participation, suggest that EnhanceFitness has the potential to generate a net societal cost savings among program participants. The results are useful for community agencies considering implementing EnhanceFitness for their populations. © 2014 Society for Public Health Education.

  16. Longitudinal spirometry among patients in a treatment program for community members with World Trade Center (WTC)-related illness

    Science.gov (United States)

    Liu, Mengling; Qian, Meng; Cheng, Qinyi; Berger, Kenneth I.; Shao, Yongzhao; Turetz, Meredith; Kazeros, Angeliki; Parsia, Sam; Goldring, Roberta M.; Fernandez-Beros, Maria Elena; Marmor, Michael; Reibman, Joan

    2013-01-01

    Objective The course of lung function in community members exposed to World Trade Center (WTC) dust and fumes remains undefined. We studied longitudinal spirometry among patients in the WTC Environmental Health Center (WTCEHC) treatment program. Methods Observational study of 946 WTCEHC patients with repeated spirometry measures analyzed on the population as a whole and stratified by smoking status, initial spirometry pattern and WTC-related exposure category. Results Improvement in forced expiratory volume (FVC; 54.4 ml/year; 95% CI: 45.0-63.8) and forced expiratory volume in one second (FEV1; 36.8 ml/year; 95% CI: 29.3-44.3) was noted for the population as a whole. Heavy smokers did not improve. Spirometry changes differed depending on initial spirometry pattern and exposure category. Conclusions These data demonstrate spirometry improvement in select populations suggesting reversibility in airway injury and reinforcing the importance of continued treatment. PMID:22995806

  17. Remote community electrification program - small wind integration in BC's offgrid communities

    Energy Technology Data Exchange (ETDEWEB)

    Lafaille, Julien [BC Hydro (Canada)

    2011-07-01

    The paper presents the Remote Community Electrification (RCE) program and wind integration in BC's off grid communities. The program offers electric utility service to eligible remote communities in BC. Most of them are offered off-grid services although it is cheaper to connect a community to a grid. BC hydro serves some communities that are not connected to the main grid. Local diesel or small hydro-generating stations are used to serve remote communities. The renewable energy program target is to reach 50% of remote communities. The reason that wind is a small part of the renewables is that hydro and biomass are abundant in BC. Some other barriers include high installation costs, durability concerns, and lack of in-house technical expertise. Some small Wind initiatives that have been taken were relatively few and fairly small. It can be concluded that due to a poor wind resource and the relatively low cost of diesel, there is limited potential for wind in BC remote communities.

  18. 75 FR 35881 - Smaller Learning Communities Program

    Science.gov (United States)

    2010-06-23

    ... Part II Department of Education Smaller Learning Communities Program; Notice #0;#0;Federal... EDUCATION Smaller Learning Communities Program Catalog of Federal Domestic Assistance (CFDA) Number: 84.215L. AGENCY: Office of Elementary and Secondary Education, Department of Education. ACTION: Notice of final...

  19. Web-Based Treatment Program Using Intensive Therapeutic Contact for Patients With Eating Disorders : Before-After Study

    NARCIS (Netherlands)

    ter Huurne, E.D.; Postel, Marloes Gerda; de Haan, H.A.; Drossaert, Constance H.C.; Jong, C.A.J.

    2013-01-01

    Background: Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive

  20. Utility of repeated praziquantel dosing in the treatment of schistosomiasis in high-risk communities in Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Charles H King

    2011-09-01

    Full Text Available Controversy persists about the optimal approach to drug-based control of schistosomiasis in high-risk communities. In a systematic review of published studies, we examined evidence for incremental benefits from repeated praziquantel dosing, given 2 to 8 weeks after an initial dose, in Schistosoma-endemic areas of Africa.We performed systematic searches of electronic databases PubMed and EMBASE for relevant data using search terms 'schistosomiasis', 'dosing' and 'praziquantel' and hand searches of personal collections and bibliographies of recovered articles. In 10 reports meeting study criteria, improvements in parasitological treatment outcomes after two doses of praziquantel were greater for S. mansoni infection than for S. haematobium infection. Observed cure rates (positive to negative conversion in egg detection assays were, for S. mansoni, 69-91% cure after two doses vs. 42-79% after one dose and, for S. haematobium, 46-99% cure after two doses vs. 37-93% after a single dose. Treatment benefits in terms of reduction in intensity (mean egg count were also different for the two species-for S. mansoni, the 2-dose regimen yielded an weighted average 89% reduction in standardized egg counts compared to a 83% reduction after one dose; for S. haematobium, two doses gave a 93% reduction compared to a 94% reduction with a single dose. Cost-effectiveness analysis was performed based on Markov life path modeling.Although schedules for repeated treatment with praziquantel require greater inputs in terms of direct costs and community participation, there are incremental benefits to this approach at an estimated cost of $153 (S. mansoni-$211 (S. haematobium per additional lifetime QALY gained by double treatment in school-based programs. More rapid reduction of infection-related disease may improve program adherence, and if, as an externality of the program, transmission can be reduced through more effective coverage, significant additional benefits are

  1. Innovative partnerships to advance public health training in community-based academic residency programs

    Directory of Open Access Journals (Sweden)

    Lo JC

    2017-10-01

    Full Text Available Joan C Lo,1–3 Thomas E Baudendistel,2,3 Abhay Dandekar,3,4 Phuoc V Le,5 Stanton Siu,2,3 Bruce Blumberg6 1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; 2Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Graduate Medical Education, Kaiser Permanente East Bay, Oakland, CA, USA; 4Department of Pediatrics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 5School of Public Health, University of California Berkeley, Berkeley, CA, USA; 6Graduate Medical Education, Kaiser Permanente Northern California, Oakland, CA, USA Abstract: Collaborative partnerships between community-based academic residency ­training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention. These residency-MPH programs draw on more than 50 years of clinical education, public health training, and health services research – creating an environment that sparks inquiry and added value by developing skills in patient-centered care through the lens of population-based outcomes. Keywords: graduate medical education, public health, master’s degree, internal medicine, pediatrics, residency training

  2. A modified culture-based study of bacterial community composition in a tannery wastewater treatment plant.

    Science.gov (United States)

    Desta, Adey F; Dalhammer, Gunnel; Kittuva, Gunatrana R

    2010-01-01

    Though culture-independent methods have been used in preference to traditional isolation techniques for characterization of microbial community of wastewater treatment plants, it is difficult to widely apply this approach in resource-poor countries. The present study aimed to develop a test to identify the culturable portion of bacterial community in a high-strength wastewater. Wastewater samples were collected from nitrification-denitrification and settling tanks of the treatment plant of Elmo Leather AB tannery located in Borås, Sweden. After cultivating on nutrient agar with the optimal dilution (10⁻²), phenotypic and biochemical identification of the bacteria were done with colony morphology, Gram reaction, growth on MacConkey, phenylethanol media, triple sugar Iron agar slants, catalase and oxidase tests. Biochemical grouping of the isolates was done based on their test results for MacConkey, phenylethanol media, triple sugar Iron agar and oxidase test reaction. From the biochemical groups, isolates were randomly selected for API test and 16SrRNA gene sequencing. The isolates from the denitrification, nitrification tank were identified to be Paracoccus denitrificans (67%), Azoarcus spp (3%) and Spingomonas wittichii (1%). From the settling tank, Paracoccus denitrificans (22%), Corynebacterium freneyi (20%) and Bacillus cereus (1%) were identified. The grouping based on biochemical test results as well as the identification based on sequencing has shown coherence except for discrepancies with the API test. The preliminary implications of the grouping based on culture-based characteristics and its potential application for resource-limited environmental microbial studies is discussed.

  3. Community oriented interprofessional health education in Mozambique: one student/one family program.

    Science.gov (United States)

    Ferrão, L J; Fernandes, Tito H

    2014-01-01

    In the remote northern region of Mozambique the ratio of doctors to patients is 1:50,000. In 2007, Lúrio University initiated an innovative, "One Student/One Family" program of teaching and learning for health professions students, to complement their traditional core curriculum. All students of each of the school's six health degree programs complete a curriculum in "Family and Community Health" in each year of their training. Groups of six students from six different health professions training programs make weekly visits to communities, where each student is allocated to a family. Students learn from their families about community life and health issues, within a community where 80% of the population still lacks access to modern health care and rely on indigenous doctors and traditional remedies. In turn, students transmit information to families about modern health care and report to the faculty any major health problems they find. The educational/experiential approach is interprofessional and community-oriented. The main perceived advantages of the program are that it is applied and problem-based learning for students, while simultaneously providing needed healthcare services to the community. The major disadvantages include the complexity of coordinating multidisciplinary groups, the time and distance required of students in traveling to communities, and interpretation of multiple reports with variable data. This community-oriented education program involving students from six disciplines uses nontraditional teaching/learning methods is the basis of the ex libris of Lúrio University.

  4. An Evidence-Based Assessment of Faith-Based Programs: Do Faith-Based Programs "Work" to Reduce Recidivism?

    Science.gov (United States)

    Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.

    2011-01-01

    Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…

  5. A Preliminary Outcome Study of an Outpatient Treatment Program for Gamblers.

    Science.gov (United States)

    Blackman, Sheldon; And Others

    The Gamblers Treatment Clinic (GTC) opened in 1982 as a New York State Office of Mental Health Demonstration Program. The basic premise of the GTC is that excessive gambling is a disorder of impulse control. Treatment, conducted in the community in a time-limited fashion, attempts to uncover the underlying dynamics that precipitate disorders of…

  6. Framework for an Evidence-Based Physical Activity Intervention: Promoting Healthy Communities

    Directory of Open Access Journals (Sweden)

    Laura E. Bruno

    2017-05-01

    Conclusions: Opportunities to participate in a community based intervention program should be extended throughout all communities in an effort to improve holistic well-being. Further, type and duration as well as point of data collection of such programs should be differentiated in future research.

  7. Changes in blood pressure among users of lay health worker or volunteer operated community-based blood pressure programs over time: a systematic review protocol.

    Science.gov (United States)

    Skar, Pål; Young, Lynne; Gordon, Carol

    2015-10-01

    The objective of this review is to identify studies reporting on lay health worker- or volunteer-led community-based programs for blood pressure screening and cardiovascular awareness in order to determine if these programs contribute to changes in blood pressure among participants over time.The specific question for this review is: What are the changes in blood pressure among adult users of community-based blood pressure screening and awareness programs operated by lay health workers or volunteers as measured by the differences in systolic and diastolic blood pressure between the user's first visit to the program and their last visit to the program? Cardiovascular diseases, such as stroke and heart disease, are quickly becoming global diseases manifesting in countries and communities where they traditionally had not been widespread. The World Health Organization (WHO) has reported that "in the Asia/Pacific region, [cardiovascular disease] has become increasingly prevalent in recent decades, and now accounts for about one third of all deaths". One risk factor that can lead to cardiovascular disease is hypertension. Based on WHO data from 2008, hypertension is now a global problem affecting 27% of the population 25 years of age or older.The risk for cardiovascular disease also appears to be higher among people in urban areas. A recent United Nations population report indicates that in the next 40 years we could see an increase in the world's population by 2.3 billion people. The majority of these people will be residing in urban areas, particularly in developing nations. Between 2011 and 2050, "the population living in urban areas is projected to gain 2.6 billion, passing from 3.6 billion in 2011 to 6.3 billion in 2050". Population growth in urban areas is therefore not only projected to include the expected population growth but also expected to include a shift of rural population to urban centers and "most of the population growth expected in urban areas will be

  8. Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji.

    Science.gov (United States)

    Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd

    2013-12-01

    Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

  9. Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

    Science.gov (United States)

    Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

    2017-06-01

    Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme.

    Science.gov (United States)

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

    2017-11-30

    Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

  11. A community translational research pilot grants program to facilitate community--academic partnerships: lessons from Colorado's clinical translational science awards.

    Science.gov (United States)

    Main, Deborah S; Felzien, Maret C; Magid, David J; Calonge, B Ned; O'Brien, Ruth A; Kempe, Allison; Nearing, Kathryn

    2012-01-01

    National growth in translational research has increased the need for practical tools to improve how academic institutions engage communities in research. One used by the Colorado Clinical and Translational Sciences Institute (CCTSI) to target investments in community-based translational research on health disparities is a Community Engagement (CE) Pilot Grants program. Innovative in design, the program accepts proposals from either community or academic applicants, requires that at least half of requested grant funds go to the community partner, and offers two funding tracks: One to develop new community-academic partnerships (up to $10,000), the other to strengthen existing partnerships through community translational research projects (up to $30,000). We have seen early success in both traditional and capacity building metrics: the initial investment of $272,742 in our first cycle led to over $2.8 million dollars in additional grant funding, with grantees reporting strengthening capacity of their community- academic partnerships and the rigor and relevance of their research.

  12. Yoga Helps Put the Pieces Back Together: A Qualitative Exploration of a Community-Based Yoga Program for Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Michael J. Mackenzie

    2016-01-01

    Full Text Available Objective. A qualitative research methods approach was used to explore the experiences of participants in an ongoing community-based yoga program developed for cancer survivors and their support persons. Methods. 25 participants took part in a series of semistructured focus groups following a seven-week yoga program and at three- and six-month follow-ups. Focus groups were transcribed verbatim and analyzed using a process of inductive thematic analysis. Results. The group was comprised of 20 cancer survivors, who were diagnosed on average 25.40 (20.85 months earlier, and five support persons. Participants had completed the yoga program an average of 3.35 (3.66 times previously and attended approximately 1.64 (0.70 of three possible focus groups. Four key themes were identified: (1 safety and shared understanding; (2 cancer-specific yoga instruction; (3 benefits of yoga participation; (4 mechanisms of yoga practice. Conclusions. Qualitative research provides unique and in-depth insight into the yoga experience. Specifically, cancer survivors and support persons participating in a community-based yoga program discussed their experiences of change over time and were acutely aware of the beneficial effects of yoga on their physical, psychological, and social well-being. Further, participants were able to articulate the mechanisms they perceived as underpinning the relationship between yoga and improved well-being as they developed their yoga practice.

  13. From where are tuberculosis patients accessing treatment in India? Results from a cross-sectional community based survey of 30 districts.

    Directory of Open Access Journals (Sweden)

    Srinath Satyanarayana

    Full Text Available BACKGROUND: Tuberculosis (TB notification in India by the Revised National TB Control Programme (RNTCP provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patients access their treatment. OBJECTIVES: To estimate the proportion of patients accessing TB treatment outside the RNTCP and to identify their basic demographic characteristics. METHODS: A cross sectional community-based survey in 30 districts. Patients were identified through a door-to-door survey and interviewed using a semi-structured questionnaire. RESULTS: Of the estimated 75,000 households enumerated, 73,249 households (97.6% were visited. Of the 371,174 household members, 761 TB patients were identified (∼205 cases per 100,000 populations. Data were collected from 609 (80% TB patients of which 331 [54% (95% CI: 42-66%] were determined to be taking treatment 'under DOTS/RNTCP'. The remaining 278 [46% (95% CI: 34-57%] were on treatment from 'outside DOTS/RNTCP' sources and hence were unlikely to be part of the TB notification system. Patients who were accessing treatment from 'outside DOTS/RNTCP' were more likely to be patients from rural areas [adjusted Odds Ratio (aOR 2.5, 95% CI (1.2-5.3] and whose TB was diagnosed in a non-government health facility (aOR 14.0, 95% CI 7.9-24.9. CONCLUSIONS: This community-based survey found that nearly half of self-reported TB patients were missed by TB notification system in these districts. The study highlights the need for 1 Reviewing and revising the scope of the TB notification system, 2 Strengthening and monitoring health care delivery systems with periodic assessment of the reach and utilisation of the RNTCP services especially among rural communities, 3 Advocacy, communication and social mobilisation activities focused at rural communities with low household incomes and 4 Inclusive involvement of all

  14. Placement from community-based mental retardation programs: how well do clients do?

    Science.gov (United States)

    Schalock, R L; Harper, R S

    1978-11-01

    Mentally retarded clients (N = 131) placed during a 2-year period from either an independent living or competitive employment training program were evaluated as to placement success. Thirteen percent returned to the training program. Successful independent living placement was related to intelligence and demonstrated skills in symbolic operations, personal maintenance, clothing care and use, socially appropriate behavior, and functional academics. Successful employment was related to sensorimotor, visual-auditory processing, language, and symbolic-operations skills. Major reasons for returning from a job to the competitive employment training program included inappropriate behavior or need for more training; returning from community living placement was related to money management, apartment cleanliness, social behavior, and meal preparation.

  15. Volunteer Delivery of a Community-Based Strength Training Program: Comparison of Adopting and Nonadopting Extension Educator Perspectives

    Directory of Open Access Journals (Sweden)

    Lisa T. Washburn

    2016-10-01

    Full Text Available Volunteer leaders are increasingly being utilized to deliver community strength training classes, but the factors affecting adoption of volunteer delivery approaches by educators or program managers have not been well explored. This study sought to identify these factors by comparing perspectives of adopting and nonadopting county Extension educators for a group strength training program delivered through county Cooperative Extension offices. Semistructured interviews were conducted with a purposive sample of adopting (n=6 and nonadopting (n=13 educators. Interviews were recorded, transcribed verbatim, and coded using thematic content analysis. Review of codes related to adoption or nonadoption of volunteer delivery approaches produced common themes. Both groups acknowledged role differences between educators and volunteers and expressed concerns about maintaining program quality. Adopters expressed greater comfort with volunteer-led program approaches and understanding of the educator-volunteer role. Nonadopters were hesitant to request program participants serve as leaders but felt participants were capable. Both groups were motivated to offer the program for dual personal and community benefit, but nonadopters expressed reliance on the program to maintain physical activity habits and for social support. Findings can inform others seeking to adapt community programs for volunteer delivery or engage volunteers in existing program delivery.

  16. Drug Assessment Program; A Community Guide. The Drug Abuse Council Handbook Series, No. 2.

    Science.gov (United States)

    Blair, Louis H.; Sessler, John

    Addiction to illicit hard drugs, and particularly opiates, has increased in the past few years. Yet, there are few comprehensive evaluations of the treatment systems, and there is little systematic planning for programs to meet current and anticipated changes in the community's need for treatment. This report has been written to assist community…

  17. Perceived Autonomy Support in the NIMH RAISE Early Treatment Program.

    Science.gov (United States)

    Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M

    2017-09-01

    This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

  18. Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

    Science.gov (United States)

    Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

    2011-01-01

    This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

  19. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  20. Using community-based participatory research in parish nursing: a win-win situation!

    Science.gov (United States)

    Maitlen, Lynn A; Bockstahler, Amie M; Belcher, Anne E

    2012-01-01

    Parish nurses contribute to community health through the expertise and programming they provide to and through faith communities. Application of community-based participatory research (CBPR) principles helps develop, implement, and evaluate effective community interventions. University graduate students partnered with a Hospital Parish Nurse Program (HPNP) in an urban community to provide assessment data in a CBPR project that led the HPNP to focus resources and interventions on high obesity rates. The HPNP utilized data to write grant proposals to expand community services to impact obesity.

  1. Examining Enabling Conditions for Community-Based Fisheries Comanagement: Comparing Efforts in Hawai'i and American Samoa

    Directory of Open Access Journals (Sweden)

    Arielle S. Levine

    2014-03-01

    Full Text Available Much attention in global fisheries management has been directed toward increasing the involvement of local communities in managing marine resources. Although community-based fisheries comanagement has the potential to address resource conservation and societal needs, the success of these programs is by no means guaranteed, and many comanagement regimes have struggled. Although promising in theory, comanagement programs meet a variety of political, social, economic, ecological, and logistical challenges upon implementation. We have provided an analysis of two community-based fisheries comanagement initiatives: Hawai'i's Community-Based Subsistence Fishing Area (CBSFA legislation and American Samoa's Community-Based Fisheries Management Program (CFMP. Although Hawai'i's initiative has struggled with only two CBSFAs designated, neither of which has an approved management plan, American Samoa's program has successfully established a functioning network of 12 villages. We have explored the factors contributing to the divergent outcomes of these initiatives, including cultural and ethnic diversity, the intactness of traditional tenure systems and community organizing structures, local leadership, and government support. Differences in program design, including processes for program implementation and community involvement, supportive government institutions, adequate enforcement, and adaptive capacity, have also played important roles in the implementation of comanagement regimes on the two island groups. The different outcomes manifested in these case studies provide insight regarding the conditions necessary to enable successful community-based comanagement, particularly within U.S.-affiliated jurisdictions.

  2. Professional confidence and job satisfaction: an examination of counselors' perceptions in faith-based and non-faith-based drug treatment programs.

    Science.gov (United States)

    Chu, Doris C; Sung, Hung-En

    2014-08-01

    Understanding substance abuse counselors' professional confidence and job satisfaction is important since such confidence and satisfaction can affect the way counselors go about their jobs. Analyzing data derived from a random sample of 110 counselors from faith-based and non-faith-based treatment programs, this study examines counselors' professional confidence and job satisfaction in both faith-based and non-faith-based programs. The multivariate analyses indicate years of experience and being a certified counselor were the only significant predictors of professional confidence. There was no significant difference in perceived job satisfaction and confidence between counselors in faith-based and non-faith-based programs. A majority of counselors in both groups expressed a high level of satisfaction with their job. Job experience in drug counseling and prior experience as an abuser were perceived by counselors as important components to facilitate counseling skills. Policy implications are discussed. © The Author(s) 2013.

  3. Changes in Social Capital and Networks: A Study of Community-Based Environmental Management through a School-Centered Research Program

    Science.gov (United States)

    Thornton, Teresa; Leahy, Jessica

    2012-01-01

    Social network analysis (SNA) is a social science research tool that has not been applied to educational programs. This analysis is critical to documenting the changes in social capital and networks that result from community based K-12 educational collaborations. We review SNA and show an application of this technique in a school-centered,…

  4. Community-based faculty: motivation and rewards.

    Science.gov (United States)

    Fulkerson, P K; Wang-Cheng, R

    1997-02-01

    The reasons why practicing physicians precept students in their offices, and the rewards they wish to receive for this work, have not been clearly elucidated. This study determined the reasons for precepting and the rewards expected among a network of preceptors in Milwaukee. A questionnaire was mailed to 120 community-based physician preceptors in a required, third-year ambulatory care clerkship. Respondents were asked to identify why they volunteered and what they considered appropriate recognition or reward. The personal satisfaction derived from the student-teacher interaction was, by far, the most important motivator for preceptors (84%). The most preferred rewards for teaching included clinical faculty appointment, CME and bookstore discounts, computer networking, and workshops for improving skills in clinical teaching. Community-based private physicians who participate in medical student education programs are primarily motivated by the personal satisfaction that they derive from the teaching encounter. An effective preceptor recognition/reward program can be developed using input from the preceptors themselves.

  5. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare?

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

    Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  6. Outcome evaluation of a community center-based program for mothers at high psychosocial risk.

    Science.gov (United States)

    Rodrigo, María José; Máiquez, María Luisa; Correa, Ana Delia; Martín, Juan Carlos; Rodríguez, Guacimara

    2006-09-01

    This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. A total of 340 mothers referred by the municipal social services of Tenerife, Spain were assessed; 185 mothers participated in the APF program that lasted 8 months, and 155 mothers were in the control group. Pre-post test comparisons for the intervention group and post-test comparisons with the control group on self-rating measures of maternal beliefs, personal agency and child-rearing practices were performed. Multivariate tests, t tests and effect sizes (ES) were calculated to determine the program effectiveness on the outcome measures. Mothers' support of nurturist and nativist beliefs and the reported use of Neglect-permissive and Coercive practices significantly decreased after program completion whereas the reported use of Inductive practices significantly increased. Increases in self-efficacy, internal control and role difficulty were also significant in relation to those of the control group. The program was especially effective for older mothers, with fewer children, living in a two-parent family, in urban areas and with either low or medium educational levels. The program was very effective in changing the mothers' perceived competences and modestly effective in changing their beliefs about child development and education and reported child-rearing practices. Changes in personal agency are very important for at-risk parents who feel helpless and with no control over their lives.

  7. Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium.

    Science.gov (United States)

    Goethals, Ilse; Vanderplasschen, Wouter; Vandevelde, Stijn; Broekaert, Eric

    2012-10-11

    Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients' early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients' early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients' ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients' ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients' (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the

  8. Evaluation of a community-based falls prevention program in South Florida, 2008-2009.

    Science.gov (United States)

    Batra, Anamica; Melchior, Michael; Seff, Laura; Frederick, Newman; Palmer, Richard C

    2012-01-01

    Many older adults experience fear of falling, which may reduce participation in routine activities. A Matter of Balance (MOB) and Un Asunto de Equilibrio (ADE) workshops were offered in South Florida to reduce fear of falling and increase activity levels in older adults. The objectives of this study were to evaluate the effectiveness of the lay leader model of the programs in the first year of their implementation and to further report on participant outcome measures. We analyzed reach, adoption, and implementation data for participants who attended workshops between October 1, 2008, and December 31, 2009, who were aged 60 years or older, and who had both baseline and posttest outcome data. Workshops were in English and Spanish and consisted of 8 two-hour sessions. Participants completed a 7-item baseline and posttest questionnaire that consisted of a falls management scale, a social activity item, and modified version of Physician-Based Assessment and Counseling on Exercise. We analyzed outcome data on multiple characteristics using a general linear model. A class evaluation questionnaire measured participant satisfaction. Results for 562 participants who provided both baseline and posttest data showed significant improvement on 6 of 7 questions for MOB and all questions for ADE (P < .001). The 391 participants who provided evaluation data indicated that the programs were effective, beneficial, and well organized. Lay leaders successfully implemented the programs in community settings. The programs were effective in reducing fear of falling among older adults.

  9. During-Treatment Outcomes among Female Methamphetamine-Using Offenders in Prison-Based Treatments

    Science.gov (United States)

    Rowan-Szal, Grace A.; Joe, George W.; Simpson, D. Dwayne; Greener, Jack M.; Vance, Jerry

    2009-01-01

    An increasingly important treatment group is the expanding population of methamphetamine-using female offenders. This study focused on women methamphetamine-using offenders (n = 359) who were treated either in a modified therapeutic community (TC) program ("Clean Lifestyle is Freedom Forever" [CLIFF]-TC: n = 234) designed for non-violent offenders…

  10. Innovative Partnerships Assist Community College Computing Programs.

    Science.gov (United States)

    O'Banion, Terry

    1987-01-01

    Relates efforts of major corporations in providing assistance to community college computing programs. Explains the goals of the League for Innovation in the Community College, a consortium of 19 community colleges, and cites examples of collaborative projects. (ML)

  11. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

    OpenAIRE

    Abbey, Mercy; Bartholomew, L. Kay; Chinbuah, Margaret A.; Gyapong, Margaret; Gyapong, John O.; van den Borne, Bart

    2017-01-01

    Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakehold...

  12. Communities of the Future: Energy Programs for Livable Communities

    International Nuclear Information System (INIS)

    Jones, J. G.; Strawn, N.

    1999-01-01

    This document relates how several of the US Department of Energy's Office of Energy Efficiency and Renewable Energy (DOE/EERE) programs help communities across the nation deal with the issues of livability and sustainable growth. Highlights include background information on renewable energy technologies, some outstanding program anecdotes, and regional and Internet contact information

  13. Community-Based Progressive Aquatic Exercise for the Management of Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Dayle Maryanna Masslon

    2016-10-01

    Full Text Available Background We examined the feasibility and effectiveness of a community-based progressive aquatic exercise program for community dwelling older adults, with moderate to severe knee osteoarthritis (OA. Objectives The purposes of this study were to 1, assess the effects of a progressive aquatic exercise program on the walking ability, stair climbing ability, quadriceps muscle strength, as well as self-reported symptoms, function, and quality of life in community dwelling adults with moderate to severe knee OA and; 2, assess the feasibility of a community-based aquatic program for community dwelling adults with knee OA. Methods Seventeen volunteers (12 women (x = 61.1 years and 5 men (x = 69.0 years participated in a progressive 8 - 10 week aquatic exercise program, consisting of 20 - 24, 1-hour sessions. Outcome measures, acquired twice before beginning the exercise protocol as well as after 4 and 8 weeks of exercise, included the Knee Injury and Osteoarthritis outcome score (KOOS instrument, a 2 minute walk test (2MWT, a 10 step stair climb for time, and an isometric knee extension strength assessment. Results Significant improvements were detected in 2 MWT, 10 step stair climb, right quadriceps isometric force development, and the KOOS symptoms and stiffness subscale. Significant improvement was found on KOOS function subscales between baseline testing sessions and maintained at follow-up. Non-significant improvements were identified in left quadriceps isometric force development, KOOS pain, and KOOS quality of life. Conclusions These data suggest that a community-based, progressive aquatic exercise program is feasible and results in measurable improvements in function without worsening symptoms. Further study is warranted to investigate the impact of a longer program and the role of aquatic exercise in the long-term management of patients with knee OA.

  14. A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

    OpenAIRE

    Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori

    2008-01-01

    Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention re...

  15. Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

    Directory of Open Access Journals (Sweden)

    Eugene Aisenberg

    2012-01-01

    Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

  16. A randomized controlled study comparing community based with health facility based direct observation of treatment models on patients' satisfaction and TB treatment outcome in Nigeria.

    Science.gov (United States)

    Adewole, Olanisun O; Oladele, T; Osunkoya, Arinola H; Erhabor, Greg E; Adewole, Temitayo O; Adeola, Oluwaseun; Obembe, Olufemi; Ota, Martin O C

    2015-12-01

    Directly observed treatment short-course (DOTS) strategy is an effective mode of treating TB. We aimed to study the cost effectiveness and patients' satisfaction with home based direct observation of treatment (DOT), an innovative approach to community-based DOT (CBDOT) and hospital based DOT (HBDOT). A randomized controlled trial involving 150 newly diagnosed pulmonary TB patients in four TB clinics in Ile Ife , Nigeria, was done. They were randomly assigned to receive treatment with anti TB drugs for the intensive phase administered at home by a TB worker (CBDOT) or at the hospital (HBDOT). Outcome measures were treatment completion/default rates, cost effectiveness and patients' satisfaction with care using a 13 item patients satisfaction questionnaire (PS-13) at 2 months. This trial was registered with pactr.org: number PACTR 201503001058381. At the end of intensive phase, 15/75 (20%) and 2/75 (3%) of patients in the HBDOT and CBDOT, respectively had defaulted from treatment, p= 0.01. Of those with pretreatment positive sputum smear, 97% (68/70) on CBDOT and 54/67 (81%) on HBDOT were sputum negative for AFB at the end of 2 months of treatment, p=0.01. The CBDOT method was associated with a higher patient satisfaction score compared with HBDOT (OR 3.1; 95% CI 1.25-7.70), p=0.001.The total cost for patients was higher in HBDOT (US$159.38) compared with the CBDOT (US$89.52). The incremental cost effectiveness ratio was US$410 per patient who completed the intensive phase treatment with CBDOT. CBDOT is a cost effective approach associated with better compliance to treatment and better patient satisfaction compared to HBDOT. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Community Based Organizations in HIV/AIDS Prevention, Patient ...

    African Journals Online (AJOL)

    Community Based Organizations in HIV/AIDS Prevention, Patient. ... behavioral change communication methods that may contribute significantly to overcoming ... Towards that objective, CBOs need both internal strengthening of programs and ...

  18. The Community Mentorship Program: Providing Community-Engagement Opportunities for Early-Stage Clinical and Translational Scientists to Facilitate Research Translation.

    Science.gov (United States)

    Patino, Cecilia M; Kubicek, Katrina; Robles, Marisela; Kiger, Holly; Dzekov, Jeanne

    2017-02-01

    A goal of the Southern California Clinical and Translational Science Institute (SC-CTSI) at the University of Southern California and Children's Hospital Los Angeles is to train early-stage clinical and translational scientists (CTSs) to conduct research that improves the health of diverse communities. This goal aligns well with the Institute of Medicine's recommendations emphasizing community engagement in biomedical research that facilitates research translation. The Community Mentorship Program (CMP), created to complement community-engaged research didactics, matches CTSs with community mentors who help them identify and complete community-engaged experiences that inform their research. The CMP was piloted in 2013-2015 by the SC-CTSI Workforce Development and Community Engagement cores. The CMP team matched three CTSs (assistant professors pursuing mentored career development awards) with mentors at community-based organizations (CBOs) aligned with their research interests. Each mentor-mentee pair signed a memorandum of understanding. The CMP team checked in regularly, monitoring progress and addressing challenges in CTSs' completion of their community-engaged experience. Each pair completed at least one community-engaged activity informing the CTS's research. In exit interviews, the CTSs and CBO mentors expressed satisfaction with the program and stated that they would continue to work together. The CTSs reported that the program provided opportunities to develop networks outside academia, build trust within the community, and receive feedback and learn from individuals in communities affected by their research. The CMP will be expanded to include all eligible early-career CTSs and promoted for use in similar settings outside the SC-CTSI.

  19. The Trajectory of Chronic Pain: Can a Community-Based Exercise/Education Program Soften the Ride?

    Directory of Open Access Journals (Sweden)

    Ruth Dubin

    2010-01-01

    Full Text Available The entire primary care record of six patients attending a community-based education/exercise self-management program for chronic noncancer pain (YMCA Pain Exercise/Education Program [Y-PEP] was reviewed. Medical visits, consultations and hospital admissions were coded as related or unrelated to their pain diagnoses. Mood disruption, financial concerns, conflicts with employers/insurers, analgesic doses, medication side effects and major life events were also recorded. The ‘chronic pain trajectory’ resembled a roller coaster with increased health care visits at the time of initial injuries and during ‘crises’ (reinjury, conflict with insurers/employers, failed back-to-work attempts and life events. Visits decreased when conflicts were resolved. Analgesic doses increased during ‘crises’ but did not fall after resolution. After attending Y-PEP, health care use fell for four of six patients and two returned to work. Primary care physicians need to recognize the functional limitations and psychosocial complications experienced by their chronic pain patients. A program such as Y-PEP may promote active self-management strategies resulting in lowered health care use.

  20. Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model

    Science.gov (United States)

    Stuart, Mary; Benvenuti, Francesco; Macko, Richard; Taviani, Antonio; Segenni, Lucianna; Mayer, Federico; Sorkin, John D.; Stanhope, Steven J.; Macellari, Velio; Weinrich, Michael

    2010-01-01

    Objective To determine whether Adaptive Physical Activity (APA-stroke), a community-based exercise program for participants with hemiparetic stroke, improves function in the community. Methods Nonrandomized controlled study in Tuscany, Italy, of participants with mild to moderate hemiparesis at least 9 months after stroke. Forty-nine participants in a geographic health authority (Empoli) were offered APA-stroke (40 completed the study). Forty-four control participants in neighboring health authorities (Florence and Pisa) received usual care (38 completed the study). The APA intervention was a community-based progressive group exercise regimen that included walking, strength, and balance training for 1 hour, thrice a week, in local gyms, supervised by gym instructors. No serious adverse clinical events occurred during the exercise intervention. Outcome measures included the following: 6-month change in gait velocity (6-Minute Timed Walk), Short Physical Performance Battery (SPPB), Berg Balance Scale, Stroke Impact Scale (SIS), Barthel Index, Hamilton Rating Scale for Depression, and Index of Caregivers Strain. Results After 6 months, the intervention group improved whereas controls declined in gait velocity, balance, SPPB, and SIS social participation domains. These between-group comparisons were statistically significant at P glucose tolerance tests were performed on a subset of participants in the intervention group. For these individuals, insulin secretion declined 29% after 6 months (P = .01). Conclusion APA-stroke appears to be safe, feasible, and efficacious in a community setting. PMID:19318465

  1. Needs and Problems of Posbindu Program: Community Health Volunteers Perspective

    Science.gov (United States)

    Putri, S. T.; Andriyani, S.

    2018-01-01

    Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases(NCD), and where it was carried out in as an integrated manner, routine and periodic event. This paper aims to investigates the needs and problems on Posbindu Program based on community health volunteers(CHVs) perspective. This study used descriptive qualitative method by open ended questions. Content analysis using to explicating the result. There are 3 theme finding about elderly needs in Posbindu; medical care, support group community, and health education. We found four theme problems which in Posbindu program: low motivation from elderly, Inadequate of facilities, physical disability, failed communication. To be effective in Posbindu program, all the stakeholders have reached consensus on the Posbindu program as elderly need. CHVs need given wide knowledge about early detection, daily care, control disease continuously so that the elderly keep feeling the advantages of coming to the Posbindu.

  2. Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial.

    Science.gov (United States)

    Maki, Yohko; Ura, Chiaki; Yamaguchi, Tomoharu; Murai, Tatsuhiko; Isahai, Mikie; Kaiho, Ayumi; Yamagami, Tetsuya; Tanaka, Satoshi; Miyamae, Fumiko; Sugiyama, Mika; Awata, Shuichi; Takahashi, Ryutaro; Yamaguchi, Haruyasu

    2012-03-01

    To evaluate the efficacy of a municipality-led walking program under the Japanese public Long-Term Care Insurance Act to prevent mental decline. Randomized controlled trial. The city of Takasaki. One hundred fifty community members aged 72.0 ± 4.0 were randomly divided into intervention (n = 75) and control (n = 75) groups. A walking program was conducted once a week for 90 minutes for 3 months. The program encouraged participants to walk on a regular basis and to increase their steps per day gradually. The intervention was conducted in small groups of approximately six, so combined benefits of exercise and social interaction were expected. Cognitive function was evaluated focusing on nine tests in five domains: memory, executive function, word fluency, visuospatial abilities, and sustained attention. Quality of life (QOL), depressive state, functional capacity, range of activities, and social network were assessed using questionnaires, and motor function was evaluated. Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function (F(1, 128) = 6.833, P = .01), QOL (F(1,128) = 9.751, P = .002), functional capacity including social interaction (F(1,128) = 13.055, P < .001), and motor function (Timed Up and Go Test: F(1,127) = 10.117, P = .002). No significant differences were observed in other cognitive tests. Walking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community-based intervention to prevent mental decline. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  3. Mothers' and fathers' attendance in a community-based universally offered parenting program in Sweden.

    Science.gov (United States)

    Wells, Michael B; Sarkadi, Anna; Salari, Raziye

    2016-05-01

    Using a public health perspective, this study examined the characteristics of mothers and fathers who attended, compared to those who did not attend, a community-based practitioner-led universally offered parenting program. Mothers (141) and fathers (96) of 4- to 5-year-olds completed a set of questionnaires, including their demographic characteristics, their child's behavioral and emotional problems, and their own parenting behavior. They were all then given the opportunity to attend level 2 of the Triple P--Positive Parenting Program. During the first six months of the study, 33 mothers and 11 fathers opted to attend the program. The relation between program attendance and parental characteristics was similar for mothers and fathers. In general, fathers, non-native and lower educated parents were less likely to attend the program. Mothers, but not fathers, were more likely to attend if they reported more child behavior problems, while fathers, but not mothers, were observed at a trend level to attend if they perceived their child as having more emotional problems. In addition, parents in general were more likely to attend if they used more harsh parenting strategies. Although the universal offer did not reach parents universally, generally those parents who needed it were more likely to attend. Furthermore, this study shows that different factors may impact mothers' and fathers' attendance; therefore, parental data should be analyzed separately and different recruitment strategies should be used for mothers and fathers. © 2015 the Nordic Societies of Public Health.

  4. Strategy community development based on local resources

    Science.gov (United States)

    Meirinawati; Prabawati, I.; Pradana, G. W.

    2018-01-01

    The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

  5. A successful model for longitudinal community-engaged health research: the 2040 Partners for Health Student Program.

    Science.gov (United States)

    Redman, Romany M; Reinsvold, Magdalena C; Reddy, Anireddy; Bennett, Paige E; Hoerauf, Janine M; Puls, Kristina M; Ovrutsky, Alida R; Ly, Alexandra R; White, Gregory; McNeil, Owetta; Meredith, Janet J

    2017-06-01

    Community-based participatory research [CBPR] is an emerging approach to collaborative research aimed at creating locally effective and sustainable interventions. The 2040 Partners for Health student program was developed as a unique model of longitudinal CBPR. Analysis of this program and its components illuminates both the challenges and the opportunities inherent in community engagement. The program rests on a foundation of a community-based, non-profit organization and a supportive academic university centre. Inter-professional health students and community members of underserved populations work together on different health projects by employing an adapted CBPR methodology. Three successful examples of sustainable CBPR projects are briefly described. The three projects are presented as primary outcomes resulting from this model. Benefits and challenges of the model as an approach to community-engaged research are discussed as well as secondary benefits of student participation. The 2040 Partners for Health student program represents a successful model of CBPR, illuminating common challenges and reiterating the profound value of community-engaged research. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Enterpreneurship/Small Business Degree Programs at Community Colleges

    Science.gov (United States)

    Maidment, Fred

    2007-01-01

    Associate degree programs at community colleges in small business/entrepreneurship were examined in this article. The study examined the community college programs in entrepreneurship and small business related, small business administration and entrepreneurship listed in "Perterson's Guide to Two-Year Colleges" (Oram, 2005). Current catalogs…

  7. How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

    Science.gov (United States)

    Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

    2017-07-01

    In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  8. Risk-based decision making and risk management of European Union regional programs

    Directory of Open Access Journals (Sweden)

    Michalopoulos Evangelos

    2008-01-01

    Full Text Available This paper presents a generalized method for management decision making incorporating risk assessment techniques. The risk based decision making methodology is applied to European Union expenditure programs used to implement its regional policy, such as the community support framework, community initiatives, special initiatives and other European policies. An example is presented for the development of an audit (inspection program in the region of West Macedonia, Greece, during the implementation of the 3rd Community Structural Support Framework Operational Program. The generic nature of the method permits its use in the management of similar European regional programs in Greece and other European countries. It is also applicable to many other industries interested in applying risk-based management decisions to physical or process based systems. .

  9. Developing a Teenage Pregnancy Program the Community Will Accept.

    Science.gov (United States)

    Harris, David; And Others

    1983-01-01

    Reacting to community opposition to a pregnancy prevention program, the Suffolk County, New York, health department assessed community needs and values to develop a program that would be acceptable. The program focuses on informing parents about teenage sexual problems and emphasizes parent-child communication. (PP)

  10. The Impact of Community Violence on School-Based Research

    Science.gov (United States)

    Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K.; Dean, Kyle C.; Scott, Darrick; Gross, Israel M.; Romeo, Edna

    2015-01-01

    Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines…

  11. Gender differences in the use of transportation services to community rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Kaneda Mariko

    2009-06-01

    Full Text Available Abstract Background Prevention and reduction of disability among community-dwelling older adults have been an important health policy concern in Japan. Moreover, it has also become a gendered issue due to the recent rapid growth in older females than males with disability living in their own homes. The aim of this study is to examine whether there is a gender difference in the use of community rehabilitation programs in Japan, and if so, whether the lack of transportation services and accompanying caregivers are the reasons for the gender difference. Methods This study was based on surveys of the program administrators and the primary caregivers of the program participants from 55 randomly selected community rehabilitation programs (CRP in the Tokyo metropolitan area. Questions included sociodemographic characteristics of program participants, types of transportation services provided by the CRP, caregiver's relationship to participant, and the nature of family support. Bivariate statistical analysis was conducted. Results Although there were more females than males with disability residing in communities, our findings showed that females were less likely to use CRP than males (1.3% and 2.3%, respectively; X2 = 93.0, p Conclusion This study builds on previous research findings, which suggest gender inequality in access to CRP.

  12. Needs assessment for adapting TB directly observed treatment intervention programme in Limpopo Province, South Africa: A community-based participatory research approach

    Directory of Open Access Journals (Sweden)

    Jabu T. Mabunda

    2016-07-01

    Full Text Available Background: Limpopo Province is one of the hardest hit by tuberculosis and human immune virus infections in the country. The province has been implementing directly observed treatment strategy since 1996. However, the cure rate was 64% in 2015 and remains far from the set target by the World Health Organization of 85%. Poor health-care seeking and adherence behaviours were identified as major risk behaviours. Aim: To apply a community-based participatory research approach in identifying barriers and facilitators to health-care seeking and adherence to treatment, and to determine strategies and messages in order to inform the design of an adapted intervention programme. Setting: This study was conducted in three districts in the Limpopo Province, Capricorn, Mopani and Sekhukhune districts. Methods: Community participatory research approach was applied. Purposive sampling was used to sample participants. Focus group discussions were used to collect data. Participatory analysis was used comparing findings within and across all the participants. Results: A total of 161 participated in the study. Participants included coordinators, professional nurses, supporters and patients. Major modifiable behavioural-related barriers were lack of knowledge about tuberculosis, misinformation and misperceptions cultural beliefs, stigma and refusal of treatment support. Environment-related barriers were attitudes of health workers, lack of support by family and community, lack of food and use of alcohol and drugs. Strategies and messages included persuasive and motivational messages to promote healthy behaviour. Conclusion: Joint programmatic collaboration between the community and academic researchers is really needed for interventions to address the needs of the community. Keywords: Health seeking, Adherence, Community based participatory research, Tuberculosis

  13. Discrepancies between Patients' Preferences and Educational Programs on Oral Anticoagulant Therapy: A Survey in Community Pharmacies and Hospital Consultations.

    Directory of Open Access Journals (Sweden)

    Diane Macquart de Terline

    Full Text Available Oral anticoagulation therapy is increasingly used for the prevention and treatment of thromboembolic complications in various clinical situations. Nowadays, education programs for patients treated with anticoagulants constitute an integrated component of their management. However, such programs are usually based on the healthcare providers' perceptions of what patients should know, rather than on patients' preferences.To investigate patients' viewpoints on educational needs and preferred modalities of information delivery.We conducted an observational study based on a self-administered questionnaire. To explore several profiles of patients, the study was designed for enrolling patients in two settings: during outpatient consultations in a cardiology department (Saint Antoine Hospital, Paris, France and in community pharmacies throughout France.Of the 371 patients who completed the questionnaire, 187 (50.4% were recruited during an outpatient consultation and 184 (49.6% were recruited in community pharmacies. 84.1% of patients were receiving a vitamin K antagonist and 15.6% a direct oral anticoagulant. Patients ranked 16 of 21 (76.2% questionnaire items on information about their treatment as important or essential; information on adverse effects of treatment was the highest ranked domain (mean score 2.38, 95% CI 2.30-2.46. Pharmacists (1.69, 1.58-1.80, nurses (1.05, 0.95-1.16, and patient associations (0.36, 0.29-0.44, along with group sessions (0.85, 0.75-0.95, the internet (0.77, 0.67-0.88, and delivery of material at the patient's home (1.26, 1.14-1.38, were ranked poorly in terms of delivering educational material.This study revealed substantial discrepancies between patient preferences and current educational programs. These findings should be useful for tailoring future educational programs that are better adapted to patients, with a potential associated enhancement of their effectiveness.

  14. Community engagement in the CTSA program: stakeholder responses from a national Delphi process.

    Science.gov (United States)

    Freeman, Elmer; Seifer, Sarena D; Stupak, Matthew; Martinez, Linda Sprague

    2014-06-01

    In response to the Institute of Medicine (IOM) Committee's December 2012 public request for stakeholder input on the Clinical and Translational Science Award (CTSA) program, two nonprofit organizations, the Center for Community Health Education Research and Service, Inc. (CCHERS) and Community-Campus Partnerships for Health (CCPH), solicited feedback from CTSA stakeholders using the Delphi method. Academic and community stakeholders were invited to participate in the Delphi, which is an exploratory method used for group consensus building. Six questions posed by the IOM Committee to an invited panel on community engagement were electronically sent to stakeholders. In Round 1 stakeholder responses were coded thematically and then tallied. Round 2 asked stakeholders to state their level of agreement with each of the themes using a Likert scale. Finally, in Round 3 the group was asked to rank the Round 2 based on potential impact for the CTSA program and implementation feasibility. The benefits of community engagement in clinical and translational research as well as the need to integrate community engagement across all components of the CTSA program were common themes. Respondents expressed skepticism as to the feasibility of strengthening CTSA community engagement. © 2014 Wiley Periodicals, Inc.

  15. A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

    Directory of Open Access Journals (Sweden)

    Odenwald Michael

    2012-07-01

    Full Text Available Abstract Background In Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care. Methods Thirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS was applied three times. Additionally, we assessed functioning, khat use and other outcomes. Results Of the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had

  16. Gambling severity, impulsivity, and psychopathology: comparison of treatment- and community-recruited pathological gamblers.

    Science.gov (United States)

    Knezevic, Bojana; Ledgerwood, David M

    2012-01-01

    Because most studies of pathological gambling gather data from participants recruited from treatment, this study compared community and treatment-enrolled pathological gamblers (PGs) with respect to demographics, gambling severity, impulsivity, and psychopathology. One hundred six PGs were recruited as part of two larger studies in Farmington, Connecticut (n= 61) and Windsor, Ontario (n= 45) using radio advertising, word of mouth, and/or newspaper ads, as well as a gambling treatment program at each location. Community (n= 49) and treatment-enrolled (n= 57) PGs did not differ on age, education, gender, race, employment, or marital status. Treatment-enrolled PGs were more likely to report past year illegal behaviors, preoccupation with gambling, and higher scores on the Barratt Impulsiveness Scale (BIS) Attention Impulsivity subscale. Assessment of psychopathology in the Ontario study indicated that treatment-enrolled PGs were more likely to present with Major Depressive and Dysthymic Disorders. Community-recruited PGs in the Connecticut study were overall more likely to present with any substance use disorder relative to their treatment-enrolled counterparts. Our findings inform intervention and research within the field of pathological gambling. Specifically, the distressing aspects of pathological gambling, such as legal issues, preoccupation with gambling, and depression, may be present more in treatment-enrolled PGs than in those recruited from the community. Such emotional disturbances should be further explored to increase motivation and treatment adherence in PGs. In addition, due to relative absence of overall differences between the groups, research findings utilizing treatment-enrolled PGs may be a good representation of both groups. Copyright © American Academy of Addiction Psychiatry.

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

    Science.gov (United States)

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

    2018-04-01

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

  18. A review of community-based solar home system projects in the Philippines

    Directory of Open Access Journals (Sweden)

    Macabebe Erees Queen B.

    2016-01-01

    Full Text Available Solar Home Systems (SHS are easy to deploy in island and in remote communities where grid connection is costly. However, issues related to maintenance of these systems emerge after they are deployed because of the remoteness and inaccessibility of the communities. This study looked into community-based programs in the Philippines and investigated the following: (1 social preparation, (2 role of the community in the project, and (3 sustainability of the program. In this paper, three communities under two government programs offering SHS are presented. These programs are the Solar Power Technology Support (SPOTS program of the Department of Agrarian Reform (DAR and the Household Electrification Program (HEP of the Department of Energy (DOE. A focused group discussion and key informant interviews were conducted in two communities in Bukidnon province and in a community in Kalinga to obtain information from the project beneficiaries and SHS users on the preparation, implementation and maintenance of the projects. The results revealed that emphasis on the economic value of the technology, proper training of the locals on the technical and management aspects of the project, as well as the establishment of a supply chain for replacement parts are crucial factors for the sustainability of the programs.

  19. Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select.

    Science.gov (United States)

    Akanni, Olufolake Odufuwa; Smith, Matthew Lee; Ory, Marcia G

    2017-05-20

    The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select , a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days ( p nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits.

  20. Mitigating fall risk: A community fall reduction program.

    Science.gov (United States)

    Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

    One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. 76 FR 744 - Community Forest and Open Space Conservation Program

    Science.gov (United States)

    2011-01-06

    ... landowners; (5) Recreational benefits, such as hiking, hunting and fishing; and (6) Public access. Community...) Recreational benefits, such as hiking, hunting and fishing; and (vi) Public access. (2) Extent and nature of... recreation, environmental and economic benefits, and forest-based educational programs, and to protect...

  2. Spiritual interventions and the impact of a faith community nursing program.

    Science.gov (United States)

    Shores, Cynthia Ingram

    2014-04-01

    Faith community nursing had its formal beginnings in the Midwestern United States in 1984 when six nurses received financial support from a local hospital to work in churches. Over time, the churches assumed increasing responsibility for the nurses' salaries. The success of this initiative was associated with the understanding that faith communities are dedicated to keeping people well. The number of programs increased over the past 30 years and now there are thousands of faith community nurses serving populations around the world. Research for this specialty practice has not experienced comparable growth, and is needed to further develop faith community nursing science. This study, based on the Roy Adaptation Model, used a qualitative design to identify spiritual nursing interventions that faith community nurses use in their practice, and to examine the spiritual impact of a faith community nursing program. Data were collected from faith community members, clergy representatives, and faith community nurses with a researcher-developed demographic tool and a six-item open-ended questionnaire that were both mailed to participants (N = 112; n = 52; response rate = 46%) and analyzed through content analysis. A variety of spiritual nursing interventions were identified. Themes related to the spiritual impact included the physical, mental, and spiritual health connection, caring, hope, spiritual support and benefits, and religious concepts.

  3. Building the base: two active living projects that inspired community participation.

    Science.gov (United States)

    Hamamoto, Mark H; Derauf, David D; Yoshimura, Sheryl R

    2009-12-01

    Kalihi Valley is a densely populated, low-income community (28,958 residents in approximately 6 square miles) with insufficient sidewalks, bike lanes, and public green space to support regular physical activity for its residents. Kokua Kalihi Valley (KKV), a community health center formed in 1972, sought to improve Kalihi Valley's built environment based on its history of community- and partnership-based preventive health initiatives that have focused on the social determinants of health. Kokua Kalihi Valley used a flexible partnership model and a focus on direct community action to develop an unused 100-acre state park (the Kalihi Valley Nature Park) and establish a bicycle repair and recycling program that mobilized thousands of community volunteers, attracted widespread media coverage, and established a number of innovative programs for active living. Kokua Kalihi Valley and its partners also contributed to the successful passage of a city charter amendment to prioritize Honolulu as a bicycle- and pedestrian-friendly city. This initiative was successful in reclaiming a substantial amount of land for active living and in stimulating both public governmental support and widespread private community involvement in programs and activities. Projects that engaged community members in activities with tangible accomplishment were shown to be most successful. This initiative showed that community health centers may be uniquely positioned to provide leadership and assume responsibility for cross-sectoral active-living health projects.

  4. Smoking cessation and its predictors: results from a community-based pharmacy tobacco cessation program in New Mexico.

    Science.gov (United States)

    Khan, Nasreen; Anderson, Joe R; Du, Juan; Tinker, Dale; Bachyrycz, Amy M; Namdar, Rocsanna

    2012-09-01

    The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.

  5. The Community-based Organizations Working Group of the Space Science Education Support Network

    Science.gov (United States)

    Lutz, J. H.; Lowes, L. L.; Asplund, S.

    2004-12-01

    The NASA Space Science Support Network Community-based Organizations Working Group (CBOWG) has been working for the past two years on issues surrounding afterschool programs and programs for youth (e.g., Girl Scouts, Boy Scouts, Boys and Girls Clubs, 4-H, summer camps, afterschool and weekend programs for various ages, programs with emphases on minority youth). In this session the co-leaders of the CBOWG will discuss the challenges of working with community-based organizations on a regional or national level. We will highlight some ties that we have forged with the National Institute for Out of School Time (NIOST) and the National Afterschool Association (NAA). We will also talk about efforts to coordinate how various entities within NASA cooperate with community-based organizations to serve the best interests of these groups. We will give a couple of examples of how NASA space science organizations have partnered with community-based organizations. The session will include some handouts of information and resources that the CBOWG has found useful in developing an understanding of this segment of informal education groups. We would like to thank NASA for providing resources to support the work of the CBOWG.

  6. The red road to wellness: cultural reclamation in a Native First Nations community treatment center.

    Science.gov (United States)

    Gone, Joseph P

    2011-03-01

    This article explores how Native American cultural practices were incorporated into the therapeutic activities of a community-controlled substance abuse treatment center on a "First Nations" reserve in the Canadian north. Analysis of open-ended interviews with nineteen staff and clients-as contextualized by participant observation, program records, and existing ethnographic resources-yielded insights concerning local therapeutic practice with outpatients and other community members. Specifically, program staff adopted and promoted a diverse array of both western and Aboriginal approaches that were formally integrated with reference to the Aboriginal symbol of the medicine wheel. Although incorporations of indigenous culture marked Lodge programs as distinctively Aboriginal in character, the subtle but profound influence of western "therapy culture" was centrally evident in healing activities as well. Nuanced explication of these activities illustrated four contributions of cultural analysis for community psychology.

  7. Community empowerment program for increasing knowledge and awareness of tuberculosis patients, cadres and community in Medan city

    Science.gov (United States)

    Harahap, J.; Amelia, R.; Wahyuni, A. S.; Andayani, L. S.

    2018-03-01

    Tuberculosis is one of a major health problem in Indonesia. WHO expressed the need for the participation of various stakeholders in addition to government. TB CEPAT Program aimed to increase knowledge and awareness in combating tuberculosis. This study aimed to compare the knowledge and awareness of community, cadres and TB patients in the program areas and non-program areas, and assess the role of the program in combating tuberculosis in Medan. The study used quantitative and qualitative methods, where 300 people (community, cadres, TB patients) as respondents and three key persons as informants. The findings revealed that in the program areas the knowledge, attitude and practice of the respondents generally are better compare to those in the non-program areas. There was a significant difference in knowledge and practice for community, cadres, and TB patients (p0.05) in program areas and non-program areas. The community empowerment through TB CEPAT Program plays an important role in improving knowledge, attitude, and practice of community, cadres, and TB patients. It would help the effort of TB control and prevention in Medan City.

  8. The Latino Migrant Worker HIV Prevention Program: Building a Community Partnership Through a Community Health Worker Training Program

    OpenAIRE

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

    2012-01-01

    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...

  9. Profile of tobacco users amongst treatment seekers: A comparison between clinic and community sample

    Directory of Open Access Journals (Sweden)

    Savita Malhotra

    2017-01-01

    Full Text Available Background and objectives: Despite the huge burden of tobacco use or addiction, there has been a glaring scarcity of resources to tackle the problem. Although some of the tobacco users want to quit, very few have the opportunity to seek help from available treatment facilities. The study aimed to find out the profile of treatment seekers from clinic and community programs and also to compare the two groups. Method: This is a cross sectional, retrospective study of subjects enrolled in the clinic and various community outreach programs of a Tobacco Cessation Centre from the year 2002-2011. Modified intake form developed by the WHO was administered to the subjects. Results: Significant difference was found between the two groups with regard to the age of treatment seeking, education and socio economic status. Older subjects reported in greater numbers to the clinic, whereas younger subjects belonged to the community group. Community group had lower level of education, belonged to lower or upper lower socio economic status whereas clinic group had higher level of education and were from the middle or upper socio economic status. Curiosity (Z score = 3.2,P = 0.001 played a significant role in initiating the use in clinic group whereas role model (Z score = 5.1, P = <0.0001 and low self esteem (Z score = 2.0, P = 0.023 were significantly associated with community sample. Presence of medical complications (Z score = 12.5, P = <0.0001, awareness of physical harm of nicotine (Z score = 5.0, P = <0.0001 and awareness of addiction was significantly more in the clinic group. Interpretation and Conclusions: The difference in the socio-demographic and clinical profile of tobacco users in these two treatment groups is noteworthy, and is expected to offer useful information for the clinicians and as well as for the policy makers.

  10. Community-Based Urban Teacher Education: Theoretical Frameworks and Practical Considerations for Developing Promising Practices

    Science.gov (United States)

    Noel, Jana

    2016-01-01

    Traditional campus-based teacher education programs, located on college or university campuses, have been criticized for being removed from the "real world" of community life, and a number of programs have moved directly into urban communities in order for preservice teachers to become immersed in the life of the community. This article…

  11. Evaluation of a Research Mentorship Program in Community Care

    Science.gov (United States)

    Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

    2008-01-01

    This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

  12. Take Heart America: A comprehensive, community-wide, systems-based approach to the treatment of cardiac arrest.

    Science.gov (United States)

    Lick, Charles J; Aufderheide, Tom P; Niskanen, Robert A; Steinkamp, Janet E; Davis, Scott P; Nygaard, Susan D; Bemenderfer, Kim K; Gonzales, Louis; Kalla, Jeffrey A; Wald, Sarah K; Gillquist, Debbie L; Sayre, Michael R; Osaki Holm, Susie Y; Oski Holm, Susie Y; Oakes, Dana A; Provo, Terry A; Racht, Ed M; Olsen, John D; Yannopoulos, Demetris; Lurie, Keith G

    2011-01-01

    To determine out-of-hospital cardiac arrest survival rates before and after implementation of the Take Heart America program (a community-based initiative that sequentially deployed all of the most highly recommended 2005 American Heart Association resuscitation guidelines in an effort to increase out-of-hospital cardiac arrest survival). Out-of-hospital cardiac arrest patients in Anoka County, MN, and greater St. Cloud, MN, from November 2005 to June 2009. Two sites in Minnesota with a combined population of 439,692 people (greater St. Cloud and Anoka County) implemented: 1) widespread cardiopulmonary resuscitation and automated external defibrillator skills training in schools and businesses; 2) retraining of all emergency medical services personnel in methods to enhance circulation, including minimizing cardiopulmonary resuscitation interruptions, performing cardiopulmonary resuscitation before and after single-shock defibrillation, and use of an impedance threshold device; 3) additional deployment of automated external defibrillators in schools and public places; and 4) protocols for transport to and treatment by cardiac arrest centers for therapeutic hypothermia, coronary artery evaluation and treatment, and electrophysiological evaluation. More than 28,000 people were trained in cardiopulmonary resuscitation and automated external defibrillator use in the two sites. Bystander cardiopulmonary resuscitation rates increased from 20% to 29% (p = .086, odds ratio 1.7, 95% confidence interval 0.96-2.89). Three cardiac arrest centers were established, and hypothermia therapy for admitted out-of-hospital cardiac arrest victims increased from 0% to 45%. Survival to hospital discharge for all patients after out-of-hospital cardiac arrest in these two sites improved from 8.5% (nine of 106, historical control) to 19% (48 of 247, intervention phase) (p = .011, odds ratio 2.60, confidence interval 1.19-6.26). A financial analysis revealed that the cardiac arrest centers

  13. Assessing community perspectives of the community based education and service model at Makerere University, Uganda: a qualitative evaluation

    Directory of Open Access Journals (Sweden)

    Okullo Isaac

    2011-03-01

    Full Text Available Abstract Background Community partnerships are defined as groups working together with shared goals, responsibilities, and power to improve the community. There is growing evidence that these partnerships contribute to the success and sustainability of community-based education and service programs (COBES, facilitating change in community actions and attitudes. Makerere University College of Health Sciences (MakCHS is forging itself as a transformational institution in Uganda and the region. The College is motivated to improve the health of Ugandans through innovative responsive teaching, provision of service, and community partnerships. Evaluating the COBES program from the community perspective can assist the College in refining an innovative and useful model that has potential to improve the health of Ugandans. Methods A stratified random sample of 11 COBES sites was selected to examine the community’s perception of the program. Key Informant Interviews of 11 site tutors and 33 community members were completed. The data was manually analyzed and themes developed. Results Communities stated the students consistently engaged with them with culturally appropriate behaviour. They rated the student’s communication as very good even though translators were frequently needed. Half the community stated they received some feedback from the students, but some communities interpreted any contact after the initial visit as feedback. Communities confirmed and appreciated that the students provided a number of interventions and saw positive changes in health and health seeking behaviours. The community reflected that some programs were more sustainable than others; the projects that needed money to implement were least sustainable. The major challenges from the community included community fatigue, and poor motivation of community leaders to continue to take students without compensation. Conclusions Communities hosting Makerere students valued the

  14. Community-Based Learning. Adding Value to Programs Involving Service Agencies and Schools.

    Science.gov (United States)

    Cumming, Jim

    Community-based learning (CBL) is a structured approach to learning and teaching that connects meaningful community experience with intellectual development, personal growth, and active citizenship. Enthusiasm for CBL is emerging in Australia and elsewhere because it is seen as the following: strategy for whole-school reform, especially in…

  15. Intermittent preventive treatment of malaria in pregnancy: a community-based delivery system and its effect on parasitemia, anemia and low birth weight in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, Ib; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: The main objective of the study was to assess the impact of a community-based delivery system of intermittent preventive treatment (IPT) for malaria in pregnancy with sulfadoxine-pyrimethamine (SP) on access, parasitemia, anemia and low birth weight as primary outcome measures. METHODS.......0001). At both health units and the community-based approaches, IPT increased mean hemoglobin by 6.7% (panemia from 5.7% to 3.1% (p.... This intervention was acceptable to 89.6% of the women at the community-based approaches intending to use IPT in the future, while 48.1% of them had recommended it to other women. CONCLUSIONS: The community-based approaches increased access and adherence to IPT with an effect on anemia, severe anemia, parasitemia...

  16. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training at Home randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Amanda Bates

    2018-04-01

    Full Text Available Introduction: Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. Research questions: This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Design: Randomised, controlled trial. Participants and setting: A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Intervention: Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. Outcome measures: The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated

  17. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training) at Home randomised, controlled trial.

    Science.gov (United States)

    Bates, Amanda; Furber, Susan; Tiedemann, Anne; Ginn, Karen; van den Dolder, Paul; Howard, Kirsten; Bauman, Adrian; Chittenden, Catherine; Franco, Lisa; Kershaw, Michelle; Sherrington, Catherine

    2018-04-01

    Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Randomised, controlled trial. A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated. Negative binomial regression models will be used to estimate the between-group difference in fall rates. Modified

  18. Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

    Science.gov (United States)

    Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

    2007-09-01

    In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

  19. Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

    Science.gov (United States)

    Rens, Lezahn; Joosten, Annette

    2014-06-01

    A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

  20. Addressing Social Anxiety Concurrently With Prison-Based Sex Offender Treatment: A Case of Individual Needs in an Era of Manualized Treatment.

    Science.gov (United States)

    Lasher, Michael P; Webb, Jon R; Stinson, Jill D; Cantrell, Peggy J

    2017-07-01

    Emotional regulation may be an underaddressed therapeutic target in sex offender treatment. This article presents a case report of "Adam," a Caucasian male referred to a prison-based sex offender treatment program. Adam's social anxiety was recognized as an antecendent to his sexual offending, and treatment of such, as a critical adjunct to sex offender treatment, is discussed herein. Adam's individualized treatment included aspects of rational emotive behavior therapy and time-limited dynamic psychotherapy. Adam showed an increased understanding of his anxiety and improvement in his social interactions, both in the context of treatment groups and with female staff, and was willing to continue follow-up care in the community. This case provides support for the individualized treatment of incarcerated offenders as opposed to exclusively utilizing manualized psychoeducational interventions.

  1. Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement Among Caribbean Latinos in the Northeastern United States of America.

    Science.gov (United States)

    Caplan, Susan; Cordero, Carolyn

    2015-01-01

    Depression is one of the leading causes of years lived with disability (YLDs) worldwide. Although depression can be successfully treated, 75% of Americans do not receive care. Treatment rates among Latinos immigrants are significantly lower than non-immigrant Latinos and non-Hispanic Whites. Known factors for mental health-care disparities such as poverty, insurance coverage, language barriers, and access to specialty mental health services in Latino neighborhoods do not fully explain the differences in treatment rates. Significant, but poorly understood factors influencing depression treatment among Latinos in the United States are lack of culturally congruent care, low mental health literacy, and stigma. Even though churches are a major source of health information, social and spiritual support for Latinos, the conceptualization of culturally congruent care rarely addresses religious beliefs. Therefore, one strategy to reduce disparities in depression treatment is to partner with churches to address faith-based stigma. Community-based participatory research is recognized as a methodology particularly well suited for creating successful culturally targeted interventions. The purpose of this article is to describe the process of creating a faith-based mental health literacy intervention in the Caribbean Latino community using the principles of community-based participatory research. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Impact of a community-based lymphedema management program on episodes of Adenolymphangitis (ADLA and lymphedema progression--Odisha State, India.

    Directory of Open Access Journals (Sweden)

    Katherine E Mues

    2014-09-01

    Full Text Available Lymphedema management programs have been shown to decrease episodes of adenolymphangitis (ADLA, but the impact on lymphedema progression and of program compliance have not been thoroughly explored. Our objectives were to determine the rate of ADLA episodes and lymphedema progression over time for patients enrolled in a community-based lymphedema management program. We explored the association between program compliance and ADLA episodes as well as lymphedema progression.A lymphedema management program was implemented in Odisha State, India from 2007-2010 by the non-governmental organization, Church's Auxiliary for Social Action, in consultation with the Centers for Disease Control and Prevention. A cohort of patients was followed over 24 months. The crude 30-day rate of ADLA episodes decreased from 0.35 episodes per person-month at baseline to 0.23 at 24 months. Over the study period, the percentage of patients who progressed to more severe lymphedema decreased (P-value  = 0.0004, while those whose lymphedema regressed increased over time (P-value<0.0001. Overall compliance to lymphedema management, lagged one time point, appeared to have little to no association with the frequency of ADLA episodes among those without entry lesions (RR = 0.87 (0.69, 1.10 and was associated with an increased rate (RR = 1.44 (1.11, 1.86 among those with entry lesions. Lagging compliance two time points, it was associated with a decrease in the rate of ADLA episodes among those with entry lesions (RR = 0.77 (95% CI: 0.59, 0.99 and was somewhat associated among those without entry lesions (RR = 0.83 (95% CI: 0.64, 1.06. Compliance to soap was associated with a decreased rate of ADLA episodes among those without inter-digital entry lesions.These results indicate that a community-based lymphedema management program is beneficial for lymphedema patients for both ADLA episodes and lymphedema. It is one of the first studies to demonstrate an association between program

  3. Cook It Up! A community-based cooking program for at-risk youth: overview of a food literacy intervention

    Directory of Open Access Journals (Sweden)

    Thomas Heather MC

    2011-11-01

    Full Text Available Abstract Background In Canada, there are limited occasions for youth, and especially at-risk youth, to participate in cooking programs. The paucity of these programs creates an opportunity for youth-focused cooking programs to be developed, implemented, and evaluated with the goal of providing invaluable life skills and food literacy to this potentially vulnerable group. Thus, an 18-month community-based cooking program for at-risk youth was planned and implemented to improve the development and progression of cooking skills and food literacy. Findings This paper provides an overview of the rationale for and implementation of a cooking skills intervention for at-risk youth. The manuscript provides information about the process of planning and implementing the intervention as well as the evaluation plan. Results of the intervention will be presented elsewhere. Objectives of the intervention included the provision of applied food literacy and cooking skills education taught by local chefs and a Registered Dietitian, and augmented with fieldtrips to community farms to foster an appreciation and understanding of food, from 'gate to plate'. Eight at-risk youth (five girls and three boys, mean age = 14.6 completed the intervention as of November 2010. Pre-test cooking skills assessments were completed for all participants and post-test cooking skills assessments were completed for five of eight participants. Post intervention, five of eight participants completed in-depth interviews about their experience. Discussion The Cook It Up! program can provide an effective template for other agencies and researchers to utilize for enhancing existing programs or to create new applied cooking programs for relevant vulnerable populations. There is also a continued need for applied research in this area to reverse the erosion of cooking skills in Canadian society.

  4. Comparing clinical and demographic characteristics of people with mental illness in hospital- and community-based residential rehabilitation units in Queensland.

    Science.gov (United States)

    Meehan, Tom; Stedman, Terry; Parker, Stephen; Curtis, Bretine; Jones, Donna

    2017-05-01

    Objective The aim of the present study was to examine care pathways and characteristics of mental health consumers participating in both hospital- and community-based residential rehabilitation programs. Methods An audit of consumers (n=240) in all publicly funded residential rehabilitation units in Queensland was performed on the same day in 2013. Data collection focused on demographic characteristics, clinical information and measures of consumer functioning. Results Significant differences emerged for consumers in community- and hospital-based services with regard to age, length of stay, functioning, Mental Health Act status, guardianship status, family contact and risk of violence. Consumers in hospital-based programs have more severe and complex problems. Conclusions Consumers in residential rehabilitation units have high levels of disability, poor physical health and high levels of vulnerability. Nonetheless, it is likely that a sizeable proportion of consumers occupying rehabilitation beds in Queensland could be discharged if more 'step-down' options to move patients on were available. What is known about the topic? A small subgroup of people with severe and complex mental health problems is likely to require time in a residential rehabilitation program. This group is characterised by failure to respond to treatment, severe negative symptoms and some degree of cognitive impairment. What does this paper add? Patients currently occupying residential rehabilitation beds in Queensland have high levels of disability, poor physical health and high levels of vulnerability. Patients in hospital-based programs are more severely disabled than those in community-based programs. What are the implications for practitioners? It is likely that a sizeable proportion of patients occupying rehabilitation beds in Queensland could be discharged if more 'step-down' options were available. Future planning initiatives need to focus on developing a greater array of community

  5. Community-based evaluation of PMTCT uptake in Nyanza Province, Kenya.

    Directory of Open Access Journals (Sweden)

    Pamela K Kohler

    Full Text Available Facility-based assessments of prevention of mother-to-child HIV transmission (PMTCT programs may overestimate population coverage. There are few community-based studies that evaluate PMTCT coverage and uptake.During 2011, a cross-sectional community survey among women who gave birth in the prior year was performed using the KEMRI-CDC Health and Demographic Surveillance System in Western Kenya. A random sample (n = 405 and a sample of women known to be HIV-positive through previous home-based testing (n = 247 were enrolled. Rates and correlates of uptake of antenatal care (ANC, HIV-testing, and antiretrovirals (ARVs were determined.Among 405 women in the random sample, 379 (94% reported accessing ANC, most of whom (87% were HIV tested. Uptake of HIV testing was associated with employment, higher socioeconomic status, and partner HIV testing. Among 247 known HIV-positive women, 173 (70% self-disclosed their HIV status. Among 216 self-reported HIV-positive women (including 43 from the random sample, 82% took PMTCT ARVs, with 54% completing the full antenatal, peripartum, and postpartum course. Maternal ARV use was associated with more ANC visits and having an HIV tested partner. ARV use during delivery was lowest (62% and associated with facility delivery. Eighty percent of HIV infected women reported having their infant HIV tested, 11% of whom reported their child was HIV infected, 76% uninfected, 6% declined to say, 7% did not recall; 79% of infected children were reportedly receiving HIV care and treatment.Community-based assessments provide data that complements clinic-based PMTCT evaluations. In this survey, antenatal HIV test uptake was high; most HIV infected women received ARVs, though many women did not self-disclose HIV status to field team. Community-driven strategies that encourage early ANC, partner involvement, and skilled delivery, and provide PMTCT education, may facilitate further reductions in vertical transmission.

  6. Impact of 3 years ivermectin treatment on onchocerciasis in Yanomami communities in the Brazilian Amazon.

    Science.gov (United States)

    Banic, Dalma M; Calvão-Brito, Regina H S; Marchon-Silva, Verônica; Schuertez, Joana C; de Lima Pinheiro, Luís Renerys; da Costa Alves, Marilene; Têva, Antônio; Maia-Herzog, Marilza

    2009-11-01

    In the current study, it was assessed, for the first time, the effect of ivermectin treatment administered twice a year on the prevalence and morbidity of onchocerciasis in the hyperendemic Yanomami communities of the Roraima State (Brazil). Physical and parasitological examinations were carried out every 6 months until six drug rounds of treatment were completed. The coverage during the six rounds of ivermectin treatment ranged from 89% to 92% of the eligible Yanomami population. Overall, comparison of results at pre-treatment with results after six rounds of treatment, the prevalence of infection had declined from 87% to 42% (P0.05, for both). These findings suggest that mass population treatment should continue without interruption and achieve higher levels of drug coverage in order to alleviate disease manifestations and interrupt infection transmission to hasten the elimination of onchocerciasis in Yanomami communities. In addition, the sensitivity of iliac crest snips for parasitological assessment in epidemiological surveillance of Yanomami communities may increase the acceptance of the population in biopsy sampling and seems to be a good choice for assessing the success of control programs.

  7. Sustainable childhood obesity prevention through community engagement (SCOPE) program: evaluation of the implementation phase.

    Science.gov (United States)

    McIntosh, Bonnie; Daly, Amelia; Mâsse, Louise C; Collet, Jean-Paul; Higgins, Joan Wharf; Naylor, Patti-Jean; Amed, Shazhan

    2015-10-01

    Childhood obesity rates are steadily rising. Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) is a community-based participatory action research (PAR) program aimed at preventing childhood obesity. This study aimed to describe community perspectives on, and elicit feedback about, SCOPE's first phase of implementation in two pilot cities in British Columbia, Canada. A case study was implemented using interviews and questionnaires to obtain feedback about SCOPE from two groups: SCOPE coordinators and stakeholders (i.e., individuals and organizations that were a member of the community and engaged with SCOPE coordinators). Participants were recruited via email and (or) by telephone. Coordinators completed a telephone interview. Stakeholders completed a questionnaire and (or) a telephone interview. Thematic analysis was conducted. Participants included 2 coordinators and 15 stakeholders. Participants similarly interpreted SCOPE as a program focused on raising awareness about childhood obesity prevention, while engaging multiple community sectors. Overall, participants valued the program's role in facilitating networking and partnership development, providing evidence-based resources, technical expertise, and contributing funding. Participants felt that SCOPE is sustainable. However, participants felt that barriers to achieving healthy weights among children included those related to the built environment, and social, behavioral, and economic obstacles. Perspectives on factors that facilitated and acted as barriers to SCOPE's first phase of implementation were obtained from the SCOPE communities and may be used to enhance the sustainability of SCOPE and its applicability to other BC communities.

  8. An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

    Science.gov (United States)

    Santoyo-Olsson, Jasmine; Cabrera, Julissa; Freyre, Rachel; Grossman, Melanie; Alvarez, Natalie; Mathur, Deepika; Guerrero, Maria; Delgadillo, Adriana T.; Kanaya, Alka M.; Stewart, Anita L.

    2011-01-01

    Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors. PMID:21565823

  9. Honolulu Community College Program Health Indicators: 2000-2001 Program Reviews.

    Science.gov (United States)

    Hawaii Univ., Honolulu. Honolulu Community Coll.

    This report presents an overall health summation of 21 programs offered at Honolulu Community College (Hawaii) during 2000-2001. The programs profiled are: (1) Auto Body Repair and Painting; (2) Aeronautics Maintenance Technology; (3) Administration of Justice; (4) Automotive Mechanics Technology; (5) Boat Maintenance Repair; (6) Carpentry; (7)…

  10. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  11. Assessing the efficacy of a modified assertive community-based treatment programme in a developing country

    Directory of Open Access Journals (Sweden)

    Botha Ulla A

    2010-09-01

    Full Text Available Abstract Background A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called "standard care" has become more comprehensive in recent years, incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. Methods High frequency service users were randomized into an intervention (n = 34 and a control (n = 26 group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS, CDSS, ESRS, WHO-QOL and SOFAS. Results At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS (p = 0.02 as well as positive (p Conclusions Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. Furthermore, these interventions need not be as expensive and comprehensive as international, first-world models in order to reduce inpatient days, improve psychopathology and overall levels of functioning in patients with severe mental illness.

  12. Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group

    NARCIS (Netherlands)

    Pradhan, M.; Brinkman, S.A.; Beatty, A.; Maika, A.; Satriawan, E.; de Ree, J.; Hasan, A.

    2013-01-01

    Background This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program

  13. Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group

    NARCIS (Netherlands)

    Pradhan, M.P.; Brinkman, S.A.; Beatty, A.; Maika, A.; Satriawan, E.; de Ree, J.; Hasan, A.

    2013-01-01

    Background: This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program

  14. Middlesex Community College Software Technical Writing Program.

    Science.gov (United States)

    Middlesex Community Coll., Bedford, MA.

    This document describes the Software Technical Writing Program at Middlesex Community College (Massachusetts). The program is a "hands-on" course designed to develop job-related skills in three major areas: technical writing, software, and professional skills. The program was originally designed in cooperation with the Massachusetts High…

  15. Weaving networks of responsibility: community work in development programs in rural Malawi.

    Science.gov (United States)

    Rosenthal, Anat

    2012-01-01

    The need to cope with the impact of the AIDS epidemic on communities in Africa has resulted in the emergence of numerous community health and development programs. Initiated by governments, international nongovernmental organizations (NGOs), and local organizations, such programs target local communities with the goal of building care and support mechanisms in the local level. Based on ethnographic field research in rural Malawi, and drawing from the cross-disciplinary debate on development work, the article explores the work of an NGO offering health and care programs to orphans and vulnerable children. Through analyzing the organization's scope of work, the article demonstrates how the NGO acts to structure local social networks as instruments of care and offers a new reading of the role of NGOs in which the limitations of development work and the work of NGOs are understood within their local context and not only in the context of broad cultural critique.

  16. The Evolution of an Innovative Community-Engaged Health Navigator Program to Address Social Determinants of Health.

    Science.gov (United States)

    Page-Reeves, Janet; Moffett, Maurice L; Steimel, Leah; Smith, Daryl T

    Health navigators and other types of community health workers (CHWs) have become recognized as essential components of quality care, and key for addressing health disparities owing to the complex health care services landscape presents almost insurmountable challenges for vulnerable individuals. Bernalillo County, New Mexico, has high rates of uninsurance, poverty, and food insecurity. The design of the Pathways to a Healthy Bernalillo County Program (BP) has evolved innovations that are unique in terms of program stability and security, expansive reach, and community capacity across six domains: sustainable public mechanism for program funding, involvement of community organizations in designing the program, expanded focus to address the broader social determinants of health with targeted outreach, an integrated, community-based implementation structure, an outcomes-based payment structure, and using an adaptive program design that actively incorporates navigators in the process. In 2008, the Pathways to a Healthy Bernalillo County Program (BP), located in the Albuquerque metropolitan area in central New Mexico, was established to provide navigation and support for the most vulnerable county residents. BP is funded through a 1% carve out of county mill levy funds. The pathways model is an outcome-based approach for health and social services coordination that uses culturally competent CHW as "navigators" trained to connect at-risk individuals to needed health and social services. One of the important innovations of the pathways approach is a shift in focus from merely providing discrete services to confirming healthy outcomes for the individual patient.

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

    Science.gov (United States)

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

    2017-03-01

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

  18. The Effects of Situated Learning Through a Community Partnership in a Teacher Preparation Program

    Directory of Open Access Journals (Sweden)

    Shelly Meyers

    2013-08-01

    Full Text Available This article examines the value of using an alternative approach to college course instruction in an off-campus location, an agency for individuals with developmental disabilities. The situated learning model is an alternative to the traditional college course instructional approach for preservice teachers. This model immerses students in the actual setting where they can practice the skills and apply the concepts emphasized in the curriculum. Through a partnership between the college, the community agency, and a public school, graduate students in the special education program developed and implemented a life-skills curriculum for individuals with developmental disabilities, at the same time learning essential principles of delivering instruction. The school-aged students who participated in the study were from a racially mixed urban school district, while the adult clients from the community agency attended the program at the end of their community-based workday. Based on the results of surveys and focus group discussions, participants in the study indicated that the situated learning model of instruction in a community setting better prepared them in the acquisition and application of their teaching skills, and built their competence in developing educational programs for individuals with disabilities.

  19. Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

    Directory of Open Access Journals (Sweden)

    Mathew Nyashanu

    2016-12-01

    Full Text Available Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from fgm@dh.gsi.gov.uk.]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.

  20. Designing a community-based lay health advisor training curriculum to address cancer health disparities.

    Science.gov (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

    2013-05-01

    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. 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.

  1. Partnership Among Peers: Lessons Learned From the Development of a Community Organization-Academic Research Training Program.

    Science.gov (United States)

    Jewett-Tennant, Jeri; Collins, Cyleste; Matloub, Jacqueline; Patrick, Alison; Chupp, Mark; Werner, James J; Borawski, Elaine A

    2016-01-01

    Community engagement and rigorous science are necessary to address health issues. Increasingly, community health organizations are asked to partner in research. To strengthen such community organization-academic partnerships, increase research capacity in community organizations, and facilitate equitable partnered research, the Partners in Education Evaluation and Research (PEER) program was developed. The program implements an 18-month structured research curriculum for one mid-level employee of a health-focused community-based organization with an organizational mentor and a Case Western Reserve University faculty member as partners. The PEER program was developed and guided by a community-academic advisory committee and was designed to impact the research capacity of organizations through didactic modules and partnered research in the experiential phase. Active participation of community organizations and faculty during all phases of the program provided for bidirectional learning and understanding of the challenges of community-engaged health research. The pilot program evaluation used qualitative and quantitative data collection techniques, including experiences of the participants assessed through surveys, formal group and individual interviews, phone calls, and discussions. Statistical analysis of the change in fellows' pre-test and post-test survey scores were conducted using paired sample t tests. The small sample size is recognized by the authors as a limitation of the evaluation methods and would potentially be resolved by including more cohort data as the program progresses. Qualitative data were reviewed by two program staff using content and narrative analysis to identify themes, describe and assess group phenomena and determine program improvements. The objective of PEER is to create equitable partnerships between community organizations and academic partners to further research capacity in said organizations and develop mutually beneficial research

  2. 77 FR 67433 - Community Advantage Pilot Program

    Science.gov (United States)

    2012-11-09

    ... comments. SUMMARY: The Community Advantage (``CA'') Pilot Program is a pilot program to increase SBA... small businesses and entrepreneurs in underserved markets, SBA is issuing this Notice to extend the term... Pilot Program was introduced to increase the number of SBA-guaranteed loans made to small businesses in...

  3. Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa.

    Science.gov (United States)

    Meehan, Sue-Ann; Sloot, Rosa; Draper, Heather R; Naidoo, Pren; Burger, Ronelle; Beyers, Nulda

    2018-01-01

    Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study utilized routinely collected data from clients who utilized stand-alone (fixed site not attached to a health facility) and mobile HIV testing services in eight communities in the City of Cape Town Metropolitan district, between January 2008 and June 2012. Clients were included in the analysis if they were ≥12 years and had a known HIV status. Generalized estimating equations (GEE) logistic regression models were used to assess the association between determinants (sex, age, HIV testing service and co-infection status) and self-reported linkage to HIV care and/or TB treatment. Linkage to HIV care was 3 738/5 929 (63.1%). Linkage to HIV care was associated with the type of HIV testing service. Clients diagnosed with HIV at mobile services had a significantly reduced odds of linking to HIV care (aOR 0.7 (CI 95%: 0.6-0.8), p<0.001. Linkage to TB treatment was 210/275 (76.4%). Linkage to TB treatment was not associated with sex and service type, but was associated with age. Clients in older age groups were less likely to link to TB treatment compared to clients in the age group 12-24 years (all, p-value<0.05). A large proportion of clients diagnosed with HIV at mobile services did not link to care. Almost a quarter of clients diagnosed with TB did not link to treatment. Integrated community-based HIV and TB testing services are efficient in diagnosing HIV and TB, but strategies to improve linkage to care are required to control these epidemics.

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

    Directory of Open Access Journals (Sweden)

    Daniel H de Vries

    Full Text Available Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs. So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability.This review includes peer-reviewed articles which meet three eligibility criteria: 1 specific focus on CLHWs or equivalent; 2 randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3 description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result

  5. Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

    Science.gov (United States)

    Kolko, David J.; Dorn, Lorah D.; Bukstein, Oscar G.; Pardini, Dustin; Holden, Elizabeth A.; Hart, Jonathan

    2009-01-01

    This study examines the treatment outcomes of 139, 6-11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC).…

  6. Fox Chase Network: Fox Chase Cancer Center's community hospital affiliation program.

    Science.gov (United States)

    Higman, S A; McKay, F J; Engstrom, P F; O'Grady, M A; Young, R C

    2000-01-01

    Fox Chase Cancer Center developed a format for affiliation with community providers in 1986. Fox Chase Network was formed to establish hospital-based community cancer centers to increase access to patients involved in clinical research. Under this program, the Fox Chase Network now contributes 500 patients per year to prevention and clinical research studies. As relationships with community providers form, patient referrals have increased at Fox Chase Cancer Center and for each Fox Chase Network member. A dedicated staff is required to operate the central office on a day-to-day basis as well as at each affiliate. We have found this to be a critical element in each program's success. New challenges in the cancer business-increasing volumes with declining revenue-have caused us to reconfigure the services offered to affiliates, while maintaining true to our mission: to reduce the burden of human cancer.

  7. Techniques for overcoming community resistance to family planning programs.

    Science.gov (United States)

    Palley, H A

    1968-01-01

    Methods of overcoming resistance to publicly subsidized family planning programs are discussed. The main sources of opposition include groups that oppose family planning for moral reasons, and those who object to the spending of government funds to provide services and information. Such opposition can be weakened by indicating that family planning clinics fulf: 11 important medical needs. Presenting social justification for family planning can help to lower oppostion. In order to secure participation in the programs by low income groups it is essential to have community leaders involved in policy decisions and to use indigenous community paraprofessionals in the clinics. A coalition of representatives of the poor community and the health and welfare system, aided by the community organization, can lead to an effective family planning program.

  8. Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

    Science.gov (United States)

    Kim, Jong-Pill; Yang, Jinhyang

    The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention.

    Science.gov (United States)

    Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard

    2007-07-01

    Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.

  10. The California active aging community grant program: translating science into practice to promote physical activity in older adults.

    Science.gov (United States)

    Hooker, Steven P; Seavey, William; Weidmer, Curtiss E; Harvey, Danielle J; Stewart, Anita L; Gillis, Dawn E; Nicholl, Katrina Lennea; King, Abby C

    2005-06-01

    Attempts to study the translation of evidence-based physical activity interventions in community settings are scarce. This project was an investigation of whether 13 diverse local lead agencies could effectively implement a choice-based, telephone-assisted physical activity promotion program for older adults based on intervention models proven efficacious in research settings. At baseline, participants developed their own physical activity programs through an individualized planning session based on preference, health status, readiness to change, and available community resources. Thereafter, participants received regular telephone calls over a 1-year period from a trained staff member or volunteer support buddy. Additional program components consisted of health education workshops, newsletters, and group-based physical activities. Self-report data on caloric expenditure due to all and moderate or greater intensity physical activities were collected from 447 participants (M age = 68 +/- 8.6 years). A significant increase (p activity duration and frequency. These changes were observed in participants across all sites. The increases in weekly caloric expenditure were commensurate with findings from several previous randomized clinical trials. The utilization of community agency staff and volunteers receiving basic training to implement essential program components proved feasible. Very favorable levels of program satisfaction expressed by community staff, volunteer support buddies, and participants, combined with the significant increases in physical activity, warrant further dissemination of the intervention model.

  11. A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment

    Science.gov (United States)

    Nemeth, Lynne S.; Jenkins, Carolyn; Jauch, Edward C.; Conway, Sharon; Pearlman, Adam; Spruill, Ida J.; Brown, Lynette J.; Linnen, Joyce; Linnen, Florene; Andrews, Jeannette O.

    2016-01-01

    Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. PMID:27545591

  12. Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

    Science.gov (United States)

    Smyth, Daniel; Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie

    2017-01-01

    The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

  13. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  14. Impact of community-based interventions on HIV knowledge, attitudes, and transmission.

    Science.gov (United States)

    Salam, Rehana A; Haroon, Sarah; Ahmed, Hashim H; Das, Jai K; Bhutta, Zulfiqar A

    2014-01-01

    In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.

  15. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

    Science.gov (United States)

    Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

    2016-01-01

    Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an

  16. Community-Academic Partnership to implement a Breast and Cervical Cancer screening education program in Puerto Rico

    Science.gov (United States)

    Colón-López, Vivian; González, Daisy; Vélez, Camille; Fernández-Espada, Natalie; Soler, Alana Feldman; Escobar, Kelly Ayala; Ayala-Marín, Alelí M.; Soto-Salgado, Marievelisse; Calo, William A.; Aragón, Angela Pattatucci; Rivera-Díaz, Marinilda; Fernández, María E.

    2018-01-01

    Objective To describe how a community-academic partnership between Taller Salud Inc., a community-based organization, and the Puerto Rico Community Cancer Control Outreach Program of the University of Puerto Rico was crucial in the adaptation and implementation of Cultivando La Salud (CLS), an evidence-based educational outreach program designed to increase breast and cervical cancer screening among Hispanic women living in Puerto Rico. This collaboration facilitated the review and adaptation of the CLS intervention to improve cultural appropriateness, relevance, and acceptability for Puerto Rican women. Methods A total of 25 interviewers and 12 Lay Health Workers (LHWs) were recruited and trained to deliver the program. The interviewers recruited women who were non-adherent to recommended screening guidelines for both breast and cervical cancer. LHWs then provided one-on-one education using the adapted CLS materials. Results A total of 444 women were recruited and 48% of them were educated through this collaborative effort. Conclusions Our main accomplishment was establishing the academic-community partnership to implement the CLS program. Nevertheless, in order to promote better collaborations with our community partners, it is important to carefully delineate and establish clear roles and shared responsibilities for each partner for the successful execution of research activities, taking into consideration the community’s needs. PMID:29220062

  17. "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

    Science.gov (United States)

    2017-06-01

    Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing

  18. A critical examination of community-based responses to household food insecurity in Canada.

    Science.gov (United States)

    Tarasuk, V

    2001-08-01

    Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the "First World." In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and community-based nature of the initiatives, and their origins in publicly funded health and social service sectors.

  19. Impact of a community based implementation of REACH II program for caregivers of Alzheimer's patients.

    Directory of Open Access Journals (Sweden)

    Kristine Lykens

    Full Text Available BACKGROUND: In 2009 an estimated 5.3 million people in the United States were afflicted with Alzheimer's disease, a degenerative form of dementia. The impact of this disease is not limited to the patient but also has significant impact on the lives and health of their family caregivers. The Resources for Enhancing Alzheimer's Caregiver Health (REACH II program was developed and tested in clinical studies. The REACH II program is now being delivered by community agencies in several locations. This study examines the impact of the REACH II program on caregiver lives and health in a city in north Texas. STUDY DESIGN: Family caregivers of Alzheimer's patients were assessed using an instrument covering the multi-item domains of Caregiver Burden, Depression, Self-Care, and Social Support upon enrollment in the program and at the completion of the 6 month intervention. The domain scores were analyzed using a multivariate paired t-test and Bonferroni confidence interval for the differences in pre- and post-service domain scores. RESULTS: A total of 494 families were enrolled in the program during the period January 1, 2011 through June 30, 2012. Of these families 177 completed the 6 month program and have pre - and post service domain scores. The median age for the caregivers was 62 years. The domain scores for Depression and Caregiver Burden demonstrated statistically significant improvements upon program completion. CONCLUSION: The REACH II intervention was successfully implemented by a community agency with comparable impacts to those of the clinical trial warranting wider scale implementation.

  20. Implementing a low-cost web-based clinical trial management system for community studies: a case study.

    Science.gov (United States)

    Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

    2011-10-01

    Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely

  1. The effect of the PROSPER partnership model on cultivating local stakeholder knowledge of evidence-based programs: a five-year longitudinal study of 28 communities.

    Science.gov (United States)

    Crowley, D Max; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L; Redmond, Cleve R

    2012-02-01

    A substantial challenge in improving public health is how to facilitate the local adoption of evidence-based interventions (EBIs). To do so, an important step is to build local stakeholders' knowledge and decision-making skills regarding the adoption and implementation of EBIs. One EBI delivery system, called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), has effectively mobilized community prevention efforts, implemented prevention programming with quality, and consequently decreased youth substance abuse. While these results are encouraging, another objective is to increase local stakeholder knowledge of best practices for adoption, implementation and evaluation of EBIs. Using a mixed methods approach, we assessed local stakeholder knowledge of these best practices over 5 years, in 28 intervention and control communities. Results indicated that the PROSPER partnership model led to significant increases in expert knowledge regarding the selection, implementation, and evaluation of evidence-based interventions. Findings illustrate the limited programming knowledge possessed by members of local prevention efforts, the difficulty of complete knowledge transfer, and highlight one method for cultivating that knowledge.

  2. Systematic Review of Community-Based Childhood Obesity Prevention Studies

    Science.gov (United States)

    Segal, Jodi; Wu, Yang; Wilson, Renee; Wang, Youfa

    2013-01-01

    OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer’s data abstraction for completeness and accuracy. RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non–randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS: The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. PMID:23753099

  3. Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

    Science.gov (United States)

    Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

    2013-01-01

    Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p 75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

  4. THE VIEWS OF FOREST OUTSKIRT COMMUNITY ON AGROFORESTRY DEVELOPMENT PROGRAM

    Directory of Open Access Journals (Sweden)

    Dewa Oka Suparwata

    2018-04-01

    Full Text Available Nowadays, development of agroforestry has been focused on the people living near forest. Positive views from community may have a good impact on agroforestry development program. This research aims to study the views of the forest outskrit community on the agroforestry development program in Dulamayo Barat village, Telaga Sub District, Gorontalo Regency, Gorontalo Province. The study used survey approach and focus group discussion (FGD method. Respondents were all the members of agroforestry farmer group. The entire population were taken for interview (10 respondents while FGD was attended by 26 participants. Data were analyzed descriptively. The result showed that 100% of the respondents want the program to be sustainable, although from the socio economic point of view the impact has not contributed significantly. From the respondents views of its benefit, 50% believe that the program is for critical land rehabilitation, 30% have a view for the improvement of environmental service, 10% view to increase community economy, and 10% view that the program is to eliminate erosion. These indicate that the community is concerned with agroforestry development, therefore, continuous facilitation is needed. Furthermore, the community expects to be actively involved in the agroforestry development program.

  5. Outcome Data for MICA Clients after Participation in an Institutional Therapeutic Community

    Science.gov (United States)

    Van Stelle, Kit R.; Moberg, D. Paul

    2004-01-01

    The current study assessed the effectiveness of a prison-based substance abuse treatment therapeutic community (TC) providing treatment to male inmates dually diagnosed with both substance abuse and mental health disorders. The findings show a short-term impact of the program on arrest after release, with program participants significantly less…

  6. Frameworks: A Community-Based Approach to Preventing Youth Suicide

    Science.gov (United States)

    Baber, Kristine; Bean, Gretchen

    2009-01-01

    Few youth suicide prevention programs are theory based and systematically evaluated. This study evaluated the pilot implementation of a community-based youth suicide prevention project guided by an ecological perspective. One hundred fifty-seven adults representing various constituencies from educators to health care providers and 131 ninth-grade…

  7. Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

    Directory of Open Access Journals (Sweden)

    R. Laws

    2016-08-01

    Full Text Available Abstract Background While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT, an obesity prevention program for parents with infants aged 3–18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Methods Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4, policy makers (n = 2 and implementers (n = 22, contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Results Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however

  8. Contribution of community-based newborn health promotion to reducing inequities in healthy newborn care practices and knowledge: evidence of improvement from a three-district pilot program in Malawi.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Nonyane, Bareng A S; Guenther, Tanya; Sitrin, Deborah; Ligowe, Reuben; Chimbalanga, Emmanuel; Zimba, Evelyn; Kachale, Fannie; Shah, Rashed; Baqui, Abdullah H

    2013-11-07

    Inequities in both health status and coverage of health services are considered important barriers to achieving Millennium Development Goal 4. Community-based health promotion is a strategy that is believed to reduce inequities in rural low-income settings. This paper examines the contributions of community-based programming to improving the equity of newborn health in three districts in Malawi. This study is a before-and-after evaluation of Malawi's Community-Based Maternal and Newborn Care (CBMNC) program, a package of facility and community-based interventions to improve newborn health. Health Surveillance Assistants (HSAs) within the catchment area of 14 health facilities were trained to make pregnancy and postnatal home visits to promote healthy behaviors and assess women and newborns for danger signs requiring referral to a facility. "Core groups" of community volunteers were also trained to raise awareness about recommended newborn care practices. Baseline and endline household surveys measured the coverage of the intervention and targeted health behaviors for this before-and-after evaluation. Wealth indices were constructed using household asset data and concentration indices were compared between baseline and endline for each indicator. The HSAs trained in the intervention reached 36.7% of women with a pregnancy home visit and 10.9% of women with a postnatal home visit within three days of delivery. Coverage of the intervention was slightly inequitable, with richer households more likely to receive one or two pregnancy home visits (concentration indices (CI) of 0.0786 and 0.0960), but not significantly more likely to receive a postnatal visit or know of a core group. Despite modest coverage levels for the intervention, health equity improved significantly over the study period for several indicators. Greater improvements in inequities were observed for knowledge indicators than for coverage of routine health services. At endline, a greater proportion of

  9. Models of Community-Based Hepatitis B Surface Antigen Screening Programs in the U.S. and Their Estimated Outcomes and Costs

    Science.gov (United States)

    Rein, David B.; Lesesne, Sarah B.; Smith, Bryce D.; Weinbaum, Cindy M.

    2011-01-01

    Objectives Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs. Methods We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening. Results The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive. Conclusions Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings. PMID:21800750

  10. Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

    Science.gov (United States)

    Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

    Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

  11. Household health care-seeking costs: experiences from a randomized, controlled trial of community-based malaria and pneumonia treatment among under-fives in eastern Uganda

    NARCIS (Netherlands)

    Matovu, F.; Nanyiti, A.; Rutebemberwa, E.

    2014-01-01

    Background: Home and community-based combined treatment of malaria and pneumonia has been promoted in Uganda since mid 2011. The combined treatment is justified given the considerable overlap between the symptoms of malaria and pneumonia among infants. There is limited evidence about the extent to

  12. The effectiveness of community-based cycling promotion: findings from the Cycling Connecting Communities project in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Merom Dafna

    2010-01-01

    Full Text Available Abstract Background Encouraging cycling is an important way to increase physical activity in the community. The Cycling Connecting Communities (CCC Project is a community-based cycling promotion program that included a range of community engagement and social marketing activities, such as organised bike rides and events, cycling skills courses, the distribution of cycling maps of the area and coverage in the local press. The aim of the study was to assess the effectiveness of this program designed to encourage the use of newly completed off-road cycle paths through south west Sydney, Australia. Methods The evaluation used a quasi-experimental design that consisted of a pre- and post-intervention telephone survey (24 months apart of a cohort of residents (n = 909 in the intervention area (n = 520 (Fairfield and Liverpool and a socio-demographically similar comparison area (n = 389 (Bankstown. Both areas had similar bicycle infrastructure. Four bicycle counters were placed on the main bicycle paths in the intervention and comparison areas to monitor daily bicycle use before and after the intervention. Results The telephone survey results showed significantly greater awareness of the Cycling Connecting Communities project (13.5% vs 8.0%, p Conclusion Despite relatively modest resources, the Cycling Connecting Communities project achieved significant increases in bicycle path use, and increased cycling in some sub-groups. However, this community based intervention with limited funding had very limited reach into the community and did not increase population cycling levels.

  13. Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

    Science.gov (United States)

    Theurer, Gregory; Lovell, David

    2008-01-01

    An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

  14. A cultural landscape approach to community-based conservation in Solomon Islands

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    Richard K. Walter

    2014-12-01

    Full Text Available International environmental organizations have an increasing commitment to the development of conservation programs in high-diversity regions where indigenous communities maintain customary rights to their lands and seas. A major challenge that these programs face is the alignment of international conservation values with those of the indigenous communities whose cooperation and support are vital. International environmental organizations are focused on biodiversity conservation, but local communities often have a different range of concerns and interests, only some of which relate to biodiversity. One solution to this problem involves adoption of a cultural landscape approach as the ethical and organizational foundation of the conservation program. In our conservation work in coastal Melanesia, we have developed a cultural landscape approach that involves the construction of a conceptual model of environment that reflects the indigenous perceptions of landscape. This model incorporates cultural, ideational, and spiritual values alongside other ecosystem services and underpins the conservation activities, priorities, and organizational structure of our programs. This cultural landscape model was a reaction to a survey of environmental values conducted by our team in which Solomon Islanders reported far greater interest in conserving cultural heritage sites than any other ecosystem resources. This caused a radical rethinking of community-based conservation programs. The methodologies we adopted are derived from the fields of archaeology and historical anthropology, in which there is an established practice of working through research problems within the framework of indigenous concepts of, and relationship to, landscape. In our work in Isabel Province, Solomon Islands, coastal communities have enthusiastically adopted conservation programs that are based on cultural landscape models that recognize indigenous values. A particularly useful tool is

  15. 76 FR 10735 - Medicaid Program; Community First Choice Option

    Science.gov (United States)

    2011-02-25

    ... for Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option... Part 441 [CMS-2337-P] RIN 0938-AQ35 Medicaid Program; Community First Choice Option AGENCY: Centers for... Section 2401 of the Affordable Care Act (ACA) which establishes a new State option to provide home and...

  16. A prehabilitation program for physically frail community-living older persons.

    Science.gov (United States)

    Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J